Resilience, the 6th Vital Sign: Conceptualizing, Contextualizing, and Operationalizing All Six Vital Signs

There are five vital signs that healthcare providers assess: temperature, pulse, respiration, blood pressure, and pain. Normal levels for the five vital signs are published by the American Heart Association, and other specialty organizations, however, the sixth vital sign (resilience) which adopts the measure of immune resilience is suggested in this paper. Resilience is the ability of the immune system to respond to attacks and defend effectively against infections and inflammatory stressors, and psychological resilience is the capacity to resist, adapt, recover, thrive, and grow from a challenge or a stressor. Individuals with better optimal immune resilience had better health outcomes than those with minimal immune resilience. The purpose of this paper is to conceptualize, contextualize, and operationalize all six vital signs. We suggest measuring resilience subjectively and objectively. Subjectively, use a 5-item guided interview revised from the Connor-Davidson Resilience Scale (CDRC), a scale of 10 items. The revised CDRC scale is a 5-item scale. The scale is rated on a 5-point Likert scale from 0 (not true) to 4 (true all the time). The total score ranges from 0 to 20, with higher total scores indicating greater resilience. The scale demonstrated good construct validity and internal consistency (α = 0.85) during the development of the scale. The CD-RISC had a good Cronbach’s alpha level of 0.85. The Revised CD-RISC can be completed in 2 - 4 minutes. To measure resilience objectively, we suggest using Immune Resilience (IR) levels, the level of resilience to preserve and/or rapidly restore immune resilience functions that promote disease resistance and control inflammation and other inflammatory stress. IR levels are gauged with two peripheral blood metrics that quantify the balance between CD8 and CD4 T-cell levels and gene expression signatures tracking longevity-associated immunocompetence and mortality- or entropy-associated inflammation. IR deregulation is potentially reversible by decreasing inflammatory stress. IR metrics and mechanisms have utility as vital signs and biomarkers for measuring immune health and improving health outcomes.

Optimal scheduling of a township integrated-energy system using the adjustable heat-electricity ratio model

With the expansion and implementation of rural revitalization strategies,there is a constant need for new energy sources for the construction of new townships.Consequently,integrated energy systems with the interconnection and interaction of multiple energy sources are developing rapidly.Biomass energy,a renewable green energy source with low pollution and wide distribution,has significant application potential in integrated energy systems.Considering the application of biomass energy in townships,this study established an integrated biomass energy system and proposed a model to optimize its operation.Lowest economic cost and highest clean energy utilization rate were considered as the objective functions.In addition,a plan was suggested to adjust the heat-electricity ratio based on the characteristics of the combined heat and power of the biomass.Finally,a simulation analysis conducted for a town in China was discussed,demonstrating that the construction of a township integrated-energy system and the use of biomass can significantly reduce operating costs and improve the energy utilization rate.Moreover,by adjusting the heat-electricity ratio,the economic cost was further reduced by 6.70%,whereas the clean energy utilization rate was increased by 5.14%.

A lightweight symmetric image encryption cryptosystem in wavelet domain based on an improved sine map

In the era of big data,the number of images transmitted over the public channel increases exponentially.As a result,it is crucial to devise the efficient and highly secure encryption method to safeguard the sensitive image.In this paper,an improved sine map(ISM)possessing a larger chaotic region,more complex chaotic behavior and greater unpredictability is proposed and extensively tested.Drawing upon the strengths of ISM,we introduce a lightweight symmetric image encryption cryptosystem in wavelet domain(WDLIC).The WDLIC employs selective encryption to strike a satisfactory balance between security and speed.Initially,only the low-frequency-low-frequency component is chosen to encrypt utilizing classic permutation and diffusion.Then leveraging the statistical properties in wavelet domain,Gaussianization operation which opens the minds of encrypting image information in wavelet domain is first proposed and employed to all sub-bands.Simulations and theoretical analysis demonstrate the high speed and the remarkable effectiveness of WDLIC.

Numerical analysis for the free-boundary current reversal equilibrium in the AC plasma current operation in a tokamak

In recent decades, tokamak discharges with zero total toroidal current have been reported in tokamak experiments, and this is one of the key problems in alternating current(AC) operations.An efficient free-boundary equilibrium code is developed to investigate such advanced tokamak discharges with current reversal equilibrium configuration. The calculation results show that the reversal current equilibrium can maintain finite pressure and also has considerable effects on the position of the X-point and the magnetic separatrix shape, and hence also on the position of the strike point on the divertor plates, which is extremely useful for magnetic design, MHD stability analysis, and experimental data analysis etc. for the AC plasma current operation on tokamaks.

Regulating interfacial chemistry and kinetic behaviors of F/Mo co-doping Ni-rich layered oxide cathode for long-cycling lithium-ion batteries over-20°C-60°C

Ni-rich layered oxide cathodes have shown promise for high-energy lithium-ion batteries(LIBs)but are usually limited to mild environments because of their rapid performance degradation under extreme temperature conditions(below0°C and above 50 °C).Here,we report the design of F/Mo co-doped LiNi_(0.8)Co_(0.1)Mn_(0.1)O_(2)(FMNCM)cathode for high-performance LIBs from-20 to 60°C.F^(-) doping with high electronegativity into the cathode surface is found to enhance the stability of surface lattice structure and protect the interface from side reactions with the electrolyte by generating a LiF-rich surface layer.Concurrently,the Mo^(6+) doping suppresses phase transition,which blocks Li^(+)/Ni^(2+) mixing,and stabilizes lithium-ion diffusion pathway.Remarkably,the FMNCM cathode demonstrates excellent cycling stability at a high cutoff voltage of 4.4 V,even at 60°C,maintaining 90.6%capacity retention at 3 C after 150 cycles.Additionally,at temperatures as low as-20°C,it retains 77.1%of its room temperature capacity,achieving an impressive 97.5%capacity retention after 500 cycles.Such stable operation under wide temperatures has been further validated in practical Ah-level pouch-cells.This study sheds light on both fundamental mechanisms and practical implications for the design of advanced cathode materials for wide-temperature LIBs,presenting a promising path towards high-energy and long-cycling LIBs with temperatureadaptability.

Double quantum images encryption scheme based on chaotic system

This paper explores a double quantum images representation(DNEQR)model that allows for simultaneous storage of two digital images in a quantum superposition state.Additionally,a new type of two-dimensional hyperchaotic system based on sine and logistic maps is investigated,offering a wider parameter space and better chaotic behavior compared to the sine and logistic maps.Based on the DNEQR model and the hyperchaotic system,a double quantum images encryption algorithm is proposed.Firstly,two classical plaintext images are transformed into quantum states using the DNEQR model.Then,the proposed hyperchaotic system is employed to iteratively generate pseudo-random sequences.These chaotic sequences are utilized to perform pixel value and position operations on the quantum image,resulting in changes to both pixel values and positions.Finally,the ciphertext image can be obtained by qubit-level diffusion using two XOR operations between the position-permutated image and the pseudo-random sequences.The corresponding quantum circuits are also given.Experimental results demonstrate that the proposed scheme ensures the security of the images during transmission,improves the encryption efficiency,and enhances anti-interference and anti-attack capabilities.

The rise of supercapacitor diodes:Current progresses and future challenges

Supercapacitor has been widely known as a representative electrochemical energy storage device with high power density and long lifespan.Recently,with the deeper understanding of its charge storage mechanism,unidirectional-charging supercapacitor,also called supercapacitor diode(CAPode),is successfully developed based on the ion-sieving effect of its working electrode towards electrolyte ions.Because CAPode integrates mobile ion and mobile electron in one hybrid circuit,it has a great potential in the emerging fields of ion/electron coupling logic operations,human–machine interface,neural network interaction,and in vivo diagnosis and treatment.Accordingly,we herein elucidate the working mechanism and design philosophy of CAPode,and summarize the electrode materials that are suitable for constructing CAPode.Meanwhile,some other supercapacitor-based devices beyond CAPode are also introduced,and their potential applications are instructively presented.Finally,we outline the challenges and chances of CAPode-related techniques.

Experimental investigation of the polarityswitching process with different bipolar ionic liquid thruster operating frequencies

The bipolar ionic liquid thruster employs ionic liquid as a propellant to discharge positively and negatively charged high-energy particles under an alternating current(AC)power source,effectively suppressing electrochemical reaction and ensuring charge neutrality.Determining an optimal AC supply power source frequency is critical for sustained stable thruster operation.This study focuses on the emission characteristics of the ionic liquid thruster under varied AC conditions.The AC power supply was set within the frequency range of 0.5-64 Hz,with eight specific frequency conditions selected for experimentation.The experimental results indicate that the thruster operates steadily within a voltage range of±1470 to±1920 V,with corresponding positive polarity current ranging from 0.41 to 4.91μA and negative polarity current ranging from−0.49 to−4.10μA.During voltage polarity switching,an emission delay occurs,manifested as a prominent peak signal caused by circuit capacitance characteristics and a minor peak signal resulting from liquid droplets.Extended emission test was conducted at 16 Hz,demonstrating approximately 1 h and 50 min of consistent emission before intermittent discharge.These findings underscore the favorable impact of AC conditions within the 8-16 Hz range on the self-neutralization capability of the ionic liquid thruster.

Dynamic interactive bitwise meta-holography with ultra-high computational and display frame rates

Interactive holography offers unmatched levels of immersion and user engagement in the field of future display.Despite of the substantial progress has been made in dynamic meta-holography,the realization of real-time,highly smooth interactive holography remains a significant challenge due to the computational and display frame rate limitations.In this study,we introduced a dynamic interactive bitwise meta-holography with ultra-high computational and display frame rates.To our knowledge,this is the first reported practical dynamic interactive metasurface holographic system.We spa-tially divided the metasurface device into multiple distinct channels,each projecting a reconstructed sub-pattern.The switching states of these channels were mapped to bitwise operations on a set of bit values,which avoids complex holo-gram computations,enabling an ultra-high computational frame rate.Our approach achieves a computational frame rate of 800 kHz and a display frame rate of 23 kHz on a low-power Raspberry Pi computational platform.According to this methodology,we demonstrated an interactive dynamic holographic Tetris game system that allows interactive gameplay,color display,and on-the-fly hologram creation.Our technology presents an inspiration for advanced dynamic meta-holography,which is promising for a broad range of applications including advanced human-computer interaction,real-time 3D visualization,and next-generation virtual and augmented reality systems.

Review of Fault-tolerant Control for Motor Inverter Failure with Operational Quality Considered

In recent years,motor drive systems have garnered increasing attention due to their high efficiency and superior control performance.This is especially apparent in aerospace,marine propulsion,and electric vehicles,where high performance,efficiency,and reliability are crucial.The ability of the drive system to maintain long-term fault-tolerant control(FTC)operation after a failure is essential.The likelihood of inverter failures surpasses that of other components in the drive system,highlighting its critical importance.Long-term FTC operation ensures the system retains its fundamental functions until safe repairs or replacements can be made.The focus of developing a FTC strategy has shifted from basic FTC operations to enhancing the post-fault quality to accommodate the realities of prolonged operation post-failure.This paper primarily investigates FTC strategies for inverter failures in various motor drive systems over the past decade.These strategies are categorized into three types based on post-fault operational quality:rescue,remedy,and reestablishment.The paper discusses each typical control strategy and its research focus,the strengths and weaknesses of various algorithms,and recent advancements in FTC.Finally,this review summarizes effective FTC techniques for inverter failures in motor drive systems and suggests directions for future research.

Finite Element Method Simulation of Wellbore Stability under Different Operating and Geomechanical Conditions

The variation of the principal stress of formations with the working and geo-mechanical conditions can trigger wellbore instabilities and adversely affect the well completion.A finite element model,based on the theory of poro-elasticity and the Mohr-Coulomb rock damage criterion,is used here to analyze such a risk.The changes in wellbore stability before and after reservoir acidification are simulated for different pressure differences.The results indicate that the risk of wellbore instability grows with an increase in the production-pressure difference regardless of whether acidification is completed or not;the same is true for the instability area.After acidizing,the changes in the main geomechanical parameters(i.e.,elastic modulus,Poisson’s ratio,and rock strength)cause the maximum wellbore instability coefficient to increase.

Ultrasound diagnosis of congenital Morgagni hernias: Ten years of experience at two Chinese centers

BACKGROUND Morgagni hernias are rare anomalies that are easily misdiagnosed or missed.AIM To summarize the ultrasound(US)imaging characteristics of Morgagni hernias through a comparison of imaging and surgical results.METHODS The records of children with Morgagni hernias who were hospitalized at two hospitals between January 2013 and November 2023 were retrospectively re-viewed in terms of clinical findings,US features,and operative details.RESULTS Between 2013 and 2023,we observed nine(five male and four female)children with Morgagni hernias.Upper abdominal scanning revealed a widening of the prehepatic space,with an abnormal channel extending from the xiphoid process to the right or left side of the thoracic cavity.The channel had intestinal duct and intestinal gas echoes.Hernia contents were found in the transverse colon(n=6),the colon and small intestine(n=2),and the colon and stomach(n=1).Among the patients,seven had a right-sided lesion,two had a left-sided lesion,and all of them had hernial sacs.CONCLUSION US imaging can accurately determine the location,extent,and content of Morgagni hernias.For suspected Mor-gagni hernias,we recommend performing sonographic screening first.

Superconducting joints using reacted multifilament MgB_(2)wires:A technology toward cryogen-free MRI magnets

The development of superconducting joining technology for reacted magnesium diboride(MgB_(2))conductors remains a critical challenge for the advancement of cryogen-free MgB_(2)-based magnets for magnetic resonance imaging(MRI).Herein,the fabrication of superconducting joints using reacted carbon-doped multifilament MgB_(2)wires for MRI magnets is reported.To achieve successful superconducting joints,the powder-in-mold method was employed,which involved tuning the filament protection mechanism,the powder compaction pressure,and the heat treatment condition.The fabricated joints demonstrated clear superconducting-to-normal transitions in self-field,with effective magnetic field screening up to 0.5 T at 20 K.To evaluate the interface between one of the MgB_(2)filaments and the MgB_(2)bulk within the joint,serial sectioning was conducted for the first time in this type of superconducting joint.The serial sectioning revealed space formation at the interface,potentially caused by the volume shrinkage associated with the MgB_(2)formation or the combined effect of the volume shrinkage and the different thermal expansion coefficients of the MgB_(2)bulk,the filament,the mold,and the sealing material.These findings are expected to be pivotal in developing MgB_(2)superconducting joining technology for MRI magnet applications through interface engineering.

TRIANGLE operation,combined with adequate adjuvant chemotherapy,can improve the prognosis of pancreatic head cancer:A retrospective study

BACKGROUND The TRIANGLE operation involves the removal of all tissues within the triangle bounded by the portal vein-superior mesenteric vein,celiac axis-common hepatic artery,and superior mesenteric artery to improve patient prognosis.Although previously promising in patients with locally advanced pancreatic ductal adenocarcinoma(PDAC),data are limited regarding the long-term oncological outcomes of the TRIANGLE operation among resectable PDAC patients undergoing pancreaticoduodenectomy(PD).AIM To evaluate the safety of the TRIANGLE operation during PD and the prognosis in patients with resectable PDAC.METHODS This retrospective cohort study included patients who underwent PD for pancreatic head cancer between January 2017 and April 2023,with or without the TRIANGLE operation.Patients were divided into the PD_(TRIANGLE)and PD_(non-TRIANGLE)groups.Surgical and survival outcomes were compared between the two groups.Adequate adjuvant chemotherapy was defined as adjuvant chemotherapy≥6 months.RESULTS The PD_(TRIANGLE)and PD_(non-TRIANGLE) groups included 52 and 55 patients,respectively.There were no significant differences in the baseline characteristics or perioperative indexes between the two groups.Furthermore,the recurrence rate was lower in the PD_(TRIANGLE) group than in the PD_(non-TRIANGLE) group(48.1%vs 81.8%,P<0.001),and the local recurrence rate of PDAC decreased from 37.8%to 16.0%.Multivariate Cox regression analysis revealed that PD_(TRIANGLE)(HR=0.424;95%CI:0.256-0.702;P=0.001),adequate adjuvant chemotherapy≥6 months(HR=0.370;95%CI:0.222-0.618;P<0.001)and margin status(HR=2.255;95%CI:1.252-4.064;P=0.007)were found to be independent factors for the recurrence rate.CONCLUSION The TRIANGLE operation is safe for PDAC patients undergoing PD.Moreover,it reduces the local recurrence rate of PDAC and may improve survival in patients who receive adequate adjuvant chemotherapy.

Loosely coordinating diluted highly concentrated electrolyte toward -60℃ Li metal batteries

Lithium metal batteries(LMBs) promise energy density over 400 Wh kg^(-1).However,they suffer severe electrochemical performance deterioration at sub-zero temperatures.Such failure behavior highly correlates to inferior lithium metal anode(LMA) compatibility and sluggish Li^(+) desolvation.Here,we demonstrate that cyclopentylmethyl ether(CPME) based diluted high-concentration electrolyte(DHCE)enables-60℃ LMBs operation.By leveraging the loose coordination between Li^(+) and CPME,such developed electrolyte boosts the formation of ion clusters to derive anion-dominant interfacial chemistry for enhancing LMA compatibility and greatly accelerates Li^(+) desolvation kinetics.The resulting electrolyte demonstrates high Coulombic efficiencies(CE),providing over 99.5%,99.1%,98.5% and 95% at 25,-20,-40,and-60℃respectively.The assembled Li-S battery exhibits remarkable cyclic stability in-20,and-40℃ at 0.2 C charging and 0.5 C discharging.Even at-60℃,Li-S cell with this designed electrolyte retains> 70% of the initial capacity over 170 cycles.Besides,lithium metal coin cell and pouch cell with10 mg cm^(-2) high S cathode loading exhibit cycling stability at-20℃.This work offers an opportunity for rational designing electrolytes toward low temperature LMBs.

Assessing environmental impact:Micro-energy network optimization in a Chinese industrial park

Micro-energy systems contribute significantly to environmental improvement by reducing dependence on power grids through the utilization of multiple renewable energy sources.This study quantified the environmental impact of a micro-energy network system in an industrial park through a life cycle assessment using the operation of the micro-energy network over a year as the functional unit and“cradle-to-gate”as the system boundary.Based on the baseline scenario,a natural gas generator set was added to replace central heating,and the light pipes were expanded to constitute the optimized scenario.The results showed that the key impact categories for both scenarios were global warming,fine particulate matter formation,human carcinogenic toxicity,and human non-carcinogenic toxicity.The overall environmental impact of the optimized scenario was reduced by 68%compared to the baseline scenario.A sensitivity analysis of the key factors showed that electricity from the power grid was the key impact factor in both scenarios,followed by central heating and natural gas.Therefore,to reduce the environmental impact of network systems,it is necessary to further optimize the grid power structure.The research approach can be used to optimize micro-energy networks and evaluate the environmental impact of different energy systems.

Simultaneous type III congenital esophageal atresia and patent ductus arteriosus in a low-weight patient: A case report

BACKGROUND We report a low-birth-weight child(1.8 kg)with neonatal type III congenital esophageal atresia(CEA)combined with symptomatic patent ductus arteriosus(PDA).After comprehensive evaluation,esophageal anastomosis was performed on postnatal day 11 after excluding surgical contraindications,and arterial catheter ligation was performed at the same time.Concurrent surgery for CEA combined with PDA has not been clearly reported in the literature.CASE SUMMARY We report a 6-day-old female child with type III CEA and PDA.The patient presented with foam at the mouth after birth,cough and shortness of breath after feeding.At another hospital,she was considered to have neonatal pneumonia,neonatal jaundice and congenital heart disease and transferred to our hospital.After iodine oil radiography of the esophagus and echocardiography we con-firmed diagnosis of CEA and PDA.The diameter of the PDA was 8 mm,with obvious left to right shunting.We performed right rear extrapleural orificium fistula ligation and esophageal anastomosis,and ligation of PDA via left axilla straight incision after 5 d of hospitalization.The operations were successful,and the incision healed after 12 d,and the patient was discharged.We re-examined the patient 1 mo after surgery.She did not vomit when she ate rice flour.Esophageal angiography showed no stricture of the anastomotic stoma.The patient weighed 3.2 kg.CONCLUSION For CEA patients with multiple risk factors,comprehensive,timely and accurate diagnosis and evaluation,and early treatment may improve prognosis.

Clinical efficacy and safety of kyphoplasty for the treatment of osteoporotic vertebral compression fractures at different surgical timings based on the theory of“dynamic-static integration”

Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-static integration”.Methods:Patients with OVCF who underwent percutaneous kyphoplasty in our hospital were selected and divided into Groups A,B,and C for those undergoing surgery within 7,7—21,and>21 days of fracture occurrence.The variations in the amount of bone cement injected,pre-and post-operative pain levels,functional activity,deformity correction of the injured vertebrae,bone cement leakage,and vertebral body height loss were compared among the three groups.Results:Regarding pain relief and functional activity,the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly improved.Furthermore,the deformities of the injured vertebrae in the three groups were significantly corrected,with Groups A and B exhibiting superior correction compared to Group C.Moreover,the bone cement leakage rates in groups A and C were higher than that in Group B.At the 3-month follow-up,the loss of vertebral height in Group C was significantly higher than those in groups A and B.Conclusion:Kyphoplasty is effective for OVCF treatment.Early surgery can effectively restore the vertebral height of the injured vertebra,reduce kyphosis,and reduce height loss of the injured vertebra after surgery;nevertheless,treatment within 1—3 weeks of the fracture can reduce the occurrence of bone cement leakage,making the surgery safer.Therefore,surgical treatment within 1—3 weeks of fracture is safer and can achieve satisfactory therapeutic effects.From the perspective of traditional Chinese medicine,PKP surgery can transform the fracture end from a micromotion state to a fixed state,which fully embodies the theory of“dynamic-static integration”.

High-speed performance self-powered short wave ultraviolet radiation detectors based onκ(ε)-Ga_(2)O_(3)

High-speed solar-blind short wavelength ultraviolet radiation detectors based onκ(ε)-Ga_(2)O_(3)layers with Pt contacts were demonstrated and their properties were studied in detail.Theκ(ε)-Ga_(2)O_(3)layers were deposited by the halide vapor phase epitaxy on patterned GaN templates with sapphire substrates.The spectral dependencies of the photoelectric properties of struc-tures were analyzed in the wavelength interval 200-370 nm.The maximum photo to dark current ratio,responsivity,detectiv-ity and external quantum efficiency of structures were determined as:180.86 arb.un.,3.57 A/W,1.78×10^(12) Hz^(0.5)∙cm·W^(-1) and 2193.6%,respectively,at a wavelength of 200 nm and an applied voltage of 1 V.The enhancement of the photoresponse was caused by the decrease in the Schottky barrier at the Pt/κ(ε)-Ga_(2)O_(3)interface under ultraviolet exposure.The detectors demon-strated could functionalize in self-powered mode due to built-in electric field at the Pt/κ(ε)-Ga_(2)O_(3)interface.The responsivity and external quantum efficiency of the structures at a wavelength of 254 nm and zero applied voltage were 0.9 mA/W and 0.46%,respectively.The rise and decay times in self-powered mode did not exceed 100 ms.

Market Operation of Energy Storage System in Smart Grid:A Review

As a flexible resource,energy storage plays an increasingly significant role in stabilizing and supporting the power system,while providing auxiliary services.Still,the current high demand for energy storage contrasts with the fuzzy lack of market-oriented mechanisms for energy storage,the principle of market-oriented operation has not been embodied,and there is no unified and systematic analytical framework for the business model.However,the dispatch management model of energy storage in actual power system operation is not clear.Still,the specific scheduling process and energy storage strategy on the source-load-network side could be more specific,and there needs to be a greater understanding of the collaborative scheduling process of the multilevel scheduling center.On this basis,this paper reviews the energy storage operation model and market-based incentive mechanism,For different functional types and installation locations of energy storage within the power system,the operational models and existing policies for energy storage participation in the market that are adapted to multiple operating states are summarized.From the point of view of the actual scheduling and operation management of energy storage in China,an energy storage regulation and operation management model based on“national,provincial,and local”multilevel coordination is proposed,as well as key technologies in the interactive scenarios of source-load,network and storage.