Some biological uses of polyethylene glycol(PEG):The use of PEG as a membrane fusogen was first reported in 1976with the creation of cell hybrids,formed by suspending two cell lines in a 50%w/w solution of PEG in w...Some biological uses of polyethylene glycol(PEG):The use of PEG as a membrane fusogen was first reported in 1976with the creation of cell hybrids,formed by suspending two cell lines in a 50%w/w solution of PEG in water.展开更多
BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subs...BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subsequent respiratory and cardiac arrest,are rarely reported.CASE SUMMARY We present the case of a 35-year-old woman,at 36+5 weeks of gestation,who presented with paroxysmal epigastric pain accompanied by low back pain,nausea,and vomiting.According to the clinical symptoms,B-ultrasound imaging and biochemical indicators,the patient was diagnosed with acute pancreatitis and initially managed conservatively.However,3 hours after admission,the patient experienced respiratory and cardiac arrest,and the fetus died.In this case,the adverse outcomes occurred due to the lack of aggressive fluid resuscitation and an active surgical intervention.CONCLUSION Implementing aggressive fluid resuscitation to sustain tissue perfusion,alongside the proactive evaluation of pharmacological agents that suppress gastric acid secretion and inhibit pancreatic enzyme activity,may be beneficial in mitigating the risk of a severely adverse prognosis.Effective management of acute pancreatitis during pregnancy requires careful timing of surgical intervention,a thorough evaluation of the risks and benefits regarding the continuation or termination of pregnancy,and a focus on safeguarding both maternal and fetal health.展开更多
Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal b...Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019(COVID-19).However,neuroimaging studies on sleep disturbances caused by COVID-19 are scarce,and existing studies have primarily focused on the long-term effects of the virus,with minimal acute phase data.As a result,little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19.To address this issue,we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection,and verified the results using 3-month follow-up data.A total of 26 COVID-19 patients with sleep disturbances(aged 51.5±13.57 years,8 women and 18 men),27 COVID-19 patients without sleep disturbances(aged 47.33±15.98 years,9 women and 18 men),and 31 age-and gender-matched healthy controls(aged 49.19±17.51 years,9 women and 22 men)were included in this study.Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis.We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes.The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores.Additionally,we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls.The 3-month follow-up data revealed indices of altered cerebral structure(cortical thickness,cortical grey matter volume,and cortical surface area)in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances.Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection.These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.展开更多
BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyro...BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and schizophrenia.METHODS In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.Their clinical data were analyzed retrospectively.Based on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control group.Venous blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS scores.RESULTS The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of schizophrenia.Logistic results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.CONCLUSION Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for...BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.展开更多
Coronavirus disease 2019(COVID-19)is a contagious disease caused by severe acute respiratory syndrome coronavirus 2.It was declared a global pandemic on March 11,2020,by the World Health Organization.An excessive infl...Coronavirus disease 2019(COVID-19)is a contagious disease caused by severe acute respiratory syndrome coronavirus 2.It was declared a global pandemic on March 11,2020,by the World Health Organization.An excessive inflammatory response is a severe respiratory manifestation of COVID-19,which becomes predominant in later stages.Due to its immunosuppressive and anti-inflammatory properties,dexamethasone is the first systemic glucocorticoid to treat severe COVID-19 patients.This editorial reviews the efficacy and safety of highdose vs low-dose dexamethasone in patients with COVID-19.Findings indicate that using low-dose dexamethasone is beneficial and emphasize the need for additional research on the use of high-dose dexamethasone.While the study provides a robust evidence base,it is limited by the lack of long-term data,focus on specific outcomes and heterogeneity of the included studies.Future research should focus on the long-term effects of dexamethasone and its impact across varying disease severities and patient populations to refine treatment strategies and improve patient care.展开更多
Urban barriers are often a consequence of the unplanned expansion of transport infrastructures,housing growth nearby existing transport infrastructures,and the vehicular traffic itself.This process,also known as“comm...Urban barriers are often a consequence of the unplanned expansion of transport infrastructures,housing growth nearby existing transport infrastructures,and the vehicular traffic itself.This process,also known as“community severance”,is a problem that affects the travel patterns of the population and causes negative impacts to adjacent communities,but it is not easy to assess.As an alternative to the costly technologies and restricted-access data sometimes used to analyze urban barriers,we propose an analytical approach that assesses community severance levels by classifying the quality of Pedestrian Crossings on Urban Streets(the PeCUS index).Additionally,the approach is used to identify possible inequities nearby the different classification groups regarding demographic data.We used the chi-square(χ^(2))test of independence and the standardized Pearson residuals to indicate deficits and excesses of residents regarding the demographic characteristics studied surrounding the urban streets.We found the following evidences of associations:residents with low-income or those aged up to 19 tend to live close to the worst crossings,whereas residents with permanent mobility constraints or the elderly tend to live near the crossings with the best classifications.Therefore,the study shows that the assessment of community severance by the analysis of the PeCUS index is feasible.Moreover,it reveals that the distribution of residents surrounding the distinct classes of quality of crossings is equitable for vulnerable social groups,except for low-income or young residents.展开更多
With'fake divorces'proving a popular loophole for gaming the housing market,we ask experts if these arrangements guarantee an even split中国式'假离婚'背后的复杂真相Even by Chinese standards,it was an e...With'fake divorces'proving a popular loophole for gaming the housing market,we ask experts if these arrangements guarantee an even split中国式'假离婚'背后的复杂真相Even by Chinese standards,it was an eye-opening figure.This March,in the small village of Jiangbei,Jiangsu province,some 160 couples filed for divorce at the same time.展开更多
The safety valve is an important component to ensure the safe operation of lithium-ion batteries(LIBs).However,the effect of safety valve type on the thermal runaway(TR)and gas venting behavior of LIBs,as well as the ...The safety valve is an important component to ensure the safe operation of lithium-ion batteries(LIBs).However,the effect of safety valve type on the thermal runaway(TR)and gas venting behavior of LIBs,as well as the TR hazard severity of LIBs,are not known.In this paper,the TR and gas venting behavior of three 100 A h lithium iron phosphate(LFP)batteries with different safety valves are investigated under overheating.Compared to previous studies,the main contribution of this work is in studying and evaluating the effect of gas venting behavior and TR hazard severity of LFP batteries with three safety valve types.Two significant results are obtained:(Ⅰ)the safety valve type dominates over gas venting pressure of battery during safety venting,the maximum gas venting pressure of LFP batteries with a round safety valve is 3320 Pa,which is one order of magnitude higher than other batteries with oval or cavity safety valve;(Ⅱ)the LFP battery with oval safety valve has the lowest TR hazard as shown by the TR hazard assessment model based on gray-fuzzy analytic hierarchy process.This study reveals the effect of safety valve type on TR and gas venting,providing a clear direction for the safety valve design.展开更多
BACKGROUND Sepsis is a life-threatening condition characterized by a dysregulation of the host response to infection that can lead to acute lung injury(ALI)and multiple organ dysfunction syndrome(MODS).Interleukin 6(I...BACKGROUND Sepsis is a life-threatening condition characterized by a dysregulation of the host response to infection that can lead to acute lung injury(ALI)and multiple organ dysfunction syndrome(MODS).Interleukin 6(IL-6)is a pro-inflammatory cytokine that plays a crucial role in the pathogenesis of sepsis and its complications.AIM To investigate the relationship among plasma IL-6 levels,risk of ALI,and disease severity in critically ill patients with sepsis.METHODS This prospective and observational study was conducted in the intensive care unit of a tertiary care hospital between January 2021 and December 2022.A total of 83 septic patients were enrolled.Plasma IL-6 levels were measured upon admission using an enzyme-linked immunosorbent assay.The development of ALI and MODS was monitored during hospitalization.Disease severity was evaluated by Acute Physiology and Chronic Health Evaluation II(APACHE II)and Sequential Organ Failure Assessment(SOFA)scores.RESULTS Among the 83 patients with sepsis,38(45.8%)developed ALI and 29(34.9%)developed MODS.Plasma IL-6 levels were significantly higher in patients who developed ALI than in those without ALI(median:125.6 pg/mL vs 48.3 pg/mL;P<0.001).Similarly,patients with MODS had higher IL-6 levels than those without MODS(median:142.9 pg/mL vs 58.7 pg/mL;P<0.001).Plasma IL-6 levels were strongly and positively correlated with APACHE II(r=0.72;P<0.001)and SOFA scores(r=0.68;P<0.001).CONCLUSIONElevated plasma IL-6 levels in critically ill patients with sepsis were associated with an increased risk of ALI andMODS.Higher IL-6 levels were correlated with greater disease severity,as reflected by higher APACHE II andSOFA scores.These findings suggest that IL-6 may serve as a biomarker for predicting the development of ALI anddisease severity in patients with sepsis.展开更多
Fires,including wildfires,harm air quality and essential public services like transportation,communication,and utilities.These fires can also influence atmospheric conditions,including temperature and aerosols,potenti...Fires,including wildfires,harm air quality and essential public services like transportation,communication,and utilities.These fires can also influence atmospheric conditions,including temperature and aerosols,potentially affecting severe convective storms.Here,we investigate the remote impacts of fires in the western United States(WUS)on the occurrence of large hail(size:≥2.54 cm)in the central US(CUS)over the 20-year period of 2001–20 using the machine learning(ML),Random Forest(RF),and Extreme Gradient Boosting(XGB)methods.The developed RF and XGB models demonstrate high accuracy(>90%)and F1 scores of up to 0.78 in predicting large hail occurrences when WUS fires and CUS hailstorms coincide,particularly in four states(Wyoming,South Dakota,Nebraska,and Kansas).The key contributing variables identified from both ML models include the meteorological variables in the fire region(temperature and moisture),the westerly wind over the plume transport path,and the fire features(i.e.,the maximum fire power and burned area).The results confirm a linkage between WUS fires and severe weather in the CUS,corroborating the findings of our previous modeling study conducted on case simulations with a detailed physics model.展开更多
Extreme droughts are anticipated to have detrimental impacts on forest ecosystems,especially in water-limited regions,due to the influence of climate change.However,considerable uncertainty remains regarding the patte...Extreme droughts are anticipated to have detrimental impacts on forest ecosystems,especially in water-limited regions,due to the influence of climate change.However,considerable uncertainty remains regarding the patterns in species-specific responses to extreme droughts.Here,we conducted a study integrating dendrochronology and remote sensing methods to investigate the mosaic-distributed maple-oak(native)natural forests and poplar plantations(introduced)in the Horqin Sandy Land,Northeast China.We assessed the impacts of extreme droughts on tree performances by measuring interannual variations in radial growth and vegetation index.The results showed that precipitation and self-calibrated palmer drought severity index(scPDSI)are the major factors influencing tree-ring width index(RWI)and normalized difference vegetation index(NDVI).The severe droughts between 2000 and 2004 resulted in reduced RWI in the three studied tree species as well as led to NDVI reductions in both the maple-oak natural forests and the poplar plantations.The RWI reached the nadir during the2000-2004 severe droughts and remained at low levels two years after the severe drought,creating a legacy effect.In contrast to the lack of significant correlation between RWI and scPDSI,NDVI exhibited a significant positive correlation with scPDSI indicating the greater sensitivity of canopy performance to droughts than radial growth.Furthermore,interspecific differences in RWI and NDVI responses were observed,with the fast-growing poplar species experiencing a more significant RWI decrease and more negative NDVI anomaly during severe droughts than native species,highlighting the species-specific trade-offs between drought resilience and growth rate.This study emphasizes the importance of combining tree-level radial growth with landscape-scale canopy remote sensing to understand forest resilience and response.Our study improves our understanding of forest responses to extreme drought and highlights species differences in climate responses,offering crucial insights for optimizing species selection in sustainable afforestation and forest management in water-limited regions under the influence of climate change.展开更多
BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abd...BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.展开更多
BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to impr...BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.展开更多
Accurate prediction of the frictional pressure drop is important for the design and operation of subsea oil and gas transporting system considering the length of the pipeline. The applicability of the correlations to ...Accurate prediction of the frictional pressure drop is important for the design and operation of subsea oil and gas transporting system considering the length of the pipeline. The applicability of the correlations to pipeline-riser flow needs evaluation since the flow condition in pipeline-riser is quite different from the original data where they were derived from. In the present study, a comprehensive evaluation of 24prevailing correlation in predicting frictional pressure drop is carried out based on experimentally measured data of air-water and air-oil two-phase flows in pipeline-riser. Experiments are performed in a system having different configuration of pipeline-riser with the inclination of the downcomer varied from-2°to-5°to investigated the effect of the elbow on the frictional pressure drop in the riser. The inlet gas velocity ranges from 0.03 to 6.2 m/s, and liquid velocity varies from 0.02 to 1.3 m/s. A total of885 experimental data points including 782 on air-water flows and 103 on air-oil flows are obtained and used to access the prediction ability of the correlations. Comparison of the predicted results with the measured data indicate that a majority of the investigated correlations under-predict the pressure drop on severe slugging. The result of this study highlights the requirement of new method considering the effect of pipe layout on the frictional pressure drop.展开更多
Highway safety researchers focus on crash injury severity,utilizing deep learning—specifically,deep neural networks(DNN),deep convolutional neural networks(D-CNN),and deep recurrent neural networks(D-RNN)—as the pre...Highway safety researchers focus on crash injury severity,utilizing deep learning—specifically,deep neural networks(DNN),deep convolutional neural networks(D-CNN),and deep recurrent neural networks(D-RNN)—as the preferred method for modeling accident severity.Deep learning’s strength lies in handling intricate relation-ships within extensive datasets,making it popular for accident severity level(ASL)prediction and classification.Despite prior success,there is a need for an efficient system recognizing ASL in diverse road conditions.To address this,we present an innovative Accident Severity Level Prediction Deep Learning(ASLP-DL)framework,incorporating DNN,D-CNN,and D-RNN models fine-tuned through iterative hyperparameter selection with Stochastic Gradient Descent.The framework optimizes hidden layers and integrates data augmentation,Gaussian noise,and dropout regularization for improved generalization.Sensitivity and factor contribution analyses identify influential predictors.Evaluated on three diverse crash record databases—NCDB 2018–2019,UK 2015–2020,and US 2016–2021—the D-RNN model excels with an ACC score of 89.0281%,a Roc Area of 0.751,an F-estimate of 0.941,and a Kappa score of 0.0629 over the NCDB dataset.The proposed framework consistently outperforms traditional methods,existing machine learning,and deep learning techniques.展开更多
Objective Sepsis is considered a major cause of health loss in children and had high mortality and morbidity.Currently,there is no reliable model for predicting the prognosis of pediatric patients with sepsis.This stu...Objective Sepsis is considered a major cause of health loss in children and had high mortality and morbidity.Currently,there is no reliable model for predicting the prognosis of pediatric patients with sepsis.This study aimed to analyze the clinical characteristics of sepsis in children and assess the risk factors associated with poor prognosis in pediatric sepsis patients to identify timely interventions and improve their outcomes.Methods This study analyzed the clinical indicators and laboratory results of septic patients hospitalized in the Pediatric Intensive Care Unit of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,China,from January 1,2019,to December 31,2021.Risk factors for sepsis were identified by logistic regression analyses.Results A total of 355 children with sepsis were enrolled,with 333 children(93.8%)in the good prognosis group,and 22 children(6.2%)in the poor prognosis group.Among them,there were 255 patients(71.8%)in the sepsis group,and 100 patients(28.2%)in the severe sepsis group.The length of hospital stay in the poor prognosis group was longer than that in the good prognosis group(P<0.01).The levels of interleukin 1β(IL-1β)in the poor prognosis group were higher than those in the good prognosis group(P>0.05),and the platelet(PLT),albumin(ALB),and hemoglobin(Hb)levels were lower in the poor prognosis group(P<0.01).The IL-8 levels in the severe sepsis group were higher than those in the sepsis group(P<0.05).Multiple logistic regression analysis suggested that lower Hb levels,ALB levels,peak PLT counts,and higher IL-1βlevels were independent risk factors for poor prognosis in children with sepsis.Conclusion Lower Hb,ALB,and PLT counts and elevated IL-1βare independent risk factors for poor prognosis in children with sepsis.展开更多
Global warming and frequent extreme drought events lead to tree death and extensive forest decline,but the underlying mechanism is not clear.In drought years,cambial development is more sensitive to climate change,but...Global warming and frequent extreme drought events lead to tree death and extensive forest decline,but the underlying mechanism is not clear.In drought years,cambial development is more sensitive to climate change,but in different phenological stages,the response rela-tionship is nonlinear.Therefore,the dynamic relationship between tree radial growth and climatic/environmental fac-tors needs to be studied.We thus continuously monitored radial growth of Qinghai spruce(Picea crassifolia Kom.)and environmental factors from January 2021 to November 2022 using point dendrometers and portable meteorological weather stations in the central area of the Qilian Mountains.The relationship and stability between the radial growth of Qinghai spruce and environmental factors were compared for different levels of drought in 2021 and 2022.The year 2022 had higher temperatures and less precipitation and was drier than 2021.Compared with 2021,the growing period in 2022 for Qinghai spruce was 10 days shorter,maximum growth rate(Grmax)was 4.5μm·d^(-1) slower,and the initiation of growth was 6 days later.Growth of Qinghai spruce was always restricted by drought,and the stem radial increment(SRI)was more sensitive to precipitation and air relative humidity.Seasonal changes in cumulative radial growth were divided into four phenological stages according to the time of growth onset,cessation,and maximum growth rate(Grmax)of Qinghai spruce.Stability responses of SRI to climate change were stronger in Stage 3 and Stage 4 of 2021 and stronger in Stage 1(initiation growth stage)and Stage 3 of 2022.The results provide important information on the growth of the trees in response to drought and for specific managing forests as the climate warms.展开更多
The superplastic behavior and associated deformation mechanisms of a fine-grained Mg-10.1 Li-0.8Al-0.6Zn alloy(LAZ1011)with a grain size of 3.2μm,primarily composed of the BCCβphase and a small amount of the HCPαph...The superplastic behavior and associated deformation mechanisms of a fine-grained Mg-10.1 Li-0.8Al-0.6Zn alloy(LAZ1011)with a grain size of 3.2μm,primarily composed of the BCCβphase and a small amount of the HCPαphase,were examined in a temperature range of 473 K to 623 K.The microstructural refinement of this alloy was achieved by employing high-ratio differential speed rolling.The best superplasticity was achieved at 523 K and at strain rates of 10^(-4)-5×10^(-4)s^(-1),where tensile elongations of 550±600%were obtained.During the heating and holding stage of the tensile samples prior to tensile loading,a significant increase in grain size was observed at temperatures above 573 K.Therefore,it was important to consider this effect when analyzing and understanding the superplastic deformation behavior and mechanisms.In the investigated strain rate range,the superplastic flow at low strain rates was governed by lattice diffusion-controlled grain boundary sliding,while at high strain rates,lattice diffusion-controlled dislocation climb creep was the rate-controlling deformation mechanism.It was concluded that solute drag creep is unlikely to occur.During the late stages of deformation at 523 K,it was observed that grain boundary sliding led to the agglomeration of theαphase,resulting in significant strain hardening.Deformation mechanism maps were constructed forβ-Mg-Li alloys in the form of 2D and 3D formats as a function of strain rate,stress,temperature,and grain size,using the constitutive equations for various deformation mechanisms derived based on the data of the current tests.展开更多
Chronic heart failure(CHF)is a clinical syndrome manifested by reduced pumping ability of the heart,increased pressure in heart chambers in both physical activity and at rest.The symptoms of this syndrome are dyspnea,...Chronic heart failure(CHF)is a clinical syndrome manifested by reduced pumping ability of the heart,increased pressure in heart chambers in both physical activity and at rest.The symptoms of this syndrome are dyspnea,undue fatigability,peripheral edema,which follow structural and functional changes of the myocardium.[1]The growing incidence of CHF,especially among elderly people,is an urgent problem for medicine in the vast majority of industrialized countries.For instance,in Russian Federation,CHF is diagnosed in about 7%of cardiovascular patients.At the same time,this indicator varies from 0.3%in young people(20-29 years old)to 70%in the older age group.[2,3].展开更多
基金supported by grants from the Lone Star Paralysis Foundationan NIH grant R01 NS081063 to GDB
文摘Some biological uses of polyethylene glycol(PEG):The use of PEG as a membrane fusogen was first reported in 1976with the creation of cell hybrids,formed by suspending two cell lines in a 50%w/w solution of PEG in water.
文摘BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subsequent respiratory and cardiac arrest,are rarely reported.CASE SUMMARY We present the case of a 35-year-old woman,at 36+5 weeks of gestation,who presented with paroxysmal epigastric pain accompanied by low back pain,nausea,and vomiting.According to the clinical symptoms,B-ultrasound imaging and biochemical indicators,the patient was diagnosed with acute pancreatitis and initially managed conservatively.However,3 hours after admission,the patient experienced respiratory and cardiac arrest,and the fetus died.In this case,the adverse outcomes occurred due to the lack of aggressive fluid resuscitation and an active surgical intervention.CONCLUSION Implementing aggressive fluid resuscitation to sustain tissue perfusion,alongside the proactive evaluation of pharmacological agents that suppress gastric acid secretion and inhibit pancreatic enzyme activity,may be beneficial in mitigating the risk of a severely adverse prognosis.Effective management of acute pancreatitis during pregnancy requires careful timing of surgical intervention,a thorough evaluation of the risks and benefits regarding the continuation or termination of pregnancy,and a focus on safeguarding both maternal and fetal health.
基金supported by grants from Major Project of Science and Technology of Guangxi Zhuang Autonomous Region,No.Guike-AA22096018(to JY)Guangxi Key Research and Development Program,No.AB22080053(to DD)+6 种基金Major Project of Science and Technology of Guangxi Zhuang Autonomous Region,No.Guike-AA23023004(to MZ)the National Natural Science Foundation of China,Nos.82260021(to MZ),82060315(to DD)the Natural Science Foundation of Guangxi Zhuang Autonomous Region,No.2021GXNSFBA220007(to GD)Clinical Research Center For Medical Imaging in Hunan Province,No.2020SK4001(to JL)Key Emergency Project of Pneumonia Epidemic of Novel Coronavirus Infection in Hunan Province,No.2020SK3006(to JL)Science and Technology Innovation Program of Hunan Province,No.2021RC4016(to JL)Key Project of the Natural Science Foundation of Hunan Province,No.2024JJ3041(to JL).
文摘Sleep disturbances are among the most prevalent neuropsychiatric symptoms in individuals who have recovered from severe acute respiratory syndrome coronavirus 2 infections.Previous studies have demonstrated abnormal brain structures in patients with sleep disturbances who have recovered from coronavirus disease 2019(COVID-19).However,neuroimaging studies on sleep disturbances caused by COVID-19 are scarce,and existing studies have primarily focused on the long-term effects of the virus,with minimal acute phase data.As a result,little is known about the pathophysiology of sleep disturbances in the acute phase of COVID-19.To address this issue,we designed a longitudinal study to investigate whether alterations in brain structure occur during the acute phase of infection,and verified the results using 3-month follow-up data.A total of 26 COVID-19 patients with sleep disturbances(aged 51.5±13.57 years,8 women and 18 men),27 COVID-19 patients without sleep disturbances(aged 47.33±15.98 years,9 women and 18 men),and 31 age-and gender-matched healthy controls(aged 49.19±17.51 years,9 women and 22 men)were included in this study.Eleven COVID-19 patients with sleep disturbances were included in a longitudinal analysis.We found that COVID-19 patients with sleep disturbances exhibited brain structural changes in almost all brain lobes.The cortical thicknesses of the left pars opercularis and left precuneus were significantly negatively correlated with Pittsburgh Sleep Quality Index scores.Additionally,we observed changes in the volume of the hippocampus and its subfield regions in COVID-19 patients compared with the healthy controls.The 3-month follow-up data revealed indices of altered cerebral structure(cortical thickness,cortical grey matter volume,and cortical surface area)in the frontal-parietal cortex compared with the baseline in COVID-19 patients with sleep disturbances.Our findings indicate that the sleep disturbances patients had altered morphology in the cortical and hippocampal structures during the acute phase of infection and persistent changes in cortical regions at 3 months post-infection.These data improve our understanding of the pathophysiology of sleep disturbances caused by COVID-19.
文摘BACKGROUND The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia,especially thyroid hormones.AIM To study the relationship between triiodothyronine(T3),thyroxine(T4),free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH)and schizophrenia.METHODS In this study,100 schizophrenia patients were selected from our hospital between April 2022 and April 2024.Their clinical data were analyzed retrospectively.Based on the Positive and Negative Syndrome Scale(PANSS)score,patients were divided into mild(1-3 points,n=39),moderate(4 points,n=45),and severe groups(5-7 points,n=16).Additionally,55 healthy individuals served as a control group.Venous blood samples were collected to measure T3,T4,FT3,FT4,TSH,and cortisol concentrations,analyzing their relationship with PANSS scores.RESULTS The serum levels of T3,FT3,FT4,TSH and cortisol in the schizophrenia group were lower than those in the control group(P<0.05).With the increase of the severity of the disease,the concentrations of T3 and T4 decreased,while the con-centrations of TSH and cortisol increased(P<0.05).The concentrations of TSH and cortisol were positively correlated with the PANSS score,while T3 and T4 were negatively correlated with the PANSS score(P<0.05).The receiver ope-rating characteristic curve results showed that T3,T4,TSH,and cortisol had good efficacy in the diagnosis of schizophrenia.Logistic results showed that decreased T3 level,decreased T4 level,decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia.CONCLUSION Thyroid hormone levels are associated with the severity of schizophrenia symptoms,which can provide new solutions for the diagnosis and treatment of schizophrenia.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.
文摘Coronavirus disease 2019(COVID-19)is a contagious disease caused by severe acute respiratory syndrome coronavirus 2.It was declared a global pandemic on March 11,2020,by the World Health Organization.An excessive inflammatory response is a severe respiratory manifestation of COVID-19,which becomes predominant in later stages.Due to its immunosuppressive and anti-inflammatory properties,dexamethasone is the first systemic glucocorticoid to treat severe COVID-19 patients.This editorial reviews the efficacy and safety of highdose vs low-dose dexamethasone in patients with COVID-19.Findings indicate that using low-dose dexamethasone is beneficial and emphasize the need for additional research on the use of high-dose dexamethasone.While the study provides a robust evidence base,it is limited by the lack of long-term data,focus on specific outcomes and heterogeneity of the included studies.Future research should focus on the long-term effects of dexamethasone and its impact across varying disease severities and patient populations to refine treatment strategies and improve patient care.
基金This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil(CAPES)-Finance Code[001].
文摘Urban barriers are often a consequence of the unplanned expansion of transport infrastructures,housing growth nearby existing transport infrastructures,and the vehicular traffic itself.This process,also known as“community severance”,is a problem that affects the travel patterns of the population and causes negative impacts to adjacent communities,but it is not easy to assess.As an alternative to the costly technologies and restricted-access data sometimes used to analyze urban barriers,we propose an analytical approach that assesses community severance levels by classifying the quality of Pedestrian Crossings on Urban Streets(the PeCUS index).Additionally,the approach is used to identify possible inequities nearby the different classification groups regarding demographic data.We used the chi-square(χ^(2))test of independence and the standardized Pearson residuals to indicate deficits and excesses of residents regarding the demographic characteristics studied surrounding the urban streets.We found the following evidences of associations:residents with low-income or those aged up to 19 tend to live close to the worst crossings,whereas residents with permanent mobility constraints or the elderly tend to live near the crossings with the best classifications.Therefore,the study shows that the assessment of community severance by the analysis of the PeCUS index is feasible.Moreover,it reveals that the distribution of residents surrounding the distinct classes of quality of crossings is equitable for vulnerable social groups,except for low-income or young residents.
文摘With'fake divorces'proving a popular loophole for gaming the housing market,we ask experts if these arrangements guarantee an even split中国式'假离婚'背后的复杂真相Even by Chinese standards,it was an eye-opening figure.This March,in the small village of Jiangbei,Jiangsu province,some 160 couples filed for divorce at the same time.
基金supported by the National Key R&D Program of China(No.2021YFB2402001)the Postgraduate Innovation and Entrepreneurship Practice Project of Anhui Province(No.2022cxcysj013)+2 种基金the China Postdoctoral Science Foundation(No.2022T150615)the Fundamental Research Funds for the Central Universities(No.WK5290000002)supported by Youth Innovation Promotion Association CAS(No.Y201768)。
文摘The safety valve is an important component to ensure the safe operation of lithium-ion batteries(LIBs).However,the effect of safety valve type on the thermal runaway(TR)and gas venting behavior of LIBs,as well as the TR hazard severity of LIBs,are not known.In this paper,the TR and gas venting behavior of three 100 A h lithium iron phosphate(LFP)batteries with different safety valves are investigated under overheating.Compared to previous studies,the main contribution of this work is in studying and evaluating the effect of gas venting behavior and TR hazard severity of LFP batteries with three safety valve types.Two significant results are obtained:(Ⅰ)the safety valve type dominates over gas venting pressure of battery during safety venting,the maximum gas venting pressure of LFP batteries with a round safety valve is 3320 Pa,which is one order of magnitude higher than other batteries with oval or cavity safety valve;(Ⅱ)the LFP battery with oval safety valve has the lowest TR hazard as shown by the TR hazard assessment model based on gray-fuzzy analytic hierarchy process.This study reveals the effect of safety valve type on TR and gas venting,providing a clear direction for the safety valve design.
文摘BACKGROUND Sepsis is a life-threatening condition characterized by a dysregulation of the host response to infection that can lead to acute lung injury(ALI)and multiple organ dysfunction syndrome(MODS).Interleukin 6(IL-6)is a pro-inflammatory cytokine that plays a crucial role in the pathogenesis of sepsis and its complications.AIM To investigate the relationship among plasma IL-6 levels,risk of ALI,and disease severity in critically ill patients with sepsis.METHODS This prospective and observational study was conducted in the intensive care unit of a tertiary care hospital between January 2021 and December 2022.A total of 83 septic patients were enrolled.Plasma IL-6 levels were measured upon admission using an enzyme-linked immunosorbent assay.The development of ALI and MODS was monitored during hospitalization.Disease severity was evaluated by Acute Physiology and Chronic Health Evaluation II(APACHE II)and Sequential Organ Failure Assessment(SOFA)scores.RESULTS Among the 83 patients with sepsis,38(45.8%)developed ALI and 29(34.9%)developed MODS.Plasma IL-6 levels were significantly higher in patients who developed ALI than in those without ALI(median:125.6 pg/mL vs 48.3 pg/mL;P<0.001).Similarly,patients with MODS had higher IL-6 levels than those without MODS(median:142.9 pg/mL vs 58.7 pg/mL;P<0.001).Plasma IL-6 levels were strongly and positively correlated with APACHE II(r=0.72;P<0.001)and SOFA scores(r=0.68;P<0.001).CONCLUSIONElevated plasma IL-6 levels in critically ill patients with sepsis were associated with an increased risk of ALI andMODS.Higher IL-6 levels were correlated with greater disease severity,as reflected by higher APACHE II andSOFA scores.These findings suggest that IL-6 may serve as a biomarker for predicting the development of ALI anddisease severity in patients with sepsis.
基金supported by the U.S.Department of Energy,Office of Science,Office of Biological and Environmental Research program as part of the Regional and Global Model Analysis and Multi-Sector Dynamics program areas(Award Number DE-SC0016605)Argonne National Laboratory is operated for the DOE by UChicago Argonne,LLC,under contract DE-AC02-06CH11357+1 种基金the National Energy Research Scientific Computing Center(NERSC)NERSC is a U.S.DOE Office of Science User Facility operated under Contract DE-AC02-05CH11231.
文摘Fires,including wildfires,harm air quality and essential public services like transportation,communication,and utilities.These fires can also influence atmospheric conditions,including temperature and aerosols,potentially affecting severe convective storms.Here,we investigate the remote impacts of fires in the western United States(WUS)on the occurrence of large hail(size:≥2.54 cm)in the central US(CUS)over the 20-year period of 2001–20 using the machine learning(ML),Random Forest(RF),and Extreme Gradient Boosting(XGB)methods.The developed RF and XGB models demonstrate high accuracy(>90%)and F1 scores of up to 0.78 in predicting large hail occurrences when WUS fires and CUS hailstorms coincide,particularly in four states(Wyoming,South Dakota,Nebraska,and Kansas).The key contributing variables identified from both ML models include the meteorological variables in the fire region(temperature and moisture),the westerly wind over the plume transport path,and the fire features(i.e.,the maximum fire power and burned area).The results confirm a linkage between WUS fires and severe weather in the CUS,corroborating the findings of our previous modeling study conducted on case simulations with a detailed physics model.
基金supported by the National Natural Science Foundation of China(Nos.32220103010,32192431,31722013)the National Key R&D Program of China(Nos.2023YFF1304201,2020YFA0608100)+1 种基金the Major Program of Institute of Applied EcologyChinese Academy of Sciences(No.IAEMP202201)。
文摘Extreme droughts are anticipated to have detrimental impacts on forest ecosystems,especially in water-limited regions,due to the influence of climate change.However,considerable uncertainty remains regarding the patterns in species-specific responses to extreme droughts.Here,we conducted a study integrating dendrochronology and remote sensing methods to investigate the mosaic-distributed maple-oak(native)natural forests and poplar plantations(introduced)in the Horqin Sandy Land,Northeast China.We assessed the impacts of extreme droughts on tree performances by measuring interannual variations in radial growth and vegetation index.The results showed that precipitation and self-calibrated palmer drought severity index(scPDSI)are the major factors influencing tree-ring width index(RWI)and normalized difference vegetation index(NDVI).The severe droughts between 2000 and 2004 resulted in reduced RWI in the three studied tree species as well as led to NDVI reductions in both the maple-oak natural forests and the poplar plantations.The RWI reached the nadir during the2000-2004 severe droughts and remained at low levels two years after the severe drought,creating a legacy effect.In contrast to the lack of significant correlation between RWI and scPDSI,NDVI exhibited a significant positive correlation with scPDSI indicating the greater sensitivity of canopy performance to droughts than radial growth.Furthermore,interspecific differences in RWI and NDVI responses were observed,with the fast-growing poplar species experiencing a more significant RWI decrease and more negative NDVI anomaly during severe droughts than native species,highlighting the species-specific trade-offs between drought resilience and growth rate.This study emphasizes the importance of combining tree-level radial growth with landscape-scale canopy remote sensing to understand forest resilience and response.Our study improves our understanding of forest responses to extreme drought and highlights species differences in climate responses,offering crucial insights for optimizing species selection in sustainable afforestation and forest management in water-limited regions under the influence of climate change.
文摘BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.
基金Supported by 2022 Fujian Medical University Qihang Fund General Project Plan,No.2022QH1120。
文摘BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.
基金the support of the Opening Fund of State Key Laboratory of Multiphase Flow in Power Engineering(SKLMF-KF-2102)。
文摘Accurate prediction of the frictional pressure drop is important for the design and operation of subsea oil and gas transporting system considering the length of the pipeline. The applicability of the correlations to pipeline-riser flow needs evaluation since the flow condition in pipeline-riser is quite different from the original data where they were derived from. In the present study, a comprehensive evaluation of 24prevailing correlation in predicting frictional pressure drop is carried out based on experimentally measured data of air-water and air-oil two-phase flows in pipeline-riser. Experiments are performed in a system having different configuration of pipeline-riser with the inclination of the downcomer varied from-2°to-5°to investigated the effect of the elbow on the frictional pressure drop in the riser. The inlet gas velocity ranges from 0.03 to 6.2 m/s, and liquid velocity varies from 0.02 to 1.3 m/s. A total of885 experimental data points including 782 on air-water flows and 103 on air-oil flows are obtained and used to access the prediction ability of the correlations. Comparison of the predicted results with the measured data indicate that a majority of the investigated correlations under-predict the pressure drop on severe slugging. The result of this study highlights the requirement of new method considering the effect of pipe layout on the frictional pressure drop.
文摘Highway safety researchers focus on crash injury severity,utilizing deep learning—specifically,deep neural networks(DNN),deep convolutional neural networks(D-CNN),and deep recurrent neural networks(D-RNN)—as the preferred method for modeling accident severity.Deep learning’s strength lies in handling intricate relation-ships within extensive datasets,making it popular for accident severity level(ASL)prediction and classification.Despite prior success,there is a need for an efficient system recognizing ASL in diverse road conditions.To address this,we present an innovative Accident Severity Level Prediction Deep Learning(ASLP-DL)framework,incorporating DNN,D-CNN,and D-RNN models fine-tuned through iterative hyperparameter selection with Stochastic Gradient Descent.The framework optimizes hidden layers and integrates data augmentation,Gaussian noise,and dropout regularization for improved generalization.Sensitivity and factor contribution analyses identify influential predictors.Evaluated on three diverse crash record databases—NCDB 2018–2019,UK 2015–2020,and US 2016–2021—the D-RNN model excels with an ACC score of 89.0281%,a Roc Area of 0.751,an F-estimate of 0.941,and a Kappa score of 0.0629 over the NCDB dataset.The proposed framework consistently outperforms traditional methods,existing machine learning,and deep learning techniques.
基金supported by the Health Commission of Hubei Province(No.WJ2023M005)Hubei Association of Pathophysiology(No.2021HBAP004).
文摘Objective Sepsis is considered a major cause of health loss in children and had high mortality and morbidity.Currently,there is no reliable model for predicting the prognosis of pediatric patients with sepsis.This study aimed to analyze the clinical characteristics of sepsis in children and assess the risk factors associated with poor prognosis in pediatric sepsis patients to identify timely interventions and improve their outcomes.Methods This study analyzed the clinical indicators and laboratory results of septic patients hospitalized in the Pediatric Intensive Care Unit of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,China,from January 1,2019,to December 31,2021.Risk factors for sepsis were identified by logistic regression analyses.Results A total of 355 children with sepsis were enrolled,with 333 children(93.8%)in the good prognosis group,and 22 children(6.2%)in the poor prognosis group.Among them,there were 255 patients(71.8%)in the sepsis group,and 100 patients(28.2%)in the severe sepsis group.The length of hospital stay in the poor prognosis group was longer than that in the good prognosis group(P<0.01).The levels of interleukin 1β(IL-1β)in the poor prognosis group were higher than those in the good prognosis group(P>0.05),and the platelet(PLT),albumin(ALB),and hemoglobin(Hb)levels were lower in the poor prognosis group(P<0.01).The IL-8 levels in the severe sepsis group were higher than those in the sepsis group(P<0.05).Multiple logistic regression analysis suggested that lower Hb levels,ALB levels,peak PLT counts,and higher IL-1βlevels were independent risk factors for poor prognosis in children with sepsis.Conclusion Lower Hb,ALB,and PLT counts and elevated IL-1βare independent risk factors for poor prognosis in children with sepsis.
基金supported by Natural Science Foundation of Gansu (No.21JR7RA111)CAS Light of West China Program (2020XBZG-XBQNXZ-A)the 2022 Major scientific Research Project Cultivation Plan of Northwest Normal University (WNU-LKZD2022-04).
文摘Global warming and frequent extreme drought events lead to tree death and extensive forest decline,but the underlying mechanism is not clear.In drought years,cambial development is more sensitive to climate change,but in different phenological stages,the response rela-tionship is nonlinear.Therefore,the dynamic relationship between tree radial growth and climatic/environmental fac-tors needs to be studied.We thus continuously monitored radial growth of Qinghai spruce(Picea crassifolia Kom.)and environmental factors from January 2021 to November 2022 using point dendrometers and portable meteorological weather stations in the central area of the Qilian Mountains.The relationship and stability between the radial growth of Qinghai spruce and environmental factors were compared for different levels of drought in 2021 and 2022.The year 2022 had higher temperatures and less precipitation and was drier than 2021.Compared with 2021,the growing period in 2022 for Qinghai spruce was 10 days shorter,maximum growth rate(Grmax)was 4.5μm·d^(-1) slower,and the initiation of growth was 6 days later.Growth of Qinghai spruce was always restricted by drought,and the stem radial increment(SRI)was more sensitive to precipitation and air relative humidity.Seasonal changes in cumulative radial growth were divided into four phenological stages according to the time of growth onset,cessation,and maximum growth rate(Grmax)of Qinghai spruce.Stability responses of SRI to climate change were stronger in Stage 3 and Stage 4 of 2021 and stronger in Stage 1(initiation growth stage)and Stage 3 of 2022.The results provide important information on the growth of the trees in response to drought and for specific managing forests as the climate warms.
文摘The superplastic behavior and associated deformation mechanisms of a fine-grained Mg-10.1 Li-0.8Al-0.6Zn alloy(LAZ1011)with a grain size of 3.2μm,primarily composed of the BCCβphase and a small amount of the HCPαphase,were examined in a temperature range of 473 K to 623 K.The microstructural refinement of this alloy was achieved by employing high-ratio differential speed rolling.The best superplasticity was achieved at 523 K and at strain rates of 10^(-4)-5×10^(-4)s^(-1),where tensile elongations of 550±600%were obtained.During the heating and holding stage of the tensile samples prior to tensile loading,a significant increase in grain size was observed at temperatures above 573 K.Therefore,it was important to consider this effect when analyzing and understanding the superplastic deformation behavior and mechanisms.In the investigated strain rate range,the superplastic flow at low strain rates was governed by lattice diffusion-controlled grain boundary sliding,while at high strain rates,lattice diffusion-controlled dislocation climb creep was the rate-controlling deformation mechanism.It was concluded that solute drag creep is unlikely to occur.During the late stages of deformation at 523 K,it was observed that grain boundary sliding led to the agglomeration of theαphase,resulting in significant strain hardening.Deformation mechanism maps were constructed forβ-Mg-Li alloys in the form of 2D and 3D formats as a function of strain rate,stress,temperature,and grain size,using the constitutive equations for various deformation mechanisms derived based on the data of the current tests.
文摘Chronic heart failure(CHF)is a clinical syndrome manifested by reduced pumping ability of the heart,increased pressure in heart chambers in both physical activity and at rest.The symptoms of this syndrome are dyspnea,undue fatigability,peripheral edema,which follow structural and functional changes of the myocardium.[1]The growing incidence of CHF,especially among elderly people,is an urgent problem for medicine in the vast majority of industrialized countries.For instance,in Russian Federation,CHF is diagnosed in about 7%of cardiovascular patients.At the same time,this indicator varies from 0.3%in young people(20-29 years old)to 70%in the older age group.[2,3].