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

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

Intranasal administration of stem cell-derived exosomes for central nervous system diseases

Exosomes,lipid bilayer-enclosed small cellular vesicles,are actively secreted by various cells and play crucial roles in intercellular communication.These nanosized vesicles transport internalized proteins,mRNA,miRNA,and other bioactive molecules.Recent findings have provided compelling evidence that exosomes derived from stem cells hold great promise as a therapeutic modality for central nervous system disorders.These exosomes exhibit multifaceted properties including antiapoptotic,anti-inflammatory,neurogenic,and vasculogenic effects.Furthermore,exosomes offer several advantages over stem cell therapy,such as high preservation capacity,low immunogenicity,the ability to traverse the blood-brain barrier,and the potential for drug encapsulation.Consequently,researchers have turned their attention to exosomes as a novel therapeutic avenue.Nonetheless,akin to the limitations of stem cell treatment,the limited accumulation of exosomes in the injured brain poses a challenge to their clinical application.To overcome this hurdle,intranasal administration has emerged as a non-invasive and efficacious route for delivering drugs to the central nervous system.By exploiting the olfactory and trigeminal nerve axons,this approach enables the direct transport of therapeutics to the brain while bypassing the blood-brain barrier.Notably,exosomes,owing to their small size,can readily access the nerve pathways using this method.As a result,intranasal administration has gained increasing recognition as an optimal therapeutic strategy for exosomebased treatments.In this comprehensive review,we aim to provide an overview of both basic and clinical research studies investigating the intranasal administration of exosomes for the treatment of central nervous system diseases.Furthermore,we elucidate the underlying therapeutic mechanisms and offer insights into the prospect of this approach.

Equilibrium Strategy of the Pursuit-Evasion Game in Three-Dimensional Space

The pursuit-evasion game models the strategic interaction among players, attracting attention in many realistic scenarios, such as missile guidance, unmanned aerial vehicles, and target defense. Existing studies mainly concentrate on the cooperative pursuit of multiple players in two-dimensional pursuit-evasion games. However, these approaches can hardly be applied to practical situations where players usually move in three-dimensional space with a three-degree-of-freedom control. In this paper,we make the first attempt to investigate the equilibrium strategy of the realistic pursuit-evasion game, in which the pursuer follows a three-degree-of-freedom control, and the evader moves freely. First, we describe the pursuer's three-degree-of-freedom control and the evader's relative coordinate. We then rigorously derive the equilibrium strategy by solving the retrogressive path equation according to the Hamilton-Jacobi-Bellman-Isaacs(HJBI) method, which divides the pursuit-evasion process into the navigation and acceleration phases. Besides, we analyze the maximum allowable speed for the pursuer to capture the evader successfully and provide the strategy with which the evader can escape when the pursuer's speed exceeds the threshold. We further conduct comparison tests with various unilateral deviations to verify that the proposed strategy forms a Nash equilibrium.

Green-washing America’s Hegemony:Biden Administration’s Military Climate Strategy and Its Impact

Since coming to office,the Biden administration has made climate a fundamental element of US foreign policy and national security.From September 2021 to October 2022,the US Department of Defense and its subordinate Departments of the Army,Navy and Air Force issued their climate strategies successively,proposing specific goals and action paths,thus building an unprecedented set of policy systems to comprehensively address climate change.

Critical Minerals Strategy of the Biden Administration

Critical minerals closely relate to the economic,environmental,defense,and intergenerational resources security of the US and are therefore infuential in US economic recovery,industrial restructuring,scientifc and technological competition,national security,and strategy toward China.Since the Obama administration,the US has been increasingly focusing on its critical minerals strategy,as illustrated by its issuance of a series of related laws and executive orders and its eforts to advance the reform of relevant agencies.The Biden administration has increased the emphasis on supply chains for critical minerals that are vital to green and lowcarbon development and pushed for more coordination among government departments and agencies.Perceiving China as a competitor to the US,Joe Biden has announced large-scale investment and procurement measures at home and promoted institutional building in concerned sectors as part of efforts to counter China’s competitive advantages.Simultaneously,he has been developing a security strategy of and advocating supply chain alliances for critical minerals based on US allies.The critical minerals strategy of the Biden administration will greatly influence the stable development of China’s supply chains.In response,China should focus on forging a new type of international relations,with an aim to promote global resource governance and ensure the sustained security of its critical mineral supplies.

The Liberal Hawks and the China Strategy of the Biden Administration

Since the Biden administration came to power, the liberal hawks who uphold the liberal internationalist strategy have regained a significant influence on foreign affairs and national security, prioritized the repair of U.S. hegemony, and maintained strategic competition with China initiated by the Trump administration. When compared with the paradigm of competition of the Trump administration, the liberal hawks of the Biden administration have improved the strategic logic of competition with China and refined the relevant policy layout to render it compatible with the overall agenda of the Democratic Party. Enhancing strategic competition with China under the leadership of the liberal hawks has not been in the interests of China, the United States(U.S.), or the entire world. The healthy and stable development of China–U.S. relations requires additional rational and pragmatic policies from the side of the U.S.

The Biden Administration's Strategy of Economic Diplomacy

Since Biden took office as the US President,he has shifted his focus from the so-called“free market economy”to governmentled economic diplomacy.He builds exclusive economic alliances in the industrial chain,advanced technology,infrastructure and digital trade,with the fundamental purpose of forging a united front against China economically and changing the status quo of the global market by the hand of government.

The Biden Administration’s Scientific and Technological Competition Strategy toward China

Scientific and technological(S&T) competition has become a core and frontier issue in the ongoing China–U.S. strategic competition and the main focus of both countries. Currently, the Biden administration is adopting an S&T competition strategy toward China based on the “small yard, high fence” tactical logic, which involves three pillars: investment to make America strong, alignment to get things under control, and competition to weaken China. In the current context of the China–U.S. competition entering a new normal, five inherent contradictions, namely, the gap between strategic expectations and policy effects, shortfall between action capabilities and policy objectives, push-and-pull between strategic deployment and domestic politics, clash between strategic intentions and the S&T innovation ecosystem, and divergences between American priorities and the interests of American allies, will dictate how this administration will implement its S&T competition strategy toward China.

Space Strategy of the Trump Administration

Since the end of the Cold War, each US administration has promulgated its national space policy. In March 2018, the Trump administration published the outline of its National Space Strategy,1 which will not only reshape American space technology and space economy, but also have an important impact on global space governance.

An Analysis of the Biden Administration’s Pacific Partnership Strategy

The Pacific island countries(PICs)1 are located in the region China regards in its diplomacy of broader-sense bordering regions.It is also a key region in the US Indo-Pacific Strategy.The PICs have gained more importance in the US comprehensive strategic competition with China since Joe Biden became US president.

Interpretation of Chinese Expert Consensus on the Diagnosis and Management Strategy of Patients with Statin Intolerance: A guiding file for helping to lipid management for Chinese population

It is well-known that elevated low-density lipoprotein cholesterol(LDL-C)is a causal risk factor for atheroscler-otic cardiovascular disease(ASCVD),statins are cornerstone drugs for the cause-based treatment of ASCVD,which has created a new era for ASCVD therapy.However,statin intolerance is not clinically uncommon,which there are several issues with confu-sion and misunderstandings.Hence,a file named Chinese Expert Consensus on the Diagnosis and Management Strategy of Pa-tients With Statin Intolerance,like a navigator,has recently been published written by a team of experts from the Cardiovascular Metabolic Medicine Professional Committee,Expert Committee of the National Center for Cardiovascular Diseases aiming to en-hance the standardized clinical application of statins and improve the prevention and clinical outcome.In this article,author briefly summarized the key points of above consensus in order to helping to comprehending the content of the consensus sugges-tions.

New Trends in Japan's“Indo-Pacific”Strategy

Introduced by the late Prime Minister Shinzo Abe and inherited and developed by Fumio Kishida,Japan's“Indo–Pacific”strategy has gradually taken shape.This strategy can be deemed a broad vision,covering a wide range of topics and an extensive network of partners,with a strong trend of pan-securitization.It is a comprehensive inter national st rateg y based on Japan's alliance policy and China containment strategy,following a global,security-oriented approach.Driven by considerations such as maintaining its economic status,realizing its long-cherished dream of becoming a political powerhouse,and containing China,Japan has stepped up its“Indo–Pacific”strategy,which may influence global development,undermine regional maritime security,and impede China's reunification process.Meanwhile,Japan's“Indo–Pacific”strategy faces the triple challenge of a strategic overdraft,the unstable economic foundations,and the weak external support.These constraints may not suffice to reverse the direction of Japan's“Indo–Pacific”strategy in the short term but will limit its effectiveness.

The Caching and Pricing Strategy for Information-Centric Networking with Advertisers’Participation

As users’access to the network has evolved into the acquisition of mass contents instead of IP addresses,the IP network architecture based on end-to-end communication cannot meet users’needs.Therefore,the Information-Centric Networking(ICN)came into being.From a technical point of view,ICN is a promising future network architecture.Researching and customizing a reasonable pricing mechanism plays a positive role in promoting the deployment of ICN.The current research on ICN pricing mechanism is focused on paid content.Therefore,we study an ICN pricing model for free content,which uses game theory based on Nash equilibrium to analysis.In this work,advertisers are considered,and an advertiser model is established to describe the economic interaction between advertisers and ICN entities.This solution can formulate the best pricing strategy for all ICN entities and maximize the benefits of each entity.Our extensive analysis and numerical results show that the proposed pricing framework is significantly better than existing solutions when it comes to free content.

Making the Complicated Simple:A Minimizing Carrier Strategy on Innovative Nanopesticides

The flourishing progress in nanotechnology offers boundless opportunities for agriculture,particularly in the realm of nanopesticides research and development.However,concerns have been raised regarding the human and environmental safety issues stemming from the unrestrained use of non-therapeutic nanomaterials in nanopesticides.It is also important to consider whether the current development strategy of nanopesticides based on nanocarriers can strike a balance between investment and return,and if the complex material composition genuinely improves the efficiency,safety,and circularity of nanopesticides.Herein,we introduced the concept of nanopesticides with minimizing carriers(NMC)prepared through prodrug design and molecular self-assembly emerging as practical tools to address the current limitations,and compared it with nanopesticides employing non-therapeutic nanomaterials as carriers(NNC).We further summarized the current development strategy of NMC and examined potential challenges in its preparation,performance,and production.Overall,we asserted that the development of NMC systems can serve as the innovative driving force catalyzing a green and efficient revolution in nanopesticides,offering a way out of the current predicament.

Machine learning solution for regional landslide susceptibility based on fault zone division strategy

Landslide susceptibility assessment is an essential tool for disaster prevention and management. In areas with multiple fault zones, the impact of fault zone on slope stability cannot be disregarded. This study performed qualitative analysis of fault zones and proposed a zoning method to assess the landslide susceptibility in Chengkou County, Chongqing Municipality, China. The region within a distance of 1 km from the faults was designated as sub-zone A, while the remaining area was labeled as sub-zone B. To accomplish the assessment, a dataset comprising 388 historical landslides and 388 non-landslide points was used to train the random forest model. 10-fold cross-validation was utilized to select the training and testing datasets for the model. The results of the models were analyzed and discussed, with a focus on model performance and prediction uncertainty. By implementing the proposed division strategy based on fault zone, the accuracy, precision, recall, F-score, and AUC of both two sub-zones surpassed those of the whole region. In comparison to the results obtained for the whole region, sub-zone B exhibited an increase in AUC by 6.15%, while sub-zone A demonstrated a corresponding increase of 1.66%. Moreover, the results of 100 random realizations indicated that the division strategy has little effect on the prediction uncertainty. This study introduces a novel approach to enhance the prediction accuracy of the landslide susceptibility mapping model in areas with multiple fault zones.

Enhancing thermodynamic stability of single-crystal Ni-rich cathode material via a synergistic dual-substitution strategy

Nickel(Ni)-rich cathode materials have become promising candidates for the next-generation electrical vehicles due to their high specific capacity.However,the poor thermodynamic stability(including cyclic performance and safety performance or thermal stability)will restrain their wide commercial application.Herein,a single-crystal Ni-rich Li Ni_(0.83)Co_(0.12)Mn_(0.05)O_(2) cathode material is synthesized and modified by a dual-substitution strategy in which the high-valence doping element improves the structural stability by forming strong metal–oxygen binding forces,while the low-valence doping element eliminates high Li^(+)/Ni^(2+)mixing.As a result,this synergistic dual substitution can effectively suppress H2-H3 phase transition and generation of microcracks,thereby ultimately improving the thermodynamic stability of Ni-rich cathode material.Notably,the dual-doped Ni-rich cathode delivers an extremely high capacity retention of 81%after 250 cycles(vs.Li/Li+)in coin-type half cells and 87%after 1000 cycles(vs.graphite/Li^(+))in pouch-type full cells at a high temperature of 55℃.More impressively,the dual-doped sample exhibits excellent thermal stability,which demonstrates a higher thermal runaway temperature and a lower calorific value.The synergetic effects of this dual-substitution strategy pave a new pathway for addressing the critical challenges of Ni-rich cathode at high temperatures,which will significantly advance the high-energy-density and high-safety cathodes to the subsequent commercialization.

MTCR-CR Routing Strategy for Connection-Oriented Routing over Satellite Networks

The high-speed movement of satellites makes it not feasible to directly apply the mature routing scheme on the ground to the satellite network.DT-DVTR in the snapshot-based connectionoriented routing strategy is one of the representative solutions,but it still has room for improvement in terms of routing stability.In this paper,we propose an improved scheme for connection-oriented routing strategy named the Minimal Topology Change Routing based on Collaborative Rules(MTCR-CR).The MTCR-CR uses continuous time static topology snapshots based on satellite status to search for intersatellite link(ISL)construction solutions that meet the minimum number of topology changes to avoid route oscillations.The simulation results in Beidou-3 show that compared with DT-DVTR,MTCR-CR reduces the number of routing changes by about 92%,the number of path changes caused by routing changes is about38%,and the rerouting time is reduced by approximately 47%.At the same time,in order to show our algorithm more comprehensively,the same experimental index test was also carried out on the Globalstar satellite constellation.

Enhancing lead-free photovoltaic performance:Minimizing buried surface voids in tin perovskite films through weakly polar solvent pre-treatment strategy

Buried interfacial voids have always been a notorious phenomenon observed in the fabrication of lead perovskite films. The existence of interfacial voids at the buried interface will capture the carrier, suppress carrier transport efficiencies, and affect the stability of photovoltaic devices. However, the impact of these buried interfacial voids on tin perovskites, a promising avenue for advancing lead-free photovoltaics, has been largely overlooked. Here, we utilize an innovative weakly polar solvent pretreatment strategy(WPSPS) to mitigate buried interfacial voids of tin perovskites. Our investigation reveals the presence of numerous voids in tin perovskites during annealing, attributed to trapped dimethyl sulfoxide(DMSO) used in film formation. The WPSPS method facilitates accelerated DMSO evaporation, effectively reducing residual DMSO. Interestingly, the WPSPS shifts the energy level of PEDOT:PSS downward, making it more aligned with the perovskite. This alignment enhances the efficiency of charge carrier transport. As the result, tin perovskite film quality is significantly improved,achieving a maximum power conversion efficiency approaching 12% with only an 8.3% efficiency loss after 1700 h of stability tests, which compares well with the state-of-the-art stability of tin-based perovskite solar cells.

Impacts of bus holding strategy on the performance and pollutant emissions of a two-lane mixed traffic system

This paper investigates the impacts of a bus holding strategy on the mutual interference between buses and passenger cars in a non-dedicated bus route,as well as the impacts on the characteristics of pollutant emissions of passenger cars.The dynamic behaviors of these two types of vehicles are described using cellular automata(CA)models under open boundary conditions.Numerical simulations are carried out to obtain the phase diagrams of the bus system and the trajectories of buses and passenger cars before and after the implementation of the bus holding strategy under different probabilities of passenger cars entering a two-lane mixed traffic system.Then,we analyze the flow rate,satisfaction rate,and pollutant emission rates of passenger cars together with the performance of a mixed traffic system.The results show that the bus holding strategy can effectively alleviate bus bunching,whereas it has no significant impact on the flow rate and pollutant emission rates of passenger cars;the flow rate,satisfaction rate,and pollutant emission rates of passenger cars for either the traffic system or for each lane are influenced by the bus departure interval and the number of passengers arriving at bus stops.

Evolution of United States Technology Alliance Strategy and Reshaping of International Strategic Landscape

Building a technology alliance is the main strategy for the United States to maintain its scientific and technological hegemony under its technopolitical strategic framework.After Joe Biden took office,the United States implemented“small yard with high fences”strategy for scientific and technological competition,as the first step toward building a technology alliance.The main goal is to restrict the flow of strategic emerging technologies and factors of innovation to rival countries.