Optic nerve sheath diameters in nontraumatic brain injury:A scoping review and role in the intensive care unit

BACKGROUND Neuromonitoring in medical intensive care units is challenging as most patients are unfit for invasive intracranial pressure(ICP)modalities or unstable to transport for imaging.Ultrasonography-based optic nerve sheath diameter(ONSD)is an attractive option as it is reliable,repeatable and easily performed at the bedside.It has been sufficiently validated in traumatic brain injury(TBI)to be incorporated into the guidelines.However,currently the data for non-TBI patients is inconsistent for a scientific recommendation to be made.AIM To compile the existing evidence for understanding the scope of ONSD in measuring ICP in adult non-traumatic neuro-critical patients.METHODS PubMed,Google Scholar and research citation analysis databases were searched for studies in adult patients with non-traumatic causes of raised ICP.Studies from 2010 to 2024 in English languages were included.RESULTS We found 37 articles relevant to our search.The cutoff for ONSD in predicting ICP varied from 4.1 to 6.3 mm.Most of the articles used cerebrospinal fluid opening pressure followed by raised ICP on computed tomography/magnetic resonance imaging as the comparator parameter.ONSD was also found to be a reliable outcome measure in cases of acute ischaemic stroke,intracerebral bleeding and intracranial infection.However,ONSD is of doubtful utility in septic metabolic encephalopathy,dysnatremias and aneurysmal subarachnoid haemorrhage.CONCLUSION ONSD is a useful tool for the diagnosis of raised ICP in non-traumatic neuro-critically ill patients and may also have a role in the prognostication of a subset of patients.

Pros and cons of continuous glucose monitoring in the intensive care unit

Diabetes mellitus affects people worldwide,and management of its acute complications or treatment-related adverse events is particularly important in critically ill patients.Previous reports have confirmed that hyperglycemia can increase the risk of mortality in patients cared in the intensive care unit(ICU).In addition,severe and multiple hypoglycemia increases the risk of mortality when using insulin or intensive antidiabetic therapy.The innovation of continuous glucose monitoring(CGM)may help to alert medical caregivers with regard to the development of hyperglycemia and hypoglycemia,which may decrease the potential complications in patients in the ICU.The major limitation of CGM is the measurement of interstitial glucose levels rather than real-time blood glucose levels;thus,there will be a delay in the treatment of hyperglycemia and hypoglycemia in patients.Recently,the European Union approved a state-of-art artificial intelligence directed loop system coordinated by CGM and a continuous insulin pump for diabetes control,which may provide a practical way to prevent acute adverse glycemic events related to antidiabetic therapy in critically ill patients.In this mini-review paper,we describe the application of CGM to patients in the ICU and summarize the pros and cons of CGM.

Intensity Retrieved from Public Monitoring Video——Cases from the May 12,2008,Wenchuan Earthquake

Macroseismic investigation is presented with a new potential means of investigation in the "digital age". In this paper we studied several cases in the May 12, 2008, Wenchuan M_S8.0 earthquake with a view to exploring the feasibility of retrieving intensity, or even strong ground motion parameters, from public monitoring video which was originally deployed for security purposes. We used public monitoring video records from 44 sites across the meizoseismal region and its surroundings to estimate the intensity. By using the video from a bank in Dujiangyan, Sichuan Province and making the simple assumption that ground vibration is in the form of a propagating harmonic wave, we estimated that the local ground motion acceleration was 0.14g.

Monitoring Forest Recovery in Protected Forests of Northern Côte d’Ivoire Using Landsat Imagery and Intensity Change Analysis

In this paper, the initiatives of reforestation of the national forests of the North of the Côte d’Ivoire were examined using geomatics and the analysis of change of intensity by taking the case of the protected Forest of Badénou (PFB). A spatial analysis based on multi-spectral and multi-temporal Landsat imagery was carried out to assess land cover changes in the (PFB) over the past two decades and determine whether patterns of change in terms of the intensity of gains/losses of each of the land cover classes were active or dormant between the period before (2000-2013) and after (2013-2019) the reforestation initiative. Five main classes were identified: forest (dry deciduous and gallery forests), tree savannah, shrub/grassy savannah (including agricultural lands), bare lands (bare soils and degraded land areas), and water course. All classes were satisfactorily classified, with an excellent producer’s and user’s and overall accuracies and very good Kappa coefficients. The results showed that between 2000 and 2019, the forest cover in the PFB increased from 7778 ha to 5054 ha, a decrease was marked between 2000 and 2013 of approximately 60% compared to its size in 2000, while a slight increase between 2013 and 2019 (4645 ha to 5054 ha) i.e. around 9%) certainly due to the reforestation since 2016. As for the annual intensities of change for each class in both study periods, changes (gain or loss) in forest and tree savanna were relatively dormant after reforestation, while annual bare land gain was relatively active and marked, indicating that degradation of forests remains a threat to the sustainability of the PFB. Forest degradation has occurred mainly in the eastern parts of the PFB, while the central parts have regained more tree cover. These results can help identify conservation and restoration priorities and improve the overall management of the PFB.

Analysis of the Risk of Water Breakout in the Bottom Plate of High-Intensity Mining of Extra-Thick Coal Seams

In order to clarify the danger of water breakout in the bottom plate of extra-thick coal seam mining, 2202 working face of a mine in the west is taken as the research object, and it is proposed to use the on-site monitoring means combining borehole peeping and microseismic monitoring, combined with the theoretical analysis to analyze the danger of water breakout in the bottom plate. The results show that: 1) the theoretically calculated maximum damage depth of the bottom plate is 27.5 m, and its layer is located above the Austrian ash aquifer, which has the danger of water breakout;2) the drill hole peeping at the bottom plate of the working face shows that the depth of the bottom plate fissure development reaches 26 m, and the integrity of the water barrier layer has been damaged, so there is the risk of water breakout;3) for the microseismic monitoring of the anomalous area, the bottom plate of the return air downstream channel occurs in the field with a one-week lag, which shows that microseismic monitoring events may reflect the water breakout of the underground. This shows that the microseismic monitoring events can reflect the changes of the underground flow field, which can provide a reference basis for the early warning of water breakout. The research results can provide reference for the prediction of sudden water hazard.

ADCP application for long-term monitoring of coastal water

Three kind of application of ADCP is reported for long-term monitoring in coastal sea.(1)The routine monitoring of water qualities. The water quality and ADCP echo data (600 kHz) observed in the long-term are analgzed at MT (Marine Tower) Station of Kansai International Airport in the Osaka Bay, Japan. The correlation between the turbidity and echo intensity in the surface layer is not good because air bubbles generated by breaking wave are not detected by the turbidity meter, but detected well by ADCP. When estimating the turbidity consists of plankton population from echo intensity, the effect of bubbles have to be eliminated. (2) Monitoring stirring up of bottom sediment. The special observation was carried out by using following two ADCP in the Osaka Bay, One ADCP was installed upward on the sea. The other ADCP was hanged downward at the gate type stand about 3 m above from the bottom. At the spring tide, high echo intensities indicating the stirring up of bottom sediment were observed. (3) The monitoring for the boundary condition of water mixing at an estuary. In summer season, the ADCP was set at the mouth of Tanabe Bay in Wakayama Prefecture, Japan. During the observation, water temperature near the bottom showed remarkable falls with interval of about 5-7 d. When the bottom temperature fell, the inflow current with low echo intensity water appears at the bottom layer in the ADCP record. It is concluded that when occasional weak northeast wind makes weak coastal upwelling at the mouth of the bay, the combination of upwelling with internal tidal flow causes remarkable water exchange and dispels the red tide.

Fire monitoring in coal mines using wireless underground sensor network and interval type-2 fuzzy logic controller

From the view of underground coal mining safety system, it is extremely important to continuous monitoring of coal mines for the prompt detection of fires or related problems inspite of its uncertainty and imprecise characteristics. Therefore, evaluation and inferring the data perfectly to prevent fire related accidental risk in underground coal mining (UMC) system are very necessary. In the present article, we have proposed a novel type-2 fuzzy logic system (T2FLS) for the prediction of fire intensity and its risk assessment for risk reduction in an underground coal mine. Recently, for the observation of underground coal mines, wireless underground sensor network (WUSN) are being concerned frequently. To implement this technique IT2FLS, main functional components are sensor nodes which are installed in coal mines to accumulate different imprecise environmental data like, temperature, relative humidity, different gas concentrations etc. and these are sent to a base station which is connected to the ground observation system through network. In the present context, a WUSN based fire monitoring system is developed using fuzzy logic approach to enhance the consistency in decision making system to improve the risk chances of fire during coal mining. We have taken Mamdani IT2FLS as fuzzy model on coal mine monitoring data to consider real-time decision making (DM). It is predicted from the simulated results that the recommended system is highly acceptable and amenable in the case of fire hazard safety with compared to the wired and off-line monitoring system for UMC. Legitimacy of the suggested model is prepared using statistical analysis and multiple linear regression analysis.

Air Pollution Concentration Approach to Potential Area Selection of the Air Quality Monitoring Station in Nakhon Ratchasima Municipality, Thailand

The purpose of the study is to generate traffic air information system） to determine a proper zone of AQMS （air analyzed were carbon monoxide （CO）, and nitrogen oxides （NOx） pollution map using mathematical model and GIS （geographic quality monitoring station） in municipality area. The pollutants which can be harmful to people living in the area. The three steps of mapping process were performed under the GIS environment using the existing vehicle emission rates and pollutant dispersion model. First, traffic volume, road network, and the emission rates of road segments varying with types of vehicle were collected from existing data. Second, the pollutant concentrations were calculated by use of CALINE4, a tool with Gaussian dispersion model. The model parameters include emission rate, wind directions and speeds, ambient temperature and observed pollutant concentration, and atmospheric stability during all seasons from the January 1, 2010 to May 31,2011 with regardless the rainy season. This resulted in concentrations at many receptor points along links of the road network. Third, distributions of pollution concentrations were generated by means of the spatial interpolation of those from receptors. The results of pollution raster-based maps are used for determining frequency of violence and combined pollution map. The resulting frequency of violence and intensity concentration will be further integrated to determine a potential area of AQMS. Finally, achieving pollution potential area of AQMS can be located as helpful basic data for efficient traffic and transportation planning.

Analysis of electro-optical intensity modulator for bunch arrival-time monitor at SXFEL

A bunch arrival-time monitor(BAM) based on an electro-optical intensity modulation scheme is currently under development at Shanghai Soft X-ray Free-Electron Laser to meet the high-resolution requirements for bunch stability. The BAM uses a radio frequency signal generated by a pickup cavity to modulate the reference laser pulses in an electro-optical intensity modulator(EOM), and the bunch arrival-time information is derived from the amplitude change of the laser pulse after laser pulse modulation.EOM is a key optical component in the BAM system.Through the basic principle analysis of BAM, many parameters of the EOM are observed to affect the measurement resolution of the BAM system. Therefore, a systematic analysis of the EOM is crucial. In this paper, we present two schemes to compare and analyze an EOM and provide a reference for selecting a new version of the EOM.

Models for Predicting the Jet Trajectory and Intensity Drop Point of Fire Monitors

Two models are defined for predicting the trajectory of a foam jet originating from a fire monitor(hydrant)and the related intensity drop point.An experimental framework is also defined and used accordingly to compare real-time data with the predictions of such models.This mixed theoretical-experimental approach is proven to be effective for the determination of otherwise unknown coefficients which take into account several important factors such as the operation pressure,the elevation angle and the nozzle diameter.It is shown that the mean absolute error is smaller than 20%.

What,why and how to monitor blood glucose in critically ill patients

Critically ill patients are prone to high glycemic variations irrespective of their diabetes status.This mandates frequent blood glucose(BG)monitoring and regulation of insulin therapy.Even though the most commonly employed capillary BG monitoring is convenient and rapid,it is inaccurate and prone to high bias,overestimating BG levels in critically ill patients.The targets for BG levels have also varied in the past few years ranging from tight glucose control to a more liberal approach.Each of these has its own fallacies,while tight control increases risk of hypoglycemia,liberal BG targets make the patients prone to hyperglycemia.Moreover,the recent evidence suggests that BG indices,such as glycemic variability and time in target range,may also affect patient outcomes.In this review,we highlight the nuances associated with BG monitoring,including the various indices required to be monitored,BG targets and recent advances in BG monitoring in critically ill patients.

动态气囊内压力监测联合专项呼吸道强化干预在婴幼儿法洛四联症术后中的应用

目的研究动态气囊内压力监测联合专项呼吸道强化干预在婴幼儿法洛四联症术后护理中的应用效果。方法前瞻性选取2021年1月至2022年12月河南省人民医院儿童心脏中心重症监护室收治的86例婴幼儿法洛四联症术后机械通气患儿为研究对象,根据随机数字表法分为观察组(43例)与对照组(43例),对照组接受常规护理干预,观察组在此基础上接受动态气囊内压力监测联合专项呼吸道强化干预。比较两组患儿术后恢复情况(机械通气时间、术后监护时间、住院时间)、呼吸系统相关并发症发生情况;比较两组干预前后血气指标[血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))];比较两组术后48 h儿童疼痛行为量表(FLACC);比较两组出院当天生存质量[儿童生存质量测定量表系列心脏病模块(PedsQLTM 3.0)家长问卷]。结果观察组机械通气时间、术后监护时间、住院时间均短于对照组(P<0.05);观察组呼吸系统相关并发症总发生率低于对照组(P<0.05)。干预后,两组患儿SpO_(2)、PaO_(2)水平升高(P<0.05),且观察组高于对照组(P<0.05);两组患儿PaCO_(2)水平降低(P<0.05),且观察组低于对照组(P<0.05)。术后48 h,观察组表情、肢体动作、行为维度评分比较差异无统计学意义(P>0.05),观察组哭闹、可安慰性、FLACC总分低于对照组(P<0.05);出院当天,观察组PedsQLTM 3.0家长问卷各维度评分高于对照组(P<0.05)。结论动态气囊内压力监测联合专项呼吸道强化干预有助于改善婴幼儿法洛四联症术后动脉血气水平,降低呼吸系统相关并发症发生率,提高患儿短期生存质量。

全院一体化重症监护管理信息系统的构建与应用

目的探讨以患者为中心的医院一体化重症监护管理信息系统的构建与应用成效。方法通过JH Framework框架搭建应用程序,采用Widget-Canvas封装功能,通过ClickOnce技术更新部署,实现监护仪、呼吸机等生命支持设备体征数据的自动采集、传输、存储、分析,实现重症患者一体化管理。结果系统应用后,重症医学科医嘱执行规范率提升至99.90%,呼吸与危重症医学科提升至99.50%(P<0.05);呼吸与危重症医学科护理文书书写合格率由98.18%上升至99.71%(P<0.05);重症医学科不良事件发生率由1.80%下降至0.56%,呼吸与危重症医学科不良事件发生率由0.32%下降至0.15%。结论该系统可以减轻医护人员手工录入、转抄工作量,降低不良事件发生率,有效规范重症电子病历文书,提高患者生命支持设备数据利用率,提升重症监护一体化和数字化管理水平。

基于地理国情监测数据的景观生态评价研究

本文以黄河三角洲国家级自然保护区作为研究对象,应用景观生态学理论,提出基于地理国情监测数据的人为干扰度划分方法,选取合适指标,构建景观生态评价指标体系。本文以500 m×500 m格网作为评价单元,采用2015―2020年六期地理国情监测数据,运用熵权法确定单个指标的权重,得到景观生态安全指数(LESI),并从空间和时间维度对保护区内景观生态情况进行分析评价。研究结果表明,2015―2020年期间,保护区的景观生态状况得到逐步改善,尤其是2020年,不仅生态安全指数全部提升到良好及以上水平,空间分布也呈现出更好的趋势。

短距离无线微波链路降雨反演模型研究

利用商用微波链路进行降雨反演是一种新型的降雨监测手段,且随着通信技术的发展,高密度的商用微波链路网络可提供更高空间分辨率的降雨空间反演结果。目前,幂律模型被广泛用于研究微波衰减与雨率的关系,该模型对长度超过1 km的链路反演精度较高,但在反演短链路(长度<1 km)雨强时出现显著的降雨强度过高估计问题。针对此问题,本文基于ITU-R P.530-16建议书中长期雨衰减公式,建立了雨强反演模型。在瑞典哥德堡地区对该模型进行了验证,并对比分析了本文模型与幂律模型降雨反演结果。结果表明,相比于幂律模型,本文模型在对短链路进行雨强反演时更稳定、精确,确定性系数提升了55.3%,标准化均方根误差下降了76.2%,累计降雨量误差下降了92.4%。本文研究结果为短链路在反演降雨时出现的过高估计问题提供了一个解决思路。

一种华北夏季潜势雨季监测方法

针对华北夏季雨季监测存在的难题,提出了华北夏季潜势雨季概念,并建立了一种新监测方法——比湿副高法。主要监测结果如下:1961—2022年平均华北夏季雨季开始日期为7月10日,结束日期为8月8日,雨季长度为28 d;华北雨季起止时间无明显长期变化趋势,但年代际变化明显。该方法监测到的华北夏季雨季降水量、雨季综合强度指数与夏季降水量变化非常一致,为高度正相关,表明监测到的各雨季参数对华北夏季降水变化具有很好的指示性。华北夏季雨季开始、结束伴随着大气环流的明显变化:850 hPa层东亚副热带夏季风增强与减弱、30°N以北华北地区大气比湿迅速增大与减小;500 hPa层高度场在华北地区出现正、负距平中心,西北太平洋副热带高压在东亚沿岸开始明显北抬或东撤;200 hPa层高空西风急流轴由37.5°N附近北移到41.5°N附近或由44.5°N附近南移到40.5°N附近。

NICOM联合重症护理超声在心脏术后容量管理中的应用

目的 探讨无创心排血量监测(noninvasive cardiac output monitoring,NICOM)联合重症护理超声在心脏术后合并血流动力学紊乱患者容量管理中的应用效果。方法 选取2021年1月至10月浙江省人民医院收治的心脏手术后出现血流动力学紊乱的91例患者为研究对象,根据随机数字法将其分为对照组(n=46)和观察组(n=45)。对照组患者采取传统的血流动力学监测方法指导液体管理;观察组患者实施NICOM联合重症护理超声为基础的容量管理策略指导液体管理。比较两组患者的术后拔除气管插管时间、左室射血分数(left ventricular ejection fraction,LVEF)、脑钠肽(brain natriuretic peptide,BNP)、术后乳酸恢复正常时间、利尿剂使用率、术后尿量、急性心力衰竭发生率、主动脉内球囊反搏留置率、机械通气时间和重症监护病房(intensive care unit,ICU)停留时间。结果 观察组术后24h内顺利拔管的患者占比显著高于对照组(χ^(2)=14.773,P=0.001)。出科时,两组患者的LVEF均显著高于本组入科时,BNP均显著低于本组入科时(P<0.05);观察组患者的LVEF显著高于对照组,BNP显著低于对照组(P<0.05)。观察组患者的乳酸恢复正常时间、机械通气时间和ICU停留时间均显著短于对照组;利尿剂使用率、液体累积平衡量、急性心力衰竭发生率均显著低于对照组;术后尿量显著多于对照组(P<0.05)。结论 基于NICOM联合重症护理超声的容量管理策略可显著减少心脏术后合并血流动力学紊乱患者的补液量,改善心功能,缩短机械通气时间,值得临床推广应用。

聚焦超声换能器电阻抗谱实时在线监测系统

高强度聚焦超声(HIFU)换能器作为聚焦超声消融手术(FUAS)系统的核心部件,其电阻抗谱是确定FUAS系统工作参数的重要参考依据,故对其进行实时在线监测具有重要意义。该文采用脉冲响应时域测量方法,将探测脉冲信号与HIFU换能器的工作时序相融合,并基于LabVIEW平台构建了一套HIFU换能器电阻抗谱实时在线监测系统,实现了对HIFU换能器电阻抗幅值与相位的高重复性及准确性的实时测量。通过对长时工作在大功率、高占空比条件下HIFU换能器电阻抗谱的实时在线监测,表明该监测系统可准确反应HIFU换能器的特征频率漂移、阻抗幅值和相位的非线性变化。这为HIFU换能器电阻抗谱实时在线监测及驱动参数优化调节提供了技术方案,对HIFU换能器的设计优化和能量损耗机制研究具有重要的应用价值。

早期渐进性运动在重症监护病房危重患者床旁超声监测中的干预效果

目的 探讨早期渐进性运动在重症监护病房(ICU)危重患者床旁超声监测中的干预效果。方法 对2020年1月至2022年1月在贵港市人民医院急诊ICU、重症医学科住院的120例行机械通气患者的一般资料进行回顾分析,2组均予以基础治疗和常规护理,根据随机数字表法将其分为对照组(60例,常规康复训练)和观察组(60例,常规康复训练+早期渐进性运动)2组。对比2组在住院期间的呼吸机相关性肺炎(VAP)发生率、呼吸肌功能、肌肉参数、肌力和握力水平。结果 观察组的机械通气、ICU及总住院时间均短于对照组,VAP发生率低于对照组(P均<0.05)。入住ICU 48 h后,观察组的咳嗽峰流速、最大吸气压力水平均高于对照组(P均<0.05)。入住ICU的1周和转出ICU时,观察组的股直肌横截面积、股直肌厚度、股中间肌厚度、胫骨前肌肌肉厚度、肱二头肌厚度、桡侧腕屈肌厚度值均大于同期对照组,英国医学研究委员会量表评分和握力均较同期对照组更优(P均<0.05)。结论 早期渐进性运动在ICU危重患者床旁超声监测中的干预效果显著,可有效减少患者的ICU住院时间,减少VAP的发生,改善其呼吸肌功能,提升其肌肉厚度、肌群肌力和握力水平。