An early scoring system to predict mechanical ventilation for botulism: a single-center-based study

BACKGROUND: Early identification of patients requiring ventilator support will be beneficial for the outcomes of botulism. The present study aimed to establish a new scoring system to predict mechanical ventilation(MV) for botulism patients.METHODS: A single-center retrospective study was conducted to identify risk factors associated with MV in botulism patients from 2007 to 2022. Univariate analysis and multivariate logistic regression analysis were used to screen out risk factors for constructing a prognostic scoring system. The area under the receiver operating characteristic(ROC) curve was calculated.RESULTS: A total of 153 patients with botulism(66 males and 87 females, with an average age of 43 years) were included. Of these, 49 patients(32.0%) required MV, including 21(13.7%) with invasive ventilation and 28(18.3%) with non-invasive ventilation. Multivariate analysis revealed that botulinum toxin type, pneumonia, incubation period, degree of hypoxia, and severity of muscle involvement were independent risk factors for MV. These risk factors were incorporated into a multivariate logistic regression analysis to establish a prognostic scoring system. Each risk factor was scored by allocating a weight based on its regression coefficient and rounded to whole numbers for practical utilization([botulinum toxin type A: 1], [pneumonia: 2], [incubation period ≤1 day: 2], [hypoxia <90%: 2], [severity of muscle involvement: grade Ⅱ, 3;gradeⅢ, 7;grade IV, 11]). The scoring system achieved an area under the ROC curve of 0.82(95% CI 0.75–0.89, P<0.001). At the optimal threshold of 9, the scoring system achieved a sensitivity of 83.7% and a specificity of 70.2%.CONCLUSION: Our study identified botulinum toxin type, pneumonia, incubation period, degree of hypoxia, and severity of muscle involvement as independent risk factors for MV in botulism patients. A score ≥9 in our scoring system is associated with a higher likelihood of requiring MV in botulism patients. This scoring system needs to be validated externally before it can be applied in clinical settings.

PERIODIC SYSTEMS WITH TIME DEPENDENT MAXIMAL MONOTONE OPERATORS

We consider a first order periodic system in R^(N),involving a time dependent maximal monotone operator which need not have a full domain and a multivalued perturbation.We prove the existence theorems for both the convex and nonconvex problems.We also show the existence of extremal periodic solutions and provide a strong relaxation theorem.Finally,we provide an application to nonlinear periodic control systems.

A Brief Introduction to the English Periodical of Contemporary Social Sciences

The English periodical of Contemporary Social Sciences is an English periodical founded by Sichuan Academy of Social Sciences and is published every two months.It was approved by the National Radio and Television Administration of the People’s Republic of China(formerly the State Administration of Press,Publication,Radio,Film and Television of the People’s Republic of China)in March 2016.

Effect of temperature gradientinduced periodic deformation of CRTS Ⅲ slab track on dynamic responses of the train-track system

Purpose-Temperature is an important load for a ballastless track.However,little research has been conducted on the dynamic responses when a train travels on a ballastless track under the temperature gradient.The dynamic responses under different temperature gradients of the slab are theoretically investigated in this work.Design/methodology/approach-Considering the moving train,the temperature gradient of the slab,and the gravity of the slab track,a dynamic model for a high-speed train that runs along the CRTS Ⅲ slab track on subgrade is developed by a nonlinear coupled way in Abaqus.Findings-The results are as follows:(1)The upward transmission of the periodic deformation of the slab causes periodic track irregularity.(2)Because of the geometric constraint of limiting structures,the maximum bending stresses of the slab occur near the end of the slab under positive temperature gradients,but in the middle of the slab under negative temperature gradients.(3)The periodic deformation of the slab can induce periodic changes in the interlayer stiffness and contact status,leading to a large vibration of the slab.Because of the vibration-reduction capacity of the fastener and the larger mass of the concrete base,the accelerations of both the slab and concrete base are far less than the acceleration of the rail.Originality/value-This study reveals the influence mechanism of temperature gradient-induced periodic deformation in the dynamic responses of the train-track system,and it also provides a guide for the safe service of CRTS Ⅲ slab track.

A Case Study of Periodical Terminologies’Mis-translations in History of Chinese Journalism by Ko Kung-chen under Analysis-Synthesis Translation Mode

From the perspective of analysis-synthesis translation mode,this paper discusses the translator’s responsibility and the translator’s role in the translation of historiography,based on the case of Ko Kung-chen’s History of Chinese Journalism.Missionary J.S.Roberts believed that translation is the logical combination of two processes of analysis and synthesis.The analysis process is characterized by understanding,emphasizing accurate understanding and professional analysis of the source text,while the synthesis process focuses on the transformation of language and culture.The two processes are dependent,forming the whole process of translation altogether.As the indisputable subject of translation,the translator should assume his own subjective responsibility in the two processes.The translator should be responsible for the fact and professional academics in the analysis process,and language and culture and translation itself in the synthesis process,playing the role of a reviewer,disseminator and translator to ensure that the translation text would be correct,accurate and professional so as to realize the value of himself and translation.

Propagation Dynamics of Forced Pulsating Waves for a Time Periodic Lotka-Volterra Cooperative System with Nonlocal Effects in Shifting Habitats

In this paper, we will concern the existence, asymptotic behaviors and stability of forced pulsating waves for a Lotka-Volterra cooperative system with nonlocal effects under shifting habitats. By using the alternatively-coupling upper-lower solution method, we establish the existence of forced pulsating waves, as long as the shifting speed falls in a finite interval where the endpoints are obtained from KPP-Fisher speeds. The asymptotic behaviors of the forced pulsating waves are derived. Finally, with proper initial, the stability of the forced pulsating waves is studied by the squeezing technique based on the comparison principle.

Global stabilization of linear periodically time-varying switched systems via matrix inequalities

In this paper, we address the stabilization problem for linear periodically time-varying switched systems. Using discretization technique, we derive new conditions for the global stabilizability in terms of the solution of matrix inequalities. An algorithm for finding stabilizing controller and switching strategy is presented.

Weak-Coupling Theory for Semiclassical Periodically Driven Two-Level Systems： Beyond Rotating-Wave Approximation

We present a weak-coupling theory of semiclassical periodically driven two-level systems. The explicit analytical approximating solution is shown to reproduce highly accurately the exact results well beyond the regime of the rotating-wave approximation.

NUMERICALLY SOLVING PERIODICALLY PERTURBED CONSERVATIVE SYSTEMS BY PARAMETER EMBEDDING METHODS

The parameter embedding method is applied for numerically solving the perturbed conservative systems. By means of Newtonian iteration, a simple algorithm has been constructed. Finally, the convergence of the iteration is proved.

A METHOD FOR CALCULATING THE LYAPUNOV EXPONENT SPECTRUM OF A PERIODICALLY EXCITED NON-AUTONOMOUS DYNAMICAL SYSTEM

The relation between the Lyapunov exponent spectrum of a periodically excited non-autonomous dynamical system and the Lyapunov exponent spectrum of the corresponding autonomous system is given and the validity of the relation is verified theoretically and computationally. A direct method for calculating the Lyapunov exponent spectrum of non-autonomous dynamical systems is suggested in this paper, which makes it more convenient to calculate the Lyapunov exponent spectrum of the dynamical system periodically excited. Following the definition of the Lyapunov dimension D-L((A)) of the autonomous system, the definition of the Lyapunov dimension D-L of the non-autonomous dynamical system is also given, and the difference between them is the integer 1, namely, D-L((A)) - D-L = 1. For a quasi-periodically excited dynamical system, similar conclusions are formed.

Effect of Dexmedetomidine on Maintaining Perioperative Hemodynamic Stability in Elderly Patients:A Systematic Review and Meta-analysis

Objective Dexmedetomidine is a highly selective alpha-2 adrenergic receptor agonist with sedative and analgesic properties but without respiratory depression effect and has been widely used in perioperative anesthesia.Here we performed a systematic review and meta-analysis to evaluate the effect of dexmedetomidine on maintaining perioperative hemodynamic stability in elderly patients.Methods PubMed,Web of Science,the Cochrane Library,China National Knowledge Infrastructure(CNKI),and Wanfang Data were searched for randomized-controlled trials(RCTs)on the application of dexmedetomidine in maintaining perioperative hemodynamic stability in elderly patients from their inception to September,2021.The standardized mean differences(SMD)with 95%confidence interval(CI)were employed to analyze the data.The random-effect model was used for the potential clinical inconsistency.Results A total of 12 RCTs with 833 elderly patients(dexmedetomidine group,546 patients;control group,287 patients)were included.There was no significant increase in perioperative heart rate(HR),mean arterial pressure(MAP),and diastolic blood pressure(DBP)in the dexmedetomidine group before and during the operation.In addition,the variations of hemodynamic indexes including HR,MAP,SBP(systolic blood pressure),and DBP were significantly lower in the dexmedetomidine group compared with the control group(HR:SMD=-0.87,95%CI:-1.13 to-0.62;MAP:SMD=-1.12,95%CI:-1.60 to-0.63;SBP:SMD=-1.27,95%CI:-2.26 to-0.27;DBP:SMD=-0.96,95%CI:-1.33 to-0.59).Subgroup analysis found that with the prolongation of 1.0μg/kg dexmedetomidine infusion,the patient’s heart rate declined in a time-dependent way.Conclusion Dexmedetomidine provides more stable hemodynamics during perioperative period in elderly patients.However,further well-conducted trials are required to assess the effective and safer doses of dexmedetomidine in elderly patients.

Quantum parameter estimation in a spin-boson dephasing quantum system by periodical projective measurements

In this paper,we explore how to estimate the phase damping parameter γ and the tunneling amplitude parameter ？from a spin-boson dephasing quantum model by periodical projective measurements.The preparation of initial states is accomplished by performing the period measurements in our scheme.The parameter γ can be always estimated when projective measurement bases are chosen as θ = π/2 and φ = 0.Based on the estimated value of γ and the interval information of ？,we can select another measurement bases（θ = π/4 and φ = π/2） to obtain the estimated value of ？.A coherent control is indispensable to estimate ？ if γ is in the interval of ？;whereas the control is not necessary if γ is out of the known interval of ？.We establish the relation between the optimal period time and the parameter γ or ？ in terms of Fisher information.Although the optimal measurement period cannot be selected beforehand,the aforementioned relation can be utilized to adjust the measurement period to approach the optimal one.

Reinforcement learning-based scheduling of multi-battery energy storage system

In this paper, a reinforcement learning-based multibattery energy storage system(MBESS) scheduling policy is proposed to minimize the consumers ’ electricity cost. The MBESS scheduling problem is modeled as a Markov decision process(MDP) with unknown transition probability. However, the optimal value function is time-dependent and difficult to obtain because of the periodicity of the electricity price and residential load. Therefore, a series of time-independent action-value functions are proposed to describe every period of a day. To approximate every action-value function, a corresponding critic network is established, which is cascaded with other critic networks according to the time sequence. Then, the continuous management strategy is obtained from the related action network. Moreover, a two-stage learning protocol including offline and online learning stages is provided for detailed implementation in real-time battery management. Numerical experimental examples are given to demonstrate the effectiveness of the developed algorithm.

Topological phase transition in cavity optomechanical system with periodical modulation

We investigate the topological phase transition and the enhanced topological effect in a cavity optomechanical system with periodical modulation.By calculating the steady-state equations of the system,the steady-state conditions of cavity fields and the restricted conditions of effective optomechanical couplings are demonstrated.It is found that the cavity optomechanical system can be modulated to different topological Su–Schrieffer–Heeger(SSH)phases via designing the optomechanical couplings legitimately.Meanwhile,combining the effective optomechanical couplings and the probability distributions of gap states,we reveal the topological phase transition between trivial SSH phase and nontrivial SSH phase via adjusting the decay rates of cavity fields.Moreover,we find that the enhanced topological effect of gap states can be achieved by enlarging the size of system and adjusting the decay rates of cavity fields.

Analytical Solution of Weak-Coupling Periodically Driven Two-Level System

We present an approximate analytical solution to periodically driven two-level system in the weak-coupling regime. The analytical solution is in good agreement with the exact numerical solution in resonance and near resonance cases when Ω 〈 0.3ωa with Ω and ωa denoting the Rabi and transition frequencies respectively.

Analysis of the Mode of the Periodically Time-varying Vibration Systems

By Liapunov reducibility theorem, the periodically time-varying vibration system can be transformed to a linear time-invariant system. Based on the dynamic characteristics of the linear time-invariant system, the mode of the periodically time-varying vibration system has been discussed. The paper defines the mode and analyzes its characteristics. It can be found that the mode of the periodically time-varying system is periodically time-varing but has such characteristics as orthogonality. Finally, a method is given to solve the mode. By solving the eigenvalues and the eigenvectors of the state transition matrix in one period, the periodically time-varying mode can be obtained.

Unstable periodic orbits analysis in the Qi system

We use the variational method to extract the short periodic orbits of the Qi system within a certain topological length.The chaotic dynamical behaviors of the Qi system with five equilibria are analyzed by the means of phase portraits,Lyapunov exponents,and Poincarémaps.Based on several periodic orbits with different sizes and shapes,they are encoded systematically with two letters or four letters for two different sets of parameters.The periodic orbits outside the attractor with complex topology are discovered by accident.In addition,the bifurcations of cycles and the bifurcations of equilibria in the Qi system are explored by different methods respectively.In this process,the rule of orbital period changing with parameters is also investigated.The calculation and classification method of periodic orbits in this study can be widely used in other similar low-dimensional dissipative systems.

Periodical polarization reversal modulation in multiferroic MnWO_(4) under high magnetic fields

We report polarization reversal periodically controlled by the electric field in multiferroic MnWO_(4) with a pulsed field up to 52 T.The electric polarization cannot be reversed by successive opposite electric fields in low magnetic fields(<14 T)at 4.2 K,whereas polarization reversal is directly achieved by two opposite electric fields under high magnetic fields(<45 T).Interestingly,the polarization curve of rising and falling fields for H∥u(magnetic easy axis)is irreversible when the magnetic field is close to 52 T.In this case,the rising and falling polarization curves can be individually reversed by the electric field,and thus require five cycles to recover to the initial condition by the order of the applied electric fields(+E,-E,-E,+E,+E).In addition,we find that ferroelectric phaseⅣcan be tuned from parallel to antiparallel in relation to ferroelectric phase AF2 by applying a magnetic field approximated to the c axis.

A Brief Introduction to the English Periodical of Contemporary Social Sciences

The English periodical of Contemporary Social Sciences is an English bimonthly periodical founded by Sichuan Academy of Social Sciences and approved by the National Radio and Television Administration of the People’s Republic of China(formerly the State Administration of Press,Publication,Radio,Film and Television of the People’s Republic of China)in March 2016.As the first English periodical sponsored by a local academy of social sciences.

Glucose metabolism profile recorded by flash glucose monitoring system in patients with hypopituitarism during prednisone replacement

BACKGROUND Commonly used glucocorticoids replacement regimens in patients with hypopituitarism have difficulty mimicking physiological cortisol rhythms and are usually accompanied by risks of over-treatment,with adverse effects on glucose metabolism.Disorders associated with glucose metabolism are established risk factors of cardiovascular events,one of the life-threatening ramifications.AIM To investigate the glycometabolism profile in patients with hypopituitarism receiving prednisone(Pred)replacement,and to clarify the impacts of different Pred doses on glycometabolism and consequent adverse cardiovascular outcomes.METHODS Twenty patients with hypopituitarism receiving Pred replacement[patient group(PG)]and 20 normal controls(NCs)were recruited.A flash glucose monitoring system was used to record continuous glucose levels during the day,which provided information on glucose-target-rate,glucose variability(GV),period glucose level,and hypoglycemia occurrence at certain periods.Islet β-cell function was also assessed.Based on the administered Pred dose per day,the PG was then regrouped into Pred>5 mg/d and Pred≤5 mg/d subgroups.Comparative analysis was carried out between the PG and NCs.RESULTS Significantly altered glucose metabolism profiles were identified in the PG.This includes significant reductions in glucose-target-rate and nocturnal glucose level,along with elevations in GV,hypoglycemia occurrence and postprandial glucose level,when compared with those in NCs.Subgroup analysis indicated more significant glucose metabolism impairment in the Pred>5 mg/d group,including significantly decreased glucose-target-rate and nocturnal glucose level,along with increased GV,hypoglycemia occurrence,and postprandial glucose level.With regard to islet β-cell function,PG showed significant difference in homeostasis model assessment(HOMA)-β compared with that of NCs;a notable difference in HOMA-βwas identified in Pred>5 mg/d group when compared with those of NCs;as for Pred≤5 mg/d group,significant differences were found in HOMA-β,and fasting glucose/insulin ratio when compared with NCs.CONCLUSION Our results demonstrated that Pred replacement disrupted glycometabolic homeostasis in patients with hypopituitarism.A Pred dose of>5 mg/d seemed to cause more adverse effects on glycometabolism than a dose of≤5 mg/d.Comprehensive and accurate evaluation is necessary to consider a suitable Pred replacement regimen,wherein,flash glucose monitoring system is a kind of promising and reliable assessment device.The present data allows us to thoroughly examine our modern treatment standards,especially in difficult cases such as hormonal replacement mimicking delicate natural cycles,in conditions such as diabetes mellitus that are rapidly growing in worldwide prevalence.