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.

Suppress oxygen evolution of lithium-rich manganese-based cathode materials via an integrated strategy

Improving the reversibility of anionic redox and inhibiting irreversible oxygen evolution are the main challenges in the application of high reversible capacity Li-rich Mn-based cathode materials.A facile synchronous lithiation strategy combining the advantages of yttrium doping and LiYO_(2) surface coating is proposed.Yttrium doping effectively suppresses the oxygen evolution during the delithiation process by increasing the energy barrier of oxygen evolution reaction through strong Y–O bond energy.LiYO_(2) nanocoating has the function of structural constraint and protection,that protecting the lattice oxygen exposed to the surface,thus avoiding irreversible oxidation.As an Li^(+) conductor,LiYO_(2) nano-coating can provide a fast Li^(+) transfer channel,which enables the sample to have excellent rate performance.The synergistic effect of Y doping and nano-LiYO_(2) coating integration suppresses the oxygen release from the surface,accelerates the diffusion of Li^(+)from electrolyte to electrode and decreases the interfacial side reactions,enabling the lithium ion batteries to obtain good electrochemical performance.The lithium-ion full cell employing the Y-1 sample(cathode)and commercial graphite(anode)exhibit an excellent specific energy density of 442.9 Wh kg^(-1) at a current density of 0.1C,with very stable safety performance,which can be used in a wide temperature range(60 to-15℃)stable operation.This result illustrates a new integration strategy for advanced cathode materials to achieve high specific energy density.

Research on the Development Strategy of Panxi Sunshine Health and Wellness Homestays and Hotels Based on Traditional Chinese Medicine Health Preservation

This study is the first phase of research results from the student innovation project“Yunqiao Sunshine Health and Wellness Homestay”group at Chengdu Normal University.By analyzing the current state of the Sunshine Health and Wellness Tourism Area economy in the Panxi region of Sichuan,local policies,and the current state of Sunshine Health and Wellness homestays and hotels,this paper proposes the possibility of developing Sunshine Health and Wellness homestays and hotels through traditional Chinese medicine(TCM)health preservation methods.It also proposes development strategies for such hotels through a market survey SWOT analysis.

AVAPS-AE模式的无创通气对AECOPD合并OSA患者PSG参数、ESS评分及舒适度的影响

目的探讨平均容积保证压力支持-自动呼气压(AVAPS-AE)模式的无创通气对慢性阻塞性肺疾病急性加重期(AECOPD)合并阻塞性睡眠呼吸暂停(OSA)患者多道睡眠监测(PSG)参数、Epworth嗜睡量表(ESS)评分及舒适度的影响。方法选取2020年1月至2022年10月自贡市第一人民医院75例AECOPD合并OSA患者,随机分为3组,各25例,均行无创通气治疗,对照A组予以AVAPS模式,对照B组予以S/T模式,观察组予以AVAPS-AE模式。比较3组治疗前、治疗24 h、48 h及72 h血气分析指标[动脉氧分压(PaO_(2))、动脉血酸碱度(pH)、动脉二氧化碳分压(PaCO_(2))]、PSG参数[微觉醒指数(MAI)、呼吸暂停低通气指数(AHI)、最低脉搏氧饱和度(miniSpO_(2))、睡眠效率(TST/TRT)]、颏舌肌肌电值(GGEMG)各变量[清醒期及睡眠NREM期张力性、峰值、时相性GGEMG]、人机对抗发生率、48 h插管率、ESS、Brog、视觉模拟量表(VAS)及健康相关生存质量(HRQL)评分。结果治疗24 h、48 h及72 h PaO_(2)组间比较:观察组>对照A组>对照B组(P<0.05);PaCO_(2)组间比较:观察组<对照A组<对照B组(P<0.05);TST/TRT、miniSpO_(2)组间比较:观察组>对照A组>对照B组(P<0.05);AHI、MAI组间比较:观察组<对照A组<对照B组(P<0.05);清醒期及睡眠NREM期张力性、峰值、时相性GGEMG组间比较:观察组<对照A组<对照B组(P<0.05);3组人机对抗发生率、48 h插管率比较,差异无统计学意义(P>0.05);ESS、Brog、VAS评分组间比较:观察组<对照A组<对照B组(P<0.05);HRQL评分组间比较:观察组>对照A组>对照B组(P<0.05)。结论AVAPS-AE模式的无创通气用于AECOPD合并OSA有利于改善患者睡眠,减少日间嗜睡,缓解呼吸困难,提高呼吸舒适度及生存质量。

Engineering Strategies for Suppressing the Shuttle Effect in Lithium–Sulfur Batteries

Lithium–sulfur(Li–S)batteries are supposed to be one of the most potential next-generation batteries owing to their high theoretical capacity and low cost.Nevertheless,the shuttle effect of firm multi-step two-electron reaction between sulfur and lithium in liquid electrolyte makes the capacity much smaller than the theoretical value.Many methods were proposed for inhibiting the shuttle effect of polysulfide,improving corresponding redox kinetics and enhancing the integral performance of Li–S batteries.Here,we will comprehensively and systematically summarize the strategies for inhibiting the shuttle effect from all components of Li–S batteries.First,the electrochemical principles/mechanism and origin of the shuttle effect are described in detail.Moreover,the efficient strategies,including boosting the sulfur conversion rate of sulfur,confining sulfur or lithium polysulfides(LPS)within cathode host,confining LPS in the shield layer,and preventing LPS from contacting the anode,will be discussed to suppress the shuttle effect.Then,recent advances in inhibition of shuttle effect in cathode,electrolyte,separator,and anode with the aforementioned strategies have been summarized to direct the further design of efficient materials for Li–S batteries.Finally,we present prospects for inhibition of the LPS shuttle and potential development directions in Li–S batteries.

How do the landslide and non-landslide sampling strategies impact landslide susceptibility assessment? d A catchment-scale case study from China

The aim of this study is to investigate the impacts of the sampling strategy of landslide and non-landslide on the performance of landslide susceptibility assessment(LSA).The study area is the Feiyun catchment in Wenzhou City,Southeast China.Two types of landslides samples,combined with seven non-landslide sampling strategies,resulted in a total of 14 scenarios.The corresponding landslide susceptibility map(LSM)for each scenario was generated using the random forest model.The receiver operating characteristic(ROC)curve and statistical indicators were calculated and used to assess the impact of the dataset sampling strategy.The results showed that higher accuracies were achieved when using the landslide core as positive samples,combined with non-landslide sampling from the very low zone or buffer zone.The results reveal the influence of landslide and non-landslide sampling strategies on the accuracy of LSA,which provides a reference for subsequent researchers aiming to obtain a more reasonable LSM.

Design strategy and comprehensive performance assessment towards Zn anode for alkaline rechargeable batteries

Alkaline Zn-based primary batteries have been commercialized in the past decades.However,their success has not been extended to secondary batteries due to the poor cycle reversibility of Zn anodes.Although some research has been conducted on alkaline Zn anodes,their performance is still far from commercial requirements.A variety of degradation mechanisms,including passivation,dendrites,morphological changes,and hydrogen precipitation,are claimed responsible for the failure of alkaline Zn metal anodes.What’s worse,these constraints always interact with each other,which leads to a single strategy being unable to suppress all the issues.Therefore,a comprehensive evaluation of the positive and negative effects of various strategies on performance is important to promote the commercialization of alkaline Zn batteries.Herein,the recent progress and performance of improvement strategies for Zn anode in alkaline conditions are reviewed systematically.First,the principles and challenges of alkaline Zn anodes are briefly analyzed.Then,various design strategies for alkaline Zn anodes from the perspectives of ion and electron regulation are highlighted.Last,through a comprehensive summary of various performance parameters,the advantages and disadvantages of different strategies are compared and evaluated.On the basis of this assessment,we aim to provide more insights into the anode design of high-performance alkaline rechargeable Zn batteries.

Overview of the immunological mechanisms in hepatitis B virus reactivation:Implications for disease progression and management strategies

Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation.

An Assessment of the Effect and Prospect of the US Indo-Pacific Strategy

Since the Trump administration,the national security strategy of the United States has focused on addressing the major power competition and regarded China as its main strategic competitor,which has been profoundly reflected in its introduction of the Indo-Pacific Strategy.The United States has certain resource advantages in the process of advancing the Indo-Pacific Strategy,and has made some progress of it.Nonetheless,the prospect of the strategy does not entirely depend on the will and action of the United States,but also on the joint action of other elements.

Climate Change vs Cultural Heritage: An Adaptation Strategy for the Archaeological Site of Ancient Messene

This article examines the effects of climate change on archaeological sites, using as a case study the archaeological site of Ancient Messene in Greece, and proposes an integrated adaptation strategy. In order to determine the site’s most significant risks, a climate data analysis was conducted, taking into account three different climate emission scenarios (Representative Concentration Pathways) and two future periods (2031-2060, 2071-2100). The Intergovernmental Panel on Climate Change (IPCC) vulnerability assessment methodology was adopted to assess the vulnerability of the archaeological site to the effects of climate change. This is the first time such a methodology has been followed in Greece. The analysis revealed that the site’s critical hazards are fire, desertification, and flooding. The geographical location of the site in an intensely dry microclimate and the lack of safe and functional electromechanical and road infrastructure increase its vulnerability. The materials of the monuments are indirectly and directly impacted by climate change, whereas the vegetation is negatively impacted by the frequency of extreme events, especially wildfires. Based on the analysis results, a five-axis adaptation strategy was developed.

Building up a general selection strategy and catalytic performance prediction expressions of heteronuclear double-atom catalysts for N_(2)reduction

The severe environmental problems and the demand for energy urgently require electrocatalysis to replace Haber-Bosch for the nitrogen reduction reaction(NRR).The descriptors and important properties of single-atom and homonuclear double-atom catalysts have been preliminarily explored,but the relationship between the inherent properties and catalytic activity of heteronuclear double-atom catalysts with better performance remains unclear.Therefore,it is very significant to explore the prediction expressions of catalytic activity of heteronuclear double-atom catalysts based on their inherent properties and find the rule for selecting catalytic centers.Herein,by summarizing the free energy for the key steps of NRR on 55 catalysts calculated through the first-principle,the expressions of predicting the free energy and the corresponding descriptors are deduced by the machine learning,and the strategy for selecting the appropriate catalytic center is proposed.The selection strategy for the central atom of heteronuclear double-atom catalysts is that the atomic number of central B atom should be between group VB and VIIIB,and the electron difference between central A atom and B atom should be large enough,and the selectivity of NRR or hydrogen evolution reaction(HER)could be calculated through the prediction formula.Moreover,five catalysts are screened to have low limiting potential and excellent selectivity,and are further analyzed by electron transfer.This work explores the relationship between the inherent properties of heteronuclear double-atom catalysts and the catalytic activity,and puts forward the rules for selecting the heteronuclear double-atom catalytic center,which has guiding significance for the experiment.

“Parenchyma transection-first”strategy is superior to“tunnel-first”strategy in robotic spleen-preserving distal pancreatectomy with conservation of splenic vessels

Background: Creating a tunnel between the pancreas and splenic vessels followed by pancreatic parenchyma transection(“tunnel-first” strategy) has long been used in spleen-preserving distal pancreatectomy(SPDP) with splenic vessel preservation(Kimura’s procedure). However, the operation space is limited in the tunnel, leading to the risks of bleeding and difficulties in suturing. We adopted the pancreatic “parenchyma transection-first” strategy to optimize Kimura’s procedure. Methods: The clinical data of consecutive patients who underwent robotic SPDP with Kimura’s procedure between January 2017 and September 2022 at our center were retrieved. The cohort was classified into a “parenchyma transection-first” strategy(P-F) group and a “tunnel-first” strategy(T-F) group and analyzed. Results: A total of 91 patients were enrolled in this cohort, with 49 in the T-F group and 42 in the P-F group. Compared with the T-F group, the P-F group had significantly shorter operative time(146.1 ± 39.2 min vs. 174.9 ± 46.6 min, P < 0.01) and lower estimated blood loss [40.0(20.0–55.0) m L vs. 50.0(20.0–100.0) m L, P = 0.03]. Failure of splenic vessel preservation occurred in 10.2% patients in the TF group and 2.4% in the P-F group( P = 0.14). The grade 3/4 complications were similar between the two groups( P = 0.57). No differences in postoperative pancreatic fistula, abdominal infection or hemorrhage were observed between the two groups. Conclusions: The pancreatic “parenchyma transection-first” strategy is safe and feasible compared with traditional “tunnel-first strategy” in SPDP with Kimura’s procedure.

The Full Load Voltage Compensation Strategy in Capacity Configuration of UPQC Integrated PV-BESS

Unified power quality conditioner(UPQC)with energy storage is commonly based on conventional capacity configuration strategy with power angle control.It has problems such as phase jumping before and after compensation.DC-link cannot continuously emit active power externally.Therefore,this paper presents the compensation strategy of full load voltage magnitude and phase in capacity configuration of UPQC.The topology of UPQC is integrated a series active power filter(SAPF),a shunt active power filter(PAPF)and a photovoltaic-battery energy storage system(PV-BESS).The principle of full load voltage compensation is analyzed based on the PV-BESS-UPQC topology.Themagnitude constant of load voltage ismaintained by controlling the appropriate shunt compensation current.Then the UPQC capacity configuration is carried out using the full load voltage compensation strategy.The compensation capacity of UPQC series and shunt units are reduced.Finally,the simulation results show that the proposed compensation strategy reduces the capacity configuration by 5.11 kVA(36.4%)compared to the conventional compensation strategy.The proposed strategy can achieve full compensation of the load voltage,which can effectively reduce the capacity allocation and improve the economy of UPQC.It also has the PV-BESS units’ability of providing active power and can stabilize the DC-link voltage.

Recent progress and challenges in structural construction strategy of metal-based catalysts for nitrate electroreduction to ammonia

Ammonia plays an essential role in human production and life as a raw material for chemical fertilizers.The nitrate electroreduction to ammonia reaction(NO_(3)RR)has garnered attention due to its advantages over the Haber-Bosch process and electrochemical nitrogen reduction reaction.Therefore,it represents a promising approach to safeguard the ecological environment by enabling the cycling of nitrogen species.This review begins by discussing the theoretical insights of the NO_(3)RR.It then summarizes recent advances in catalyst design and construction strategies,including alloying,structure engineering,surface engineering,and heterostructure engineering.Finally,the challenges and prospects in this field are presented.This review aims to guide for enhancing the efficiency of electrocatalysts in the NO_(3)RR,and offers insights for converting NO_(3)-to NH_(3).

Accurate models and nutritional strategies for specific oxidative stress factors: Does the dose matter in swine production?

Oxidative stress has been associated with a number of physiological problems in swine,including reduced production efficiency.Recently,although there has been increased research into regulatory mechanisms and antioxidant strategies in relation to oxidative stress-induced pig production,it remains so far largely unsuccessful to develop accurate models and nutritional strategies for specific oxidative stress factors.Here,we discuss the dose and dose intensity of the causes of oxidative stress involving physiological,environmental and dietary factors,recent research models and the antioxidant strategies to provide theoretical guidance for future oxidative stress research in swine.

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.

A Temporary Frequency Response Strategy Using a Voltage Source-Based PermanentMagnet Synchronous Generator and Energy Storage Systems

Energy storage systems(ESS)and permanent magnet synchronous generators(PMSG)are speculated to be able to exhibit frequency regulation capabilities by adding differential and proportional control loops with different control objectives.The available PMSG kinetic energy and charging/discharging capacities of the ESS were restricted.To improve the inertia response and frequency control capability,we propose a short-term frequency support strategy for the ESS and PMSG.To this end,the weights were embedded in the control loops to adjust the participation of the differential and proportional controls based on the system frequency excursion.The effectiveness of the proposed control strategy was verified using PSCAD/EMTDC.The simulations revealed that the proposed strategy could improve the maximum rate of change of the frequency nadir and maximum frequency excursion.Therefore,it provides a promising solution of ancillary services for frequency regulation of PMSG and ESS.

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.

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.

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.