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 pr...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.展开更多
This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patie...This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patient recovery.Highlightingthe paradox of modern medical advances,it emphasizes the urgent needfor early identification and intervention to mitigate ICU-AW's impact.Innovatively,the study by Wang et al is showcased for employing a multilayer perceptronneural network model,achieving high accuracy in predicting ICU-AWrisk.This advancement underscores the potential of neural network models inenhancing patient care but also calls for continued research to address limitationsand improve model applicability.The editorial advocates for the developmentand validation of sophisticated predictive tools,aiming for personalized carestrategies to reduce ICU-AW incidence and severity,ultimately improving patientoutcomes in critical care settings.展开更多
Statins have been shown to be effective in reducing cardiovascular events.Their magnitude of benefits has been proportionate to the reduction in low-density lipoprotein cholesterol(LDL-c).Intensive lipid-lowering ther...Statins have been shown to be effective in reducing cardiovascular events.Their magnitude of benefits has been proportionate to the reduction in low-density lipoprotein cholesterol(LDL-c).Intensive lipid-lowering therapies using ezetimibe and more recently proprotein convertase subtilisin kexin 9 inhibitors have further improved clinical outcomes.Unselective application of these treatments is undesirable and unaffordable and,therefore,has been guided by LDL-c level.Nonetheless,the residual risk in the post-statin era is markedly heterogeneous,including thrombosis and inflammation risks.Moreover,the lipoprotein related risk is increasingly recognised to be related to other non-LDL-c markers such as Lp(a).Emerging data show that intensive lipid-lowering therapy produce larger absolute risk reduction in patients with polyvascular disease,post coronary artery bypass graft and diabetes.Notably,these clinical entities share similar phenotype of large burden of atherosclerotic plaques.Novel plaque imaging may aid decision making by identifying patients with propensity to develop lipid rich plagues at multi-vascular sites.Those patients may be suitable candidates for intensive lipid lowering treatment.展开更多
College students have more difficulty in Intensive Reading course resulting from their language proficiency.Therefore,reading strategies should be focused on in intensive reading to help college students to lower the ...College students have more difficulty in Intensive Reading course resulting from their language proficiency.Therefore,reading strategies should be focused on in intensive reading to help college students to lower the threshold of the course aswell as facilitate stu dents'performance in intensive reading.展开更多
Background:Maternalenewborn bonding during the first hours of is crucial to infant development.Effective bonding requires that newborn baby and mother be close to each another,so that the baby can signal his/her needs...Background:Maternalenewborn bonding during the first hours of is crucial to infant development.Effective bonding requires that newborn baby and mother be close to each another,so that the baby can signal his/her needs and the mother can respond.However,normal bonding process is hindered by illness,as the infants will be separated from their mothers and admitted to neonatal intensive care units.No study has explored the techniques applied by nurses and midwives to facilitate bonding between mothers and their sick newborn babies admitted in neonatal intensive care units in Malawi.Purpose:This study aimed to investigate the strategies for supporting maternalenewborn bonding for mothers whose neonates were admitted to an intensive care unit at a tertiary hospital in Malawi.Methods:An explorative qualitative design was used,and 15 participants(10 mothers and five nurses/midwives)were recruited.Data were collected by conducting in-depth interviews.Audio recorded data were transcribed verbatim and analyzed by utilizing ATLAS.ti version 7 in accordance with Hennink's stages of content analysis.Results:It was showed that nurses and midwives used different approaches to facilitate maternal enewborn bonding.The responses revealed two major themes:motherenewborn interaction and motherenurse/midwife interaction.Motherenewborn interaction involved breastfeeding and maternal involvement in newborn care,whereas motherenurse/midwife interaction involved effective communication and psychosocial support.Maternalenewborn bonding promotes a mother's successful transition into motherhood,nurses and midwives should actively initiate strategies facilitating early maternal enewborn bonding.展开更多
In the last few years, vegetable industry developed rapidly in Hebei province, intensive raising seedling as its main component, also entered a period of rapid development. The background and characteristics, the curr...In the last few years, vegetable industry developed rapidly in Hebei province, intensive raising seedling as its main component, also entered a period of rapid development. The background and characteristics, the current situation and existed questions of intensive seedling cultivation were analyzed. A series of developmental ideas and response strategies for developing more quickly in Hebei Province were put forward.展开更多
目的了解重症监护室护士道德困境的真实体验,为管理者制定干预措施,提高重症监护室护士幸福感,稳定护理队伍提供参考。方法检索中国知网、维普、中国生物医学文献数据库、万方、PubMed、the Cochrane Library、Web of Science、Embase...目的了解重症监护室护士道德困境的真实体验,为管理者制定干预措施,提高重症监护室护士幸福感,稳定护理队伍提供参考。方法检索中国知网、维普、中国生物医学文献数据库、万方、PubMed、the Cochrane Library、Web of Science、Embase数据库关于重症监护室护士道德困境的质性研究,检索时限为建库至2023年7月24日。根据JBI循证卫生保健中心推荐的质性研究质量评价标准对纳入文献进行质量评价,运用Meta整合方法对研究结果进行整合。结果共纳入8篇文献,从纳入研究中提炼出36个主题,将其归纳成为10个新类别,综合成3个整合结果,即ICU护士经历道德困境受多种因素影响,护士遭遇道德困境时的情感体验,应对道德困境的策略。结论重症监护室护士存在一定程度的道德困境,护理管理者应了解其产生的原因,并制定和实施有效干预措施,以减少重症监护室护士道德困扰,促进护士生理心理健康发展,稳定护理队伍。展开更多
为提高智能网联(connected and automated,CA)卡车、小车及人工驾驶卡车、小车的混合流道路通行能力,提出基于排强度和渗透率的CA车辆单独编队和合作编队策略.分别设计两种策略下混合流车辆跟驰模式,推导出基于改进Markov模型,涵盖CA车...为提高智能网联(connected and automated,CA)卡车、小车及人工驾驶卡车、小车的混合流道路通行能力,提出基于排强度和渗透率的CA车辆单独编队和合作编队策略.分别设计两种策略下混合流车辆跟驰模式,推导出基于改进Markov模型,涵盖CA车辆渗透率和排强度的车辆状态转移概率;分析两种策略下CA车辆队列分布,建立各策略下的混合流道路容量模型,并通过理论证明和仿真实验予以验证.结果表明,与不编队策略相比,两种策略下道路容量分别提高1.23%~49.62%和1.47%~60.34%,合作编队策略与单独编队策略相比能将道路容量再提高11%;当CA车辆渗透率大于50%和排强度大于0时,编队策略对道路容量的提升效果更显著,容量能提高13.27%~60.34%;单独编队策略下CA小车和CA卡车最大队列规模分别为8辆和6辆,合作编队下CA车辆最大队列规模为8辆.展开更多
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘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.
文摘This editorial explores the significant challenge of intensive care unit-acquiredweakness(ICU-AW),a prevalent condition affecting critically ill patients,characterizedby profound muscle weakness and complicating patient recovery.Highlightingthe paradox of modern medical advances,it emphasizes the urgent needfor early identification and intervention to mitigate ICU-AW's impact.Innovatively,the study by Wang et al is showcased for employing a multilayer perceptronneural network model,achieving high accuracy in predicting ICU-AWrisk.This advancement underscores the potential of neural network models inenhancing patient care but also calls for continued research to address limitationsand improve model applicability.The editorial advocates for the developmentand validation of sophisticated predictive tools,aiming for personalized carestrategies to reduce ICU-AW incidence and severity,ultimately improving patientoutcomes in critical care settings.
文摘Statins have been shown to be effective in reducing cardiovascular events.Their magnitude of benefits has been proportionate to the reduction in low-density lipoprotein cholesterol(LDL-c).Intensive lipid-lowering therapies using ezetimibe and more recently proprotein convertase subtilisin kexin 9 inhibitors have further improved clinical outcomes.Unselective application of these treatments is undesirable and unaffordable and,therefore,has been guided by LDL-c level.Nonetheless,the residual risk in the post-statin era is markedly heterogeneous,including thrombosis and inflammation risks.Moreover,the lipoprotein related risk is increasingly recognised to be related to other non-LDL-c markers such as Lp(a).Emerging data show that intensive lipid-lowering therapy produce larger absolute risk reduction in patients with polyvascular disease,post coronary artery bypass graft and diabetes.Notably,these clinical entities share similar phenotype of large burden of atherosclerotic plaques.Novel plaque imaging may aid decision making by identifying patients with propensity to develop lipid rich plagues at multi-vascular sites.Those patients may be suitable candidates for intensive lipid lowering treatment.
文摘College students have more difficulty in Intensive Reading course resulting from their language proficiency.Therefore,reading strategies should be focused on in intensive reading to help college students to lower the threshold of the course aswell as facilitate stu dents'performance in intensive reading.
基金The researchers wish to thank the management of Zomba Central Hospital for allowing the researchers entry as well as all the participants for their contributions。
文摘Background:Maternalenewborn bonding during the first hours of is crucial to infant development.Effective bonding requires that newborn baby and mother be close to each another,so that the baby can signal his/her needs and the mother can respond.However,normal bonding process is hindered by illness,as the infants will be separated from their mothers and admitted to neonatal intensive care units.No study has explored the techniques applied by nurses and midwives to facilitate bonding between mothers and their sick newborn babies admitted in neonatal intensive care units in Malawi.Purpose:This study aimed to investigate the strategies for supporting maternalenewborn bonding for mothers whose neonates were admitted to an intensive care unit at a tertiary hospital in Malawi.Methods:An explorative qualitative design was used,and 15 participants(10 mothers and five nurses/midwives)were recruited.Data were collected by conducting in-depth interviews.Audio recorded data were transcribed verbatim and analyzed by utilizing ATLAS.ti version 7 in accordance with Hennink's stages of content analysis.Results:It was showed that nurses and midwives used different approaches to facilitate maternal enewborn bonding.The responses revealed two major themes:motherenewborn interaction and motherenurse/midwife interaction.Motherenewborn interaction involved breastfeeding and maternal involvement in newborn care,whereas motherenurse/midwife interaction involved effective communication and psychosocial support.Maternalenewborn bonding promotes a mother's successful transition into motherhood,nurses and midwives should actively initiate strategies facilitating early maternal enewborn bonding.
基金Supported by Hebei Province Natural Science Fund ( C2010001595)Hebei Science and Technology Bureau Program (06220116D)+1 种基金Shijiazhuang Station of China Agriculture Research System (CARS-25-G-05)Hebei Province Quliaty Technology Supervision Bureau Program (NY201144)
文摘In the last few years, vegetable industry developed rapidly in Hebei province, intensive raising seedling as its main component, also entered a period of rapid development. The background and characteristics, the current situation and existed questions of intensive seedling cultivation were analyzed. A series of developmental ideas and response strategies for developing more quickly in Hebei Province were put forward.
文摘目的了解重症监护室护士道德困境的真实体验,为管理者制定干预措施,提高重症监护室护士幸福感,稳定护理队伍提供参考。方法检索中国知网、维普、中国生物医学文献数据库、万方、PubMed、the Cochrane Library、Web of Science、Embase数据库关于重症监护室护士道德困境的质性研究,检索时限为建库至2023年7月24日。根据JBI循证卫生保健中心推荐的质性研究质量评价标准对纳入文献进行质量评价,运用Meta整合方法对研究结果进行整合。结果共纳入8篇文献,从纳入研究中提炼出36个主题,将其归纳成为10个新类别,综合成3个整合结果,即ICU护士经历道德困境受多种因素影响,护士遭遇道德困境时的情感体验,应对道德困境的策略。结论重症监护室护士存在一定程度的道德困境,护理管理者应了解其产生的原因,并制定和实施有效干预措施,以减少重症监护室护士道德困扰,促进护士生理心理健康发展,稳定护理队伍。
文摘为提高智能网联(connected and automated,CA)卡车、小车及人工驾驶卡车、小车的混合流道路通行能力,提出基于排强度和渗透率的CA车辆单独编队和合作编队策略.分别设计两种策略下混合流车辆跟驰模式,推导出基于改进Markov模型,涵盖CA车辆渗透率和排强度的车辆状态转移概率;分析两种策略下CA车辆队列分布,建立各策略下的混合流道路容量模型,并通过理论证明和仿真实验予以验证.结果表明,与不编队策略相比,两种策略下道路容量分别提高1.23%~49.62%和1.47%~60.34%,合作编队策略与单独编队策略相比能将道路容量再提高11%;当CA车辆渗透率大于50%和排强度大于0时,编队策略对道路容量的提升效果更显著,容量能提高13.27%~60.34%;单独编队策略下CA小车和CA卡车最大队列规模分别为8辆和6辆,合作编队下CA车辆最大队列规模为8辆.
