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ObjectiveTo explore the impact of an airway stepwise management strategy in the treatment of hospital acquired pneumonia (HAP) in the ultra elderly critically ill patients.MethodsClinical data on the ultra eldely(≥80 years old) HAP patients at the department of Critied Care Medicine, Peking Union Medical College Hospital from January 2021 to April 2023 was retrospective collected, and the enrolled patients were divided into an observation group (January 2022-April 2023) and control group (January 2021-December 2021) according to the airway stepwise management strategy. In the control group, conventional airway manage- ment was used, and in the observation group, an airway stepwise management strategy from simple to complex and from noninvasive to invasive was used. The oxygenation indices before and after airway interventiont, tracheal intubation/tracheostomy rate, and invasive ventilator usage rate was compared in both groups.ResultsA total of 61 HAP patients who met the inclusion and exclusion criteria were selected, including 31 in the observation group and 30 in the control group. Compared with before airway intervention, the arterial partial pressure of carbon dioxide gradually decreased, arterial partial pressure of oxygen and oxygenation index gradually increased at 12 h, 48 h and 72 h of airway intervention(all P < 0.05). Compared with the control group, the observation group had lower arterial partial pressure of carbon dioxide, and higher arterial partial pressure of oxygen and oxygenation index(all P < 0.05), and the rate of tracheal intubation/incision (35.5% vs. 66.7%, P=0.015) and the rate of invasive ventilator use (41.9% vs. 73.3%, P=0.013) were lower in the observation group at 48 h of airway intervention.ConclusionsThe application of an airway stepwise management strategy in the ultra elderly HAP patients can significantly improve oxygenation status and reduce iatrogenic trauma.

Density wave (DW) order is believed to be correlated with superconductivity in the recently discovered high-temperature superconductor La3Ni2O7. However, experimental investigations of its evolution under high pressure are still lacking. Here, we explore the quasiparticle dynamics in bilayer nickelate La3Ni2O7 single crystals using ultrafast optical pump-probe spectroscopy under high pressures up to 34.2 GPa. At ambient pressure, the temperature-dependent relaxation dynamics demonstrate a phonon bottleneck effect due to the opening of an energy gap around 151 K. The energy scale of the DW-like gap is determined to be 66 meV by the Rothwarf-Taylor model. Combined with recent experiential results, we propose that this DW-like transition at ambient pressure and low temperature is spin density wave (SDW). With increasing pressure, this SDW order is significantly suppressed up to 13.3 GPa before it completely disappears around 26 GPa. Remarkably, at pressures above 29.4 GPa, we observe the emergence of another DW-like order with a transition temperature of approximately 135 K, which is probably related to the predicted charge density wave (CDW) order. Our study provides the experimental evidences of the evolution of the DW-like gap under high pressure, offering critical insights into the correlation between DW order and superconductivity in La3Ni2O7. The evolution of density-wave-like orders under pressure is crucial for unraveling the mechanism of superconductivity in La3Ni2O7. Here, the authors provide evidence that the spin density wave is suppressed when the superconductivity emerges, and that another density wave appears above 29 GPa. [ABSTRACT FROM AUTHOR]

Geomechanical and heat transfer characteristics of gas hydrate-bearing sediment (GHBS) are significantly affected by hydrate dissociation during gas production from reservoirs, which is typically tens of meters in thickness. This paper presents the development of an innovative in-flight apparatus that is capable of modeling hydrate dissociation in GHBS on a geotechnical centrifuge, by which a series of model tests are conducted under normal gravity (1g) and hypergravity (100g and 80g). The effects of the hypergravity field on the development of pore pressure, soil deformation, as well as particle migration and gas production during hydrate dissociation are explored. Results show that gas released from hydrate dissociation increases excess pore pressure and changes the soil pore structure. During hydrate dissociation, the accumulation of excess pore pressure leads to the development of gas-driven fractures and the subsequent formation of a dominant seepage channel. The critical excess pore pressure of fracture formation in the 100g test is higher than that in the 1g test. The dominant seepage channel promoting fluid seepage and fine particle migration is more likely to be formed into obvious fracture structures under 100g compared with slender pipe structures under 1g. Two peaks are witnessed in gas production in the 100g test, corresponding to the stage at maximum pressure difference and at the complete formation of dominant seepage channels, which is consistent with that in the field trails. These results indicate that the formation of fracture during hydrate dissociation is beneficial to efficient gas production, while the problem of particle migration should be carefully paid attention to. [ABSTRACT FROM AUTHOR]

The FeCoCrNiMn high-entropy alloy coating reinforced with WC particles was fabricated on 45# steel using plasma surfacing technique. A comprehensive characterization was conducted to investigate the friction and wear behavior of the coating at various temperatures. Results demonstrated that this coating exhibited exceptional wear resistance at room temperature (RT). However, it experienced slight decomposition of WC particles and oxidation corrosion at 400 °C, resulting in a degradation of its wear resistance. The WC decomposition and oxidation corrosion were aggravated at 600 °C, inducing a stronger oxidation corrosion wear effect, and thus led to a more severe wear of this coating. However, these oxidation products provided considerable lubrication effect resulting in a continuous decrease in friction coefficient, from 0.49 at RT to 0.44 at 400 °C, and reached a lower value of 0.16 at 600 °C. The potential oxidation corrosion wear and lubricating mechanisms of this coating at evaluated temperatures were discussed systematically. [ABSTRACT FROM AUTHOR]

In recent years, with the continuous evolution of the global economy and the adjustment of industrial structures, the understanding of the role played by human capital in the process of economic development has become particularly important. However, existing research on the impact of human capital on economic growth often adopts traditional regression methods, failing to comprehensively consider the heterogeneity and nonlinear relationships in the data. Therefore, to more accurately understand the influence of human capital on economic growth at different stages, this study employs Bayesian quantile regression method (BQRM). By incorporating BQRM, a better capture of the dynamic effects of human capital in the process of industrial structure upgrading is achieved, offering policymakers more targeted and effective policy recommendations to drive the economy towards a more sustainable direction. Additionally, the experiment also examines the impact of other key factors such as technological progress, capital investment, and labor market conditions on economic growth. These factors, combined with human capital, collectively promote the upgrading of industrial structure and the sustainable development of the economy. This study, by introducing BQRM, aims to fill the research gap regarding the impact of human capital on economic development during the industrial structural upgrading process. In the backdrop of the ongoing evolution of the global economy and adjustments in industrial structure, understanding the role of human capital in economic development becomes particularly crucial. To better comprehend the direct impact of human capital, the experiment collected macroeconomic data, including GDP, industrial structure, labor skills, and human capital, from different regions over the past 20 years. By establishing a dynamic panel data model, this study delves into the trends in the impact of human capital at various stages of industrial structure upgrading. The research findings indicate that during the high-speed growth phase, the contribution of human capital to GDP growth is 15.2% ± 2.1%, rising to 23.8% ± 3.4% during the period of industrial structure adjustment. Technological progress, capital investment, and labor market conditions also significantly influence economic growth at different stages. In terms of innovation improvement, this study pioneers the use of BQRM to gain a deeper understanding of the role of human capital in economic development, providing more targeted and effective policy recommendations. Ultimately, to promote sustainable economic development, the experiment proposes concrete and targeted policy recommendations, emphasizing government support in training and skill development. This study not only fills a research gap in the relevant field but also provides substantive references for decision-makers, driving the economy towards a more sustainable direction. [ABSTRACT FROM AUTHOR]