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Objective: To investigate the association between prestroke frailty and nonhome discharge, prolonged length of stay as well as functional outcomes. Design: Prospective observational study. Setting: Single urban teaching hospital in Guangzhou, China. Participants: Consecutive sample of 271 older patients admitted with acute stroke. Intervention: N/A. Main measures: A five-item FRAIL scale (0∼5 points) and the stroke severity at onset were measured. The primary outcome of interest was nonhome discharge, with secondary outcomes including prolonged length of stay and worse short-term prognosis. Multivariable logistic regression adjusting for confounding factors was used to determine the association between patient-reported frailty and nonhome discharge, prolonged length of stay, worse short-term prognosis. Results: The population had a median age of 68 [interquartile range (IQR), 64∼74)]years, with 50 individuals (18.5%) identified as frail. After adjusting for age, sex, Barthel index, National Institutes of Health Stroke Scale, and Mini-Mental Status Exam score at admission, patients with self-reported frailty were significantly likely to experience nonhome discharge (Odds Ratio [ OR ] = 4.788; 95% confidence interval [CI] = 1.272∼18.017; p =.021), prolonged length of stay (OR = 4.76; 95% CI = 1.80∼12.56; p =.002), mRS scores at 30 days (OR = 6.72;95% CI = 1.79∼25.20; p =.005) and three months postdischarge and three-month (OR = 8.94; 95% CI = 2.10∼38.08; p =.003). Conclusions: In older adults with stroke, frailty is associated with nonhome discharge, prolonged length of stay, and worse short-term prognosis, regardless of the stroke severity, cognition, and Barthel index score at admission. FRAIL scale can be used as a practical screening tool in acute care setting by multidisciplinary team in supporting discharge process. [ABSTRACT FROM AUTHOR]

Background/aim: Efficient discharge for stroke patients is crucial but challenging. The study aimed to develop early predictive models to explore which patient characteristics and variables significantly influence the discharge planning of patients, based on the data available within 24 h of admission. Design: Prospective observational study. Methods: A prospective cohort was conducted at a university hospital with 523 patients hospitalised for stroke. We built and trained six different machine learning (ML) models, followed by testing and tuning those models to find the best‐suited predictor for discharge disposition, dichotomized into home and non‐home. To evaluate the accuracy, reliability and interpretability of the best‐performing models, we identified and analysed the features that had the greatest impact on the predictions. Results: In total, 523 patients met the inclusion criteria, with a mean age of 61 years. Of the patients with stroke, 30.01% had non‐home discharge. Our model predicting non‐home discharge achieved an area under the receiver operating characteristic curve of 0.95 and a precision of 0.776. After threshold was moved, the model had a recall of 0.809. Top 10 variables by importance were National Institutes of Health Stroke Scale (NIHSS) score, family income, Barthel index (BI) score, FRAIL score, fall risk, pressure injury risk, feeding method, depression, age and dysphagia. Conclusion: The ML model identified higher NIHSS, BI, and FRAIL, family income, higher fall risk, pressure injury risk, older age, tube feeding, depression and dysphagia as the top 10 strongest risk predictors in identifying patients who required non‐home discharge to higher levels of care. Modern ML techniques can support timely and appropriate clinical decision‐making. Relevance to Clinical Practice: This study illustrates the characteristics and risk factors of non‐home discharge in patients with stroke, potentially contributing to the improvement of the discharge process. Reporting Method: STROBE guidelines. [ABSTRACT FROM AUTHOR]

The access of wind power reduces the carbon emissions of the power system from the generation side, and the introduction of demand response to eliminate wind abandonment provides a new idea for carbon reduction from the load side. Considering wind power and demand response comprehensively, based on the theory of carbon emission flow of power system, a day-ahead and day-in two-stage low carbon optimal dispatching method for power grid is proposed. Firstly, the carbon emission flow theory of power system is analyzed, and the node carbon potential model of load side is established. Then, the flexible load is divided into two types, transferable load and reducible load. Based on the carbon potential model of load nodes, the response mechanism of calling these two types of loads to reduce carbon is designed. On this basis, the source load coordination day-ahead optimal scheduling model considering low-carbon and economic is established. Based on model predictive control, the day-ahead optimal scheduling model is solved, and the day-ahead scheduling results are changed through feedback correction. Finally, the simulation results of the improved PJM-5 node system and IEEE 300-node system show that the proposed optimal scheduling method can effectively promote the flexible load to absorb wind power, and reduce wind abandonment, and achieve the goal of load side carbon reduction.

Natural pectin mostly exists in the form of high-methoxyl pectin, and it requires a strong acidic environment and high concentration of sugar to form hydrogel. Moreover, the hydrogel formed belongs to physical crosslinking hydrogel, with defects such as weak strength, poor toughness, and poor stability in the application process. Therefore, the natural pectin structure has been modified to improve its intrinsic gel properties to prepare pectin hydrogels with good properties and make them more applicable to the fields of food and medicine, which have recently become a research hotspot. In this study, the modification methods of pectin and fabrication methods of modified pectin hydrogels are first summarized. Second, the application status of modified pectin hydrogels in food and pharmaceutical fields is expounded. Finally, some problems in pectin modification as well as the fabrication and application of modified pectin hydrogels are indicated, and future development directions are proposed to provide reference for the further development and utilization of pectin hydrogels. [ABSTRACT FROM AUTHOR]