Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Etude comparative de l'organisation des materiaux argileux en termes de dimensions fractales

SIGLECNRS T Bordereau / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

Model for Managing the Integration of a Vehicle-to-Home Unit into an Intelligent Home Energy Management System

Integration of vehicle-to-home (V2H) centralized photovoltaic (HCPV) systems is a requested and potentially fruitful research topic for both industry and academia. Renewable energy sources, such as wind turbines and solar photovoltaic panels, alleviate energy deficits. Furthermore, energy storage technologies, such as batteries, thermal, and electric vehicles, are indispensable. Consequently, in this article, we examine the impact of solar photovoltaic (SPV), microgrid (MG) storage, and an electric vehicle (EV) on maximum sun radiation hours. As a result, an HCPV scheduling algorithm is developed and applied to maximize energy sustainability in a smart home (SH). The suggested algorithm can manage energy demand between the MG and SPV systems, as well as the EV as a mobile storage system. The model is based on several limitations to meet households’ electrical needs during sunny and cloudy weather. A multi-agent system (MAS) is undertaken to ensure proper system operation and meet the power requirements of various devices. An experimental database for weather and appliances is deployed to evaluate and control energy consumption and production cost parameters. The obtained results illustrate the benefits of V2H technology as a prospective unit storage solution

A Reinforcement Learning Approach for Integrating an Intelligent Home Energy Management System with a Vehicle-to-Home Unit

These days, users consume more electricity during peak hours, and electricity prices are typically higher between 3:00 p.m. and 11:00 p.m. If electric vehicle (EV) charging occurs during the same hours, the impact on residential distribution networks increases. Thus, home energy management systems (HEMS) have been introduced to manage the energy demand among households and EVs in residential distribution networks, such as a smart micro-grid (MG). Moreover, HEMS can efficiently manage renewable energy sources, such as solar photovoltaic (PV) panels, wind turbines, and vehicle energy storage. Until now, no HEMS has intelligently coordinated the uncertainty of smart MG elements. This paper investigated the impact of PV solar power, MG storage, and EVs on the maximum solar radiation hours. Several deep learning (DL) algorithms were utilized to account for the uncertainties. A reinforcement learning home centralized photovoltaic (RL-HCPV) scheduling algorithm was developed to manage the energy demand between the smart MG elements. The RL-HCPV system was modelled according to several constraints to meet household electricity demands in sunny and cloudy weather. Additionally, simulations demonstrated how the proposed RL-HCPV system could incorporate uncertainty, and efficiently handle the demand response and how vehicle-to-home (V2H) can help to level the appliance load profile and reduce power consumption costs with sustainable power production. The results demonstrated the advantages of utilizing RL and V2H technology as potential smart building storage technology