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BackgroundCOVID-19 has overwhelmed health systems worldwide. It is important to identify severe cases as early as possible, such that resources can be mobilized and treatment can be escalated. ObjectiveThis study aims to develop a machine learning approach for automated severity assessment of COVID-19 based on clinical and imaging data. MethodsClinical data—including demographics, signs, symptoms, comorbidities, and blood test results—and chest computed tomography scans of 346 patients from 2 hospitals in the Hubei Province, China, were used to develop machine learning models for automated severity assessment in diagnosed COVID-19 cases. We compared the predictive power of the clinical and imaging data from multiple machine learning models and further explored the use of four oversampling methods to address the imbalanced classification issue. Features with the highest predictive power were identified using the Shapley Additive Explanations framework. ResultsImaging features had the strongest impact on the model output, while a combination of clinical and imaging features yielded the best performance overall. The identified predictive features were consistent with those reported previously. Although oversampling yielded mixed results, it achieved the best model performance in our study. Logistic regression models differentiating between mild and severe cases achieved the best performance for clinical features (area under the curve [AUC] 0.848; sensitivity 0.455; specificity 0.906), imaging features (AUC 0.926; sensitivity 0.818; specificity 0.901), and a combination of clinical and imaging features (AUC 0.950; sensitivity 0.764; specificity 0.919). The synthetic minority oversampling method further improved the performance of the model using combined features (AUC 0.960; sensitivity 0.845; specificity 0.929). ConclusionsClinical and imaging features can be used for automated severity assessment of COVID-19 and can potentially help triage patients with COVID-19 and prioritize care delivery to those at a higher risk of severe disease.

Sludge anaerobic digestion promoted by enzymes has the advantages of mild reaction, high efficiency and environmental protection etc. However, the difficulty of recovery and poor catalytic stability seriously restrict its application. Enzyme immobilization is the key to solve the above problems. A new type of polyvinyl alcohol(PVA) carrier was prepared by Noria and polyethylenimide(PEI) co-deposition. The effect of lysozyme immobilized with Noria-PEI modified PVA carriers on the efficiency of sludge anaerobic fermentation for VFAs production was studied. The results showed that immobilized lysozyme could enhance sludge fermentation to promote SCOD, and SCOD reached the highest concentration of 2 892.4 mg/L within 36 h, which was 3.4 times higher than in the blank(day 6). VFAs concentration peaked at 2 130.8 mg/L on day 4, mainly comprised of acetic acid and propionic acid, accounting for 61.8%-80.7%. The average particle size and specific surface area of sludge in the immobilized enzyme system were 42.957 μm and 0.413 m2/g, indicating that immobilized enzyme enhanced the hydrolysis of granular sludge. Microbial community analysis showed that the hydrolytic acid-producing phyla of Firmicutes, Proteobacteria and Bacteroides accounted for high proportion in the immobilized enzyme system. At the genus level, Macellibacteroides, Petrimona, Lactobacillu, and Clostridium_sensu_stricto_1 were the main genera, which revealed the mechanism of enhanced VFAs production by the immobilized enzyme at microscopic level.

Live streaming is revolutionizing the landscape of e-commerce, creating new opportunities for platforms and e-tailers to improve their performance. However, little is known about the underlying mechanisms that shape consumer behavior in this burgeoning business phenomenon. This study aims to shed light on the relationships between environmental cues generated by live streaming and online impulse buying. Drawing upon the Stimulus-Organism-Response framework, a comprehensive model was formulated to explore how social cues (streamer interaction, peer interaction) and media cues (vividness, realness) impact pleasure, arousal, perceived uncertainty, and subsequently induce consumers’ urge to buy impulsively. The model was tested by survey data from 403 consumers. SPSS and PLS are employed to verify the model. The findings revealed that realness and streamer interaction can reduce perceived uncertainty and foster a pleasant consumer experience, while vividness and peer interaction serve to awaken and delight consumers. Pleasure, arousal, and perceived uncertainty mediate antecedent variables’ effects on urge to buy impulsively in a parallel and reverse way, and emotions exert a more powerful influence. This study enriched the research on the influence mechanisms of impulse buying driven by live streaming and provided suggestions for platforms and streamers to optimize product display and guide interaction, which is conducive to leveraging the advantages of live streaming and creating greater commercial value.

Abstract Objective To investigate the risk factors associated with the peripheral venous catheter-related complication and infection in children with bronchopneumonia. Methods A total of 185 patients were divided into case group (n = 114) and control group (n = 71) according to the presence of catheter-related infection and complications related to indwelling needle. We performed a multivariate logistic regression analysis to explore the risk factors associated with the infection. Results Age was divided into 4 categories (0 6). The case group had a higher percentage of patients with 0

Background Dilated cardiomyopathy has an extremely poor prognosis, sacubitril/valsartan and dapagliflozin are important drugs to improve the prognosis. However, patients with dilated cardiomyopathy tend to have low blood pressure, which would make it unable to use both drugs at the same time. There is no comparative study of the efficacy and safety of sacubitril/valsartan and dapagliflozin in the treatment of dilated cardiomyopathy with low blood pressure. Objective To investigate the efficacy and safety of sacubitril/valsartan and dapagliflozin in dilated cardiomyopathy patients with low blood pressure. Methods A total of 124 patients with dilated cardiomyopathy admitted to the First Affiliated Hospital of Xi'an Jiaotong University from March 2021 to May 2022 were selected as the study subjects. All patients were diagnosed with dilated cardiomyopathy for the first time, and the systolic blood pressure (SBP) was 95-110 mmHg before medication. Patients were prescribed with sacubitril/valsartan (50 mg/time, twice a day) or dapagliflozin tablets (10 mg/time, once a day) before or at discharge and divided into the sacubitril/valsartan group (71 cases) and dapagliflozin group (53 cases) according to clinical drug use. The outpatient follow-up was performed 6 months after discharge until November 2022. General information of the two groups such as age and gender were collected through the hospital electronic medical record system, baseline and 6-month follow-up SBP, diastolic blood pressure (DBP) , and BMI of the two groups were recorded. Baseline and 6-month biochemical indicators〔N-terminal pro-B-type natriuretic peptide (NT-proBNP) , glycated hemoglobin (HbA1c) , fasting blood glucose (FBG) , estimated glomerular filtration rate (eGFR) , blood potassium〕, cardiac function indicators〔left ventricular ejection fraction (LVEF) , left ventricular end-diastolic diameter (LVEDD) , left ventricular end-systolic diameter (LVESD) , left atrial diameter (LAD) 〕, 6 min walking test (6MWT) and clinical events were collected. The biochemical indicators, cardiac function indicators and incidence of clinical events before and after treatment were compared between the two groups. Results Compared with the pre-treatment period, the levels of blood potassium, LVEF and 6MWT were increased in the sacubitril/valsartan group and dapagliflozin group after 6 months of treatment (P0.05) . Conclusion Both sacubitril/valsartan and dapagliflozin were effective in improving cardiac function in dilated cardiomyopathy patients with low blood pressure. The safety of the two groups is similar. However, the use of sacubitril/valsartan should be noted for the risk of hypotension and renal insufficiency.