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The treatment of severe hemorrhagic fever with renal syndrome (HFRS) cases is difficult.We lack an early warning model for severe HFRS patients today. We retrospectively collected the data of 235 HFRS patients from January 2013 to December 2019, as well as 394 laboratory indicators. The multivariate logistic regression model was used to construct an early warning model for severe disease. The accuracy of the model was evaluated based on the area under the receiver operating characteristic (ROC) curve. The area under curve (AUCs) of the early warning models both exceeded 0.9 for the two stages. In the febrile stage, there were significant differences between the severe and mild groups (P0.05) in the renal estimated glomerular filtration rate (eGFR), urinary leukocytes , electrolytes, urine conductivity and urinary epithelial cell count. In the non-febrile stage, there were significant differences between the severe and mild groups (P0.05) in the renal eGFR, electrolytes, urine conductivity and renal cystatin C. The two early warning models are well fitted and have excellent predictive performance. That can help clinicians gain time to provide appropriate preemptive treatment to avoid the further development of severe disease and reduce the mortality rate.

Combinatorial metaheuristic optimization algorithms have newly become a remarkable domain for handling real-world and engineering design optimization problems. In this paper, the Whale Optimization Algorithm (WOA) and the Woodpecker Mating Algorithm (WMA) are combined as HWMWOA. WOA is an effective algorithm with the advantage of global searching ability, where the control parameters are very less. But WOA is more probable to get trapped in the local optimum points and miss diversity of population, therefore suffering from premature convergence. The fundamental goal of the HWMWOA algorithm is to overcome the drawbacks of WOA. This betterment includes three basic mechanisms. First, a modified position update equation of WMA by efficient exploration ability is embedded into HWMWOA. Second, a new self-regulation Cauchy mutation operator is allocated to the proposed hybrid method. Finally, an arithmetic spiral movement with a novel search guide pattern is used in the suggested HWMWOA algorithm. The efficiency of the suggested algorithm is appraised over 48 test functions, and the optimal outcomes are compared with 15 most popular and newest metaheuristic optimization algorithms. Moreover, the HWMWOA algorithm is applied for simultaneously optimizing the parameters of SVM (Support Vector Machine) and feature weighting to handle the data classification problem on several real-world datasets from the UCI database. The outcomes prove the superiority of the suggested hybrid algorithm compared to both WOA and WMA. In addition, the results represent that the HWMWOA algorithm outperforms other efficient techniques impressively.

Depressive symptoms have a series of negative effects and are considered especially severe among nurses, whereas there is a lack of quantitative studies comparing the risk of depressive symptoms between nurses and the general population.We respectively conducted a nationwide cross-sectional online survey among 17,582 Chinese nurses from July to August 2018, and 101,120 Chinese community residents from January to February 2019. The questionnaire covered social-demographic characteristics and depressive symptoms for both, work-related factors and life-related factors for nurses. Propensity Score Matching was performed to match nurses and residents by gender, age, educational level, marital status, and habitual residence.Before Propensity Score Matching, the risk of depressive symptoms in nurses was higher than residents (OR, 2.16; 95% CI, 2.07-2.26). After matching, there were 15,256 nurses and residents respectively, and the risk in nurses was higher (OR, 2.14; 95% CI, 2.02-2.27). Logistic regression showed that longer years of service (OR, 1.54; 95% CI, 1.30-1.83), higher night shift frequency (OR, 1.48; 95% CI, 1.35-1.64), perceived shortage of nurses (OR, 1.98; 95% CI, 1.84-2.13), suffered verbal violence (OR, 2.43; 95% CI, 2.21-2.66) and physical violence (OR, 1.80; 95% CI, 1.64-1.98) were risk factors for depressive symptoms in nurses.Convenience sampling and online survey were adopted in this cross-sectional study, which may diminish the representativeness of samples.Compared with the general population, nurses have a higher risk of depressive symptoms in China. Reasonable work allocation, adequate staffing, scientific shift system and violence emergency system should be implemented.

Despite the need in various applications, accurate quantification of nucleic acids still remains a challenge. The widely-used qPCR has reduced accuracy at ultralow template concentration and is susceptible to nonspecific amplifications. The more recently developed dPCR is costly and cannot handle high-concentration samples. We combine the strengths of qPCR and dPCR by performing PCR in silicon-based microfluidic chips and demonstrate high quantification accuracy in a large concentration range. Importantly, at low template concentration, we observe on-site PCR (osPCR), where only certain sites of the channel show amplification. The sites have almost identical ct values, showing osPCR is a quasi-single molecule phenomenon. Using osPCR, we can measure both the ct values and the absolute concentration of templates in the same reaction. Additionally, osPCR enables identification of each template molecule, allowing removal of nonspecific amplification during quantification and greatly improving quantification accuracy. We develop sectioning algorithm that improves the signal amplitude and demonstrate improved detection of COVID in patient samples.

Developing efficient photocatalyst for the photoreduction of CO2 and degradation of organic pollutants is an effective alternative to address increasingly serious energy problems and environmental pollution. Herein, the isostructural Sillén–Aurivillius oxyhalides, Bi7Fe2Ti2O17X (X = Cl, Br, and I; BFTOX), are fabricated for CO2 reduction and degradation of organic pollutants for the first time. Density functional theory (DFT) calculations show that the valence band maximum (VBM) of BFTOC and BFTOB is contributed by the dispersive 2p orbitals of O-atoms, providing the narrow band gap (Eg) and possibly the stability against self-decomposition deactivation. The photocatalytic activities of BFTOX are strongly affected by the halogens (Cl, Br, and I), namely, the BFTOCl sample displays outstanding activity improvement (3.74 μmol·g−1·h−1) for photocatalytic performance. This is mainly attributed to the high separation of charge carriers, small optical band gap, and extended optical absorption. This work focuses on affording a reference to develop efficient and stable photocatalysts from Sillén-Aurivillius layered oxyhalide materials.

Background: Invasive candidiasis may be caused by Candida albicans (C. albicans) colonisation of the intestinal tract. Therefore, protection against invasive C. albicansinfections requires a functional intestinal epithelial barrier. Mice infected with Candida albicans in the gut and healthy mice were sampled for faecal analysis. After C. albicans infection, we found significant changes in tryptophan metabolites-kynurenic acid (KynA) and indole acrylate (IA)compared with healthy mice. Results: We identify the mechanism by which KynA and IA ameliorate dextran sulphate sodium (DSS)-induced intestinal C. albicansinfection, based on a systematic analysis of the gut microbiota, metabolomics and transcriptome sequencing in mice. KynA and IA suppress inflammation, upregulate the expression of intestinal tight junctions and reduce IL-22 secretion of colonic lamina propria ILC3 in response of invasive Candida infection. Furthermore, we demonstrated that the gut barrier protection and ILC3 regulation mediated by KynA and IA were dependent on gut microbiota modification by transplanting faecal microbiota into ABX-treated C57BL/6J mice. Conclusion: Our study provides microbiome-to-metabolite alterations in C. albicans gut infection and identifies gut microbiome regulation and IL-22 derived from colonic lamina propria ILC3 as novel targets for C. albicans gut infection therapies.

Primary systemic amyloidosis (PSA) is a systemic disease caused by amyloid deposition in various tissues and organs. In the early stages of the disease, approximately 40% of patients have skin damage, which may be the only clinical manifestation. This report described the case of a 67-year-old male with PSA who presented with characteristic cutaneous manifestations. Physical examination showed seborrheic keratotic-like plaques around the orbit, purpura and ecchymosis on the neck and dorsum manus, as well as nail dystrophy. An auxiliary examination indicated a 24-h urine protein content of 2.89 g, and serum immunoelectrophoresis showed a monoclonal λ light chain. Echocardiography showed decreased left ventricular diastolic function and mild pulmonary hypertension. The dermoscopic features were multiple comedo-like openings and milia-like cysts. Histopathology showed multiple keratinous cysts in the dermis and eosinophilic, acellular, homogenous material in the dermis that was Congo red-positive. The diagnosis was confirmed through biopsy of skin lesions and kidney.Skin lesions of this case are rare.Skin lesions around the orbit need to arouse the vigilance of dermatologists. PSA should be considered if the patient with multisystemic symptoms.Skin biopsy and Congo red staining were very important for early diagnosis of PSA.

To investigate whether the treatment zone (TZ) decentration in orthokeratology (OK) lenses affects retinal expansion in Chinese children with myopia.Children aged 8 to 13 years (n = 30) were assessed over 13 months comprising 12 months of OK lens wear followed by discontinuation of lens wear for 1 month. Corneal topography was measured at 0, 1, 3, 6, 9, 12 and 13 months. TZ decentration of the OK lens was calculated, and subjects were subdivided into a small decentration group (group S) and a large decentration group (group L) based on the median value of the weighted average decentration (dMean AL growth for one year was 0.28 ± 0.17 mm. In a multiple linear regression model, AL elongation was related to the baseline age (β = -0.41, p = 0.01) and the dGreater TZ decentration with the use of OK lenses was associated with slower axial growth and a more oblate retinal shape. TZ decentration caused local defocusing changes, which may inhibit myopic progression. These findings may have important implications for improving optical designs for myopia control.

Guided tissue regeneration (GTR) membranes not only can hamper undesirable tissues down-growth into the defects but also can selectively promote the in-growth of regenerative bone tissue, playing a critical role in periodontal regeneration. Herein, a bi-layered electrospun membrane with different sized pores was designed and fabricated by adjusting electrospinning parameters combing with facile two-step electrospinning. The small-sized pore layer (SL) as occlusive layer consisted of electrospun poly (lactic-co-glycolic acid) (PLGA) nanofibers, while the macroporous osteoconductive layer (ML) was attained via introducing the nano-hydroxyapatite (nHA) particles into PLGA nanofibers during electrospinning. Morphological results such as surface topography, nanofiber size, and pore size distribution, showed that the SL exhibited a dense structure with pore size mainly from 4 to 7 μm. In contrast, the ML possessed a loosely packed structure with pore size mainly from 20 to 28 μm, which was beneficial to the infiltration of the cells. Fourier transform infrared spectroscopy (FTIR), Energy dispersive spectrometer (EDS), and X-ray diffractometry (XRD) results showed that nHA particles were evenly loaded in PLGA nanofibers. In vitro biodegradation tests suggested that the bi-layered membrane possessed a proper degradation timeframe, which must function for at least 4 to 6 weeks. The cell experiments indicated that the bi-layered electrospun membrane possessed good cytocompatibility and proved the effective barrier potency of the small-sized pore layer. Furthermore, as revealed by the alkaline phosphate activity test, the PLGA/nHA layer possessed an improved osteogenic capacity for Human osteosarcoma cells (MG63). These results indicate that the bi-layered electrospun membrane may have potential for periodontal tissue regeneration.

Turnover intention among nurses is high, especially in the emergency department. However, factors that are associated with Chinese emergency department nurses' turnover intention have been scarcely studied.The present study examined relationships between turnover intention and demographic characteristics, job-related factors, depressive symptoms, and organizational commitment among emergency department nurses.A cross-sectional study of emergency department nurses was conducted in China between July and August 2018. The questionnaire included demographic characteristics (age, gender, level of education, and self-rated health status), job-related factors (qualification title, job seniority, night shifts, and workplace violence), depressive symptoms, organizational commitment, and turnover intention. A hierarchical linear regression model was used to identify factors that are associated with turnover intention among emergency department nurses.A total of 17 582 emergency department nurses participated in the study. The response rate was 68.9%. The findings indicated that poor self-rated health status (β = 0.25, p .001), working more than 11 night shifts per month (β = 0.14, p .01), experiencing workplace violence in the past year (β = 0.08, p .05), and higher depressive symptom scores (β = 0.07, p .001) positively correlated with turnover intention. More years of service (β = -0.38, p .001) and higher organizational commitment scores (β = -0.45, p .001) negatively correlated with turnover intention.Health status, job seniority, night shift frequency per month, workplace violence, depressive symptoms, and organizational commitment were significantly associated with emergency department nurses' turnover intention.To reduce turnover intention in the emergency department nurses, hospital administrators and managers should implement measures to improve their physical and mental health, increase organizational commitment, develop staff acceptable shift schedules, and reduce incidences of workplace violence.

Early clinical trials indicate that patients with anaplastic lymphoma kinase (ALK)-driven non-small cell lung cancer (NSCLC) have a lower response rate to programmed cell death protein 1 (PD-1) antibody therapy. However, the specific mechanism underlying this remains unclear. To further explore the characteristics of the tumor microenvironment and determine the potential mechanism of immunotherapy resistance in patients with ALK, we selected another important immune-related molecule, major histocompatibility complex class I (HLA-I), as the focus of our study.We collected the biopsy samples of 140 patients with NSCLC. The number of CD8+ T cells and HLA-I/programmed cell death 1 ligand 1 (PD-L1) expression were determined by immunohistochemistry. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method, and their relationship with patient clinical characteristics analyzed using Cox proportional hazards regression. In addition, we treated ALK-positive lung cancer cells with ALK inhibitors in vitro to observe changes of HLA-I.ALK positivity was associated with low membrane PD-L1 and HLA-I expression. However, these two indicators were not associated with the prognosis of patients with stage I-IIIa NSCLC. Inhibition of ALK could upregulate HLA-I membrane expression to a certain extent.Patients with ALK fusion showed downregulation of PD-L1 and HLA-I expression on the tumor cell membrane. Inhibition of ALK and its downstream signaling pathway can reverse it. These results suggest that the appropriate combination therapy should be considered for patients with ALK fusion and using targeted therapy at the proper time may increase patient benefits.

Guided tissue regeneration (GTR) membranes have great potential to promote periodontal tissue regeneration and reestablishment. However, the regeneration potential and microbial infection resistance of current GTR membranes still need to be improved. Here, a bi-layered nanofibrous membrane on the basis of poly (lactic-co-glycolic acid) (PLGA)/gelatin with osteogenic and antibacterial functions was fabricated for periodontal tissue regeneration. The antimicrobial layer (AL) of the bi-layered nanofibrous membrane was composed of nanofibrous PLGA/gelatin nanofibers loaded with nano-silver (nAg), while the osteoconductive layer (OL) of the nanofibrous membrane consisted of PLGA/gelatin nanofibers loaded with nano-hydroxyapatite (nHA). The bi-layered nanofibrous membrane was examined by scanning electron microscopy (SEM), energy dispersive spectrometer (EDS), transmission electron microscope (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectrometry (XPS) and X-ray diffractometry (XRD). The results showed that nHA and nAg particles were well evenly loaded or embedded in PLGA/gelatin nanofibers. The cell culture experiments suggested that the bi-layered nanofibrous membrane possessed good cytocompatibility and the OL of the bi-layered nanofibrous membrane possessed an enhanced osteogenic capacity for human osteoblast-like cells (MG63), which was verified by the good cell viability and the increased alkaline phosphatase (ALP) activity, respectively. The results of in vitro antimicrobial study displayed that the AL of the bi-layered nanofibrous membrane possessed an effective antibacterial capability. In conclusion, the prepared bi-layered nanofibrous membrane with osteogenic and antibacterial functions may have great potential for periodontal tissue regeneration and reestablishment. [Formula: see text]

In this study, we investigate the hydrodynamic behavior of the different time-periodic electrically driven nanofluid flows through parallel plate microchannels under the combined influences of externally applied axial pressure gradient and transverse magnetic field. The analytical solutions for electro-magneto-hydro-dynamic (EMHD) flow in microchannels are obtained under the Debye–Huckel linearization. It's worth mentioning that the analytical solution of the velocity field under the unsteady state conditions is obtained by the Green's function method. In addition, we also compare the streaming potential and electrokinetic energy conversion efficiency under different time-periodic with related experimental data and theoretical research and conclude that the square waveform can effectively improve the streaming potential and electrokinetic energy conversion efficiency. The influences of several dimensionless parameters on velocity field, streaming potential and electrokinetic energy conversion efficiency are discussed in briefly and presented graphically.

Two-dimensional electromagnetohydrodynamic behavior of nanofluids through rectangular microchannels is investigated. The combined effects of time-periodic pressure gradients and magnetic fields in terms of the Hall effects on nanofluid flow are considered. Under the Debye–Hückel linearization approximation, the semi-analytic solution of the velocity field is derived by Green’s function method. Furthermore, the semi-analytic solutions of electrokinetic energy conversion (EKEC) efficiency and the streaming potential of nanofluids through the rectangular microchannels are obtained. The variations of the velocity, streaming potential, and EKEC efficiency with the electric double layer thickness K, Hartmann number Ha, Hall parameter m, and dimensionless frequency Ω are shown and briefly discussed.

Photoactive metal-organic frameworks, MIL-100(Fe), with controllable thickness are coated on plasmonic Ag/AgCl nanowire, for boosting visible light photodegradation of rhodamine B and tetracycline hydrochloride. The morphology and composition of the obtained nano-heterostructure were investigated in detail by SEM imaging, TEM imaging, XRD patterns, FT-IR spectra, N

A novel supramolecular gelator (G3) exhibited excellent selectivity toward Mg2+ as well as showed excellent gelation abilities. Meanwhile, an efficient artificial light-harvesting system has been constructed between G3@Mg-sol or G3@Mg-gel and RhB.

Human–object interaction (HOI) detection is important for promoting the development of many fields such as human–computer interactions, service robotics, and video security surveillance. A high percentage of human–object pairs with invalid interactions are discovered in the object detection phase of conventional human–object interaction detection algorithms, resulting in inaccurate interaction detection. To recognize invalid human–object interaction pairs, this paper proposes a model structure, the interactivity recognition graph neural network (IR-GNN) model, which can directly infer the probability of human–object interactions from a graph model architecture. The model consists of three modules: The first one is the human posture feature module, which uses key points of the human body to construct relative spatial pose features and further facilitates the discrimination of human–object interactivity through human pose information. Second, a human–object interactivity graph module is proposed. The spatial relationship of human–object distance is used as the initialization weight of edges, and the graph is updated by combining the message passing of attention mechanism so that edges with interacting node pairs obtain higher weights. Thirdly, the classification module is proposed; by finally using a fully connected neural network, the interactivity of human–object pairs is binarily classified. These three modules work in collaboration to enable the effective inference of interactive possibilities. On the datasets HICO-DET and V-COCO, comparative and ablation experiments are carried out. It has been proved that our technology can improve the detection of human–object interactions.