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PurposeThe Quick Sequential Organ Failure Assessment (qSOFA) score proposed by Sepsis-3 as a sepsis screening tool has shown suboptimal accuracy. Heparin-binding protein (HBP) has been shown to identify early sepsis with high accuracy. Herein, we aim to investigate whether or not HBP improves the model performance of qSOFA.MethodsWe conducted a multicenter prospective observational study of 794 adult patients who presented to the emergency department (ED) with presumed sepsis between 2018 and 2019. For each participant, serum HBP levels were measured and the hospital course was followed. The qSOFA score was used as the comparator. The data was split into a training dataset (n = 556) and a validation dataset (n = 238). The primary endpoint was 30-day all-cause mortality.ResultsCompared with survivors, non-survivors had significantly higher serum HBP levels (median: 71.5 ng/mL vs 209.5 ng/mL, p < 0.001). Serum level of HBP weakly correlated with qSOFA class (r2 = 0.240, p < 0.001). Compared with the qSOFA model alone, the addition of admission HBP level to the qSOFA model significantly improved 30-day mortality discrimination (AUC, 0.70 vs. 0.80; P < 0.001), net reclassification improvement [26% (CI, 17–35%); P < 0.001], and integrated discrimination improvement [12% (CI, 9–14%); P < 0.001]. Addition of C-reactive protein (CRP) level or neutrophil-to-lymphocyte ratio (NLR) to qSOFA did not improve its performance. A web-based mortality risk prediction calculator was created to facilitate clinical implementation.ConclusionThis study confirms the value of combining qSOFA and HBP in predicting sepsis mortality. The web calculator provides a user-friendly tool for clinical implementation. Further validation in different patient populations is needed before widespread application of this prediction model.

Hand hygiene is now regarded as one of the most important element of infection control activities in hospital. This paper reviewed the importance, current status and hospital management strategies on hand hygiene of nursing students, in order to provide a reference of hand hygiene management in healthcare settings. (手卫生是控制和预防医院感染最有效的手段之一。本文综述了护理实习生手卫生重要性、现状以及医院管理护理实习生手卫生的各种举措, 以期为医院手卫生管理提供依据。)

This note examines the conditional least squares (CLS) estimators for integer-valued autoregressive (INAR) models, with a focus on the INAR(1) model. Our investigation reveals that the joint limiting distribution of the CLS estimators for the autoregressive coefficient and the mean of the model errors is degenerate in the case of mildly unstable INAR(1) models with moderate deviations from unity. This degeneracy may pose challenges for statistical inference. We provide commenting notes based on the asymptotic results to address this issue. Additionally, we conduct simulation studies and analyze a real-world dataset to validate the theoretical findings. [ABSTRACT FROM AUTHOR]

This article considers the problem of estimating the high-dimensional Poisson regression model with group sparsity in the parameter vector using the weighted group Lasso method. Non asymptotic oracle inequalities measuring the convergence rate of the estimation and prediction errors are given, provided that the true regression coefficients and the covariates satisfy suitable conditions. The non asymptotic oracle inequalities imply that the weighted group lasso estimator is consistent. A comparison of the performance of our proposed weights with other adaptive weights in simulated data shows that the weighted group Lasso estimator provides a good sparse approximation to the true parameters. [ABSTRACT FROM AUTHOR]

Parallel or convergent evolution may result in phenotypically closely similar species. Many studies have reported that using solely traditional external morphological features can result in misidentification. Here, we discuss using the reproductive systems and immature developmental stages for scientific classification in Eupelmidae (Hymenoptera: Chalcidoidea), exemplifying with Anastatus Motschulsky and Mesocomys Cameron (Eupelmidae, Eupelminae). Results show that there are at least 6 distinct differences in the immature stages and the reproductive systems of the adults between species of the 2 genera: (1) the terminal ends of the left and right ovarioles are connected together in the studied species of Anastatus but not in Mesocomys , (2) the base of the lateral oviduct of Anastatus has a diverticulum that is lobate-shaped, whereas this diverticulum is spherical in Mesocomys , (3) the peduncle of the egg of Anastatus is significantly longer than that of Mesocomys , (4) the head capsule of the terminal instar larvae of Anastatus is uniformly translucent, whereas in Mesocomys it has a brown pattern, (5) the ocelli of the Anastatus pupa are smooth and slightly raised whereas the ocelli of Mesocomys each have a long filament each, and (6) the phallobase of adult male Anastatus is sharp basally but rounded in Mesocomys. Our findings not only provide novel insights for the differentiation of similar genera that can be difficult to distinguish in the immature stages but also provide a more comprehensive theoretical basis for clarifying the evolutionary and phylogenic status of Anastatus and Mesocomys. [ABSTRACT FROM AUTHOR]

Using γ ray to irradiat six types of lithium grease, the color of these greases was observed to change, and the degree of change was found to be positively correlated with an increase in the absorbed dose. After irradiation with an absorbed dose of 8.1×103 kGy, the thickener of the lithium complex grease softened, degraded, and entered the hardening and crosslinking stage ahead of its ordinary degradation process. Furthermore, its average shear stress increased by 169%. Additional oxidation products were generated from the base oil of the lithium complex grease compared with the simple lithium-based grease treated with the same absorbed dose. When simple lithium grease absorbed a dose of 8.1×103 kGy, its thickener also softened and the consistency decreased; however, its average shear stress decreased. The degree of deterioration of the simple lithium grease was seemingly lighter than that of the lithium complex grease. Therefore, simple lithium grease may be more suitable for irradiation facilities.

Self-assembly of supramolecular structures has become an attractive means to create new biologically inspired materials and interfaces. We report the first robust hybrid bilayer systems readily coassembled from amphiphilic dendrimers and a naturally occurring phospholipid. Both concentration and generation of the dendrimers have direct impacts on the biophysical properties of the coassemblies. Raising the dendrimer concentration increases the hybrid bilayer stability, while changes in the generation and the concentration of the embedded dendrimers impact the fluidity of the coassembled systems. Multivalent dendrimer amine terminals allow for nondestructive in situ derivatization, providing a convenient approach to decorate and modulate the local environment of the hybrid bilayer. The coassembly of lipid/dendrimer interfaces offers a unique platform for the creation of hybrid systems with modular and precisely controllable behavior for further applications in sensing and drug delivery.

Abstract Background Klebsiella pneumoniae is a leading cause of hospital-associated (HA) infections. It has been reported that gastrointestinal colonization (GI) is likely to be a common and significant reservoir for the transmission and infections of K. pneumoniae in both adults and neonates. However, the homologous relationship between clinically isolated extraintestinal and enteral K. pneumoniae in neonates hasn’t been characterized yet. Results Forty-three isolates from 21 neonatal patients were collected in this study. The proportion of carbapenem resistance was 62.8%. There were 12 patients (12/21, 57.4%) whose antibiotic resistance phenotypes, genotypes, and ST types (STs) were concordant. Six sequence types were detected using MLST, with ST37 and ST54 being the dominant types. The results of MLST were consist with the results of PFGE. Conclusions These data showed that there might be a close homologous relationship between extraintestinal K. pneumoniae (EXKP) and enteral K. pneumoniae (EKP) in neonates, indicating that the K. pneumoniae from the GI tract is possibly to be a significant reservoir for causing extraintestinal infections.