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Summary: Accurate detection of pathogens, particularly distinguishing between Gram-positive and Gram-negative bacteria, could improve disease treatment. Host gene expression can capture the immune system’s response to infections caused by various pathogens. Here, we present a deep neural network model, bvnGPS2, which incorporates the attention mechanism based on a large-scale integrated host transcriptome dataset to precisely identify Gram-positive and Gram-negative bacterial infections as well as viral infections. We performed analysis of 4,949 blood samples across 40 cohorts from 10 countries using our previously designed omics data integration method, iPAGE, to select discriminant gene pairs and train the bvnGPS2. The performance of the model was evaluated on six independent cohorts comprising 374 samples. Overall, our deep neural network model shows robust capability to accurately identify specific infections, paving the way for precise medicine strategies in infection treatment and potentially also for identifying subtypes of other diseases.

Microplastic pollution is a growing ecological problem and human exposure to micrioplastic through dietary intake, air inhalation and skin-to-skin contact is inevitable. This study provides an overview on the properties of microplastics, the pathways of microplastic exposure in humans, and potential impact of microplastics on human body systems as a reference to future research.

Abstract Load bearing/energy storage integrated devices (LEIDs) allow using structural parts to store energy, and thus become a promising solution to boost the overall energy density of mobile energy storage systems, such as electric cars and drones. Herein, with a new high-strength solid electrolyte, we prepare a practical high-performance load-bearing/energy storage integrated electrochemical capacitors with excellent mechanical strength (flexural modulus: 18.1 GPa, flexural strength: 160.0 MPa) and high energy storage ability (specific capacitance: 32.4 mF cm−2, energy density: 0.13 Wh m−2, maximum power density: 1.3 W m−2). We design and compare two basic types of multilayered structures for LEID, which significantly enhance the practical bearing ability and working flexibility of the device. Besides, we also demonstrate the excellent processability of the LEID, by forming them into curved shapes, and secondarily machining and assembling them into complex structures without affecting their energy storage ability.

Abstract Background Vascular calcification is a major cause of the high morbidity and mortality of cardiovascular diseases and is closely associated with the intestinal microbiota. Short-chain fatty acids (SCFAs) are derived from the intestinal microbiota and can also regulate intestinal microbiota homeostasis. However, it remains unclear whether exogenous supplementation with propionate, a SCFA, can ameliorate vascular calcification by regulating the intestinal microbiota. This study was conducted to explore the roles of propionate and the intestinal microbiota in the process of vascular calcification. Methods In total, 92 patients were enrolled consecutively as the observational cohort to analyse the relationship between SCFAs and vascular calcification in both blood and faecal samples. A rat model of vascular calcification was induced by vitamin D3 and nicotine (VDN) to validate the effect of propionate. Differences in the intestinal microbiota were analysed by 16S ribosomal RNA gene sequencing. Faecal microbiota transplantation and Akkermansia muciniphila transplantation experiments were performed to evaluate the functions of the intestinal microbiota. Results The results of the observational cohort study revealed that the levels of SCFAs (particularly propionate) in both blood and faecal samples independently correlated negatively with calcification scores (P < 0.01). To verify the activities of propionate, it was provided to VDN-treated rats, and oral or rectal propionate delivery reshaped the intestinal microbiota, resulted in elevated SCFA production, improved intestinal barrier function and alleviated inflammation, ultimately ameliorating vascular calcification. Furthermore, we demonstrated that transplantation of the propionate-modulated intestinal microbiota induced beneficial outcomes similar to those with oral or rectal propionate administration. Interestingly, linear discriminant analysis (LDA) effect size (LEfSe) revealed that oral or rectal propionate administration and propionate-modulated intestinal microbiota transplantation both enriched primarily Akkermansia. Subsequently, we demonstrated that Akkermansia supplementation could ameliorate VDN-induced vascular calcification in rats. Conclusions Propionate can significantly ameliorate vascular calcification in VDN-treated rats, and this effect is mediated by intestinal microbiota remodelling. The findings in our study indicate that the intestinal tract-vessel axis is a promising target for alleviating vascular calcification. Video Abstract

Objectives: To investigate the prevalence of post-traumatic stress disorder in intensive care unit survivors, and disorder’s correlation with analgesia use. Method: The single-centre retrospective cohort study was conducted at the First Affiliated Hospital of Jinan University, China, and comprised data from February 2021 to January 2022 related to patients of either gender aged 18 years who were admitted to the intensive care unit and were successfully transferred out to the general ward. Post-traumatic stress disorder Checklist-Civilian Version scale was used for follow-up within one month of getting transferred out of intensive care. Data was analysed using Empower Stats. Results: Of the 121 patients with mean age 54.34±18.19 years, 52(43percent) were positive for post-traumatic stress disorder; 32(61.5percent) males and 20(38.5percent) females with mean age 54.48 ± 19.56 years. The remaining 69(57percent) patients were negative; 40(58percent) males and 29(42percent) females with mean age 54.23±17.24 years (p 0.05). The positive rate of re-experiencing symptoms was noted in 68(56.20percent) patients. Analgesia usage was positive in 61(50.4percent) cases and negative in 60(49.6percent) cases. Compared to the non-analgesic group, the risk of post-traumatic stress disorder occurrence in the analgesic group was significantly high (p=0.018). The duration of analgesia usage 24-48h was also significant (p=0.017). Conclusions: There was a high prevalence of post-traumatic stress disorder in intensive care unit survivors, which was affected by the use of analgesics in intensive care settings. Key Words: Post-traumatic stress disorder, PTSD, Analgesics, Intensive care unit.

Background: The number of older people in the world is increasing year by year; studies have shown that more than 90% of cardiovascular disease occurs in the older people population, indicating that aging is one of the major risks involved in the development of cardiovascular disease. Therefore, retarding the development of cardiac aging is an important strategy to prevent aging-related cardiovascular diseases. Methods: In the current study, we examined the anti-cardiovascular aging potential of canthaxanthin in vitro and in vivo experiments. For this, a model of cardiomyocyte senescence induced by D-galactose was established, which was used to investigate the canthaxanthin’s effect on cardiac premature aging. Results: We found that canthaxanthin obviously mitigated the cardiomyocyte senescence in vitro. Further mechanistic studies revealed that canthaxanthin seems to alleviate cardiomyocyte senescence by regulating the autophagy process. Furthermore, the effects of canthaxanthin on cardiovascular senescence were further evaluated. We also observed that canthaxanthin mitigated cardiac aging and fibrosis in the aged mice model. Conclusions: To sum up, the current work showed that canthaxanthin could obviously alleviate cardiac premature aging, indicating that canthaxanthin could be used as a biologically active molecule for the treatment of cardiac aging and fibrosis.

Previous allocations of new urban land were ineffective because they lacked synergy between quota and space, challenging the government planning authority. This study proposes a new and more reasonable urban land allocation method to guide the smart growth of cities. We used a logistic regression model and multisource data to explore the laws of urban growth and employed a cellular automata (CA) model to simulate this under inertial and constrained scenarios. In addition, the disparities between both scenarios concerning allocation were analyzed. We realized the synergy of quota and space allocations of new urban land through urban growth simulation. Further, the allocation of new urban land was more consistent with the development strategy of Guangzhou under a constrained scenario. The allocation of space was more regular and concentrated under a constrained scenario, which aligns with the requirements of the Government Land Space Planning. Additionally, in the constrained scenario, the bottom lines of cultivated land protection, ecological service, and geological safety were better controlled. This study compensated for the shortcomings of the disjoined quota and space allocations of new urban land and proved that a constrained scenario can more effectively promote reasonable urban growth.

In this study, the uniaxial compressive mechanical properties of earth materials are tested, and the effects of four influencing factors, such as shape, size, curing age, and loading rate, on the strength, damage pattern, and stress-strain curve of the specimens are analyzed. The standard uniaxially compressed specimen size and the recommended loading rate are proposed for the earth specimens. The uniaxial compressive constitutive equations of earth materials are modified on the basis of the Illampas constitutive equation. By fitting the results of this study and typical literature tests, the applicability of the modified constitutive equation form to the uniaxial compressive test curves of soils in different regions of China based on standard sizes is verified. Finally, the formulae for calculating the parameters related to the constitutive equation of earth materials are established. In its application, only the compressive strength of 100-mm-cubic standard specimens with a curing age of 28 d needs to be measured to calculate and determine the specific values of the relevant parameters of the constitutive equation. This is a good reference value for promoting the development of computational analysis methods for earth structures and promoting the engineering design applications of earth structures.

Objectives: Delirium is a common acute cognitive impairment syndrome among intensive care unit (ICU) patients. This study was aimed to investigate the incidence, risk factors, and cumulative risk of delirium among ICU patients. Methods: A case-control study including clinical records of 452 patients were retrospectively analyzed. Delirium was assessed using the Confusion Assessment Method for the ICU and Richmond Agitation–Sedation Scale. Results: We found that 163 out of the 452 patients (36.1%) had delirium. Multivariate analysis showed that use of sedatives, length of ICU hospitalization, and physical restraint were independent risk factors for delirium. The additive effect of all three factors resulted to an odds ratio of 30.950. Conclusion: The incidence of delirium remained high. Thus, nurses shall strengthen the monitoring of delirium, regularly access the patient's level of calmness, and limit the use of physical restraint. Keywords: Delirium, Intensive care units, Risk factors, Cumulative risk, Case-control studies

Abstract Background: Elevated plasma levels of Lipoprotein(a) [Lp(a)] are recognized as a significant risk factor for atherosclerotic vascular disease. However, there are limited data regarding association between Lp(a) and recurrent heart failure (HF) in patients with chronic HF caused by coronary heart disease (CHD). Objective: Elevated levels of Lp(a) might have a prognostic impact on recurrent HF in patients with chronic HF caused by CHD. Methods: A total of 309 patients with chronic HF caused by CHD were consecutively enrolled in this study. The patients were divided into 2 groups according to whether Lp(a) levels were above or below the median level for the entire cohort (20.6 mg/dL): the high Lp(a) group (n = 155) and the low Lp(a) group (n = 154). A 2-sided p < 0.05 was statistically considered significant. Results: During the median follow-up period of 186 days, 31 cases out of a total of 309 patients (10.03%) could not be reached during follow-up. A Kaplan-Meier analysis demonstrated that patients with higher Lp(a) levels had a higher incidence of recurrent HF than those with lower Lp(a) levels (log-rank < 0.0001). A multivariate Cox regression analysis revealed that Lp(a) levels were independently correlated with the incidence of recurrent HF after adjustment of potential confounders (hazard ratio: 2.720, 95 % confidence interval: 1.730-4.277, p < 0.0001). Conclusions: In Chinese patients with chronic HF caused by CHD, elevated levels of Lp(a) are independently associated with recurrent HF.

PurposeThis study aimed to evaluate the effectiveness of generative adversarial networks (GANs) in creating synthetic OCT images as an educational tool for teaching image diagnosis of macular diseases to medical students and ophthalmic residents.MethodsIn this randomized trial, 20 fifth-year medical students and 20 ophthalmic residents were enrolled and randomly assigned (1:1 allocation) into Group real OCT and Group GANs OCT. All participants had a pretest to assess their educational background, followed by a 30-min smartphone-based education program using GANs or real OCT images for macular disease recognition training. Two additional tests were scheduled: one 5 min after the training to assess short-term performance, and another 1 week later to assess long-term performance. Scores and time consumption were recorded and compared. After all the tests, participants completed an anonymous subjective questionnaire.ResultsGroup GANs OCT scores increased from 80.0 (46.0 to 85.5) to 92.0 (81.0 to 95.5) 5 min after training (p

Abstract Methane activation by photocatalysis is one of the promising sustainable technologies for chemical synthesis. However, the current efficiency and stability of the process are moderate. Herein, a PdCu nanoalloy (~2.3 nm) was decorated on TiO2, which works for the efficient, stable, and selective photocatalytic oxidative coupling of methane at room temperature. A high methane conversion rate of 2480 μmol g−1 h−1 to C2 with an apparent quantum efficiency of ~8.4% has been achieved. More importantly, the photocatalyst exhibits the turnover frequency and turnover number of 116 h−1 and 12,642 with respect to PdCu, representing a record among all the photocatalytic processes (λ > 300 nm) operated at room temperature, together with a long stability of over 112 hours. The nanoalloy works as a hole acceptor, in which Pd softens and weakens C-H bond in methane and Cu decreases the adsorption energy of C2 products, leading to the high efficiency and long-time stability.

In order to improve the energy capture efficiency of direct-drive wave power generation (DDWEG) systems and enhance the robustness of the reference power tracking control, a Fourier coefficient-based energy capture (FCBEC) and a position sensorless disturbance suppression (PSDS) control strategy are proposed. For energy capture, FCBEC is proposed to construct the objective function by maximizing the average power over a period of time and expanding the variables in the Fourier basis when the maximum power is captured, which is used as the basis for obtaining the reference trajectory. To address the limitations of the mechanical encoder, the position sensorless technique, based on a sliding mode observer (SMO), is used in the power tracking control, and the position information is obtained through an inverse tangent function. The perturbation caused by the inverse electromotive force error in the system is theoretically analyzed. A full-order terminal sliding mode approach is employed to design a current controller that suppresses the perturbation and ensures accurate tracking of the reference current. Simulation results show that the ocean-wave energy capture strategy proposed in this paper can make the energy captured by the PTO reach the optimal value under the impedance matching condition, and that the response speed and robustness of the full-order terminal sliding mode are better than the traditional PI control.

Offshore wind power generation has been developed rapidly. In order to improve the efficiency of offshore wind power generation, this paper studies the parallel connection of two same-phase cables of two-circuit of submarine cables. Firstly, the mathematical model of same-phase parallel connection of submarine cables is established, and the cable impedance matrix and the expression of cable current unbalance are obtained. Then, two parallel cable parallel schemes are selected for comparative analysis. The results show that the triangle parallel scheme is more suitable for same-phase parallel connection of submarine cables. In addition, this paper is optimized for the triangle parallel scheme. On this basis, the operation strategy of the cable combined with cable temperature is studied in this paper. Enables cables to carry higher currents and to operate longer overloads. This study is beneficial to provide recommendations for the laying of practical submarine cables.

Purpose: This study aimed to investigate sub-health status (SHS) of people living in China during the Coronavirus disease 2019 (COVID-19) COVID-19 pandemic. COVID-19 is a severe acute respiratory syndrome coronavirus (SARS-CoV) infection-induced acute infectious disease, which is featured by universal susceptibility and strong infectivity, and SHS (a status of low quality health) refers to a status of low-quality health. COVID-19 has gradually developed into a global pandemic, making the public in a high stress situation in physiological, psychological and social states in the short term. Methods: From March 6 to 11, 2020, a large-scale cross-sectional survey was conducted by convenient sampling, and SHS assessment scale was used in the questionnaire. The ordinal logistic regression analysis was used to identify the factors affecting SHS. Results: In this study, 17,078 questionnaires were delivered with 16,820 effective questionnaires collected, and 10,715 subjects (63.7%) were found with SHS, with moderate SHS primarily. Physiological sub-scale scored the highest, followed by psychological and social sub-scales. Ordinal logistic regression analysis indicated that man, only-child, workers and farmers were risk factors of SHS. Protective factors of SHS included living in rural areas and townships, laid-off retirees and education degree. Conclusion: It shows many people in China place in a poor health status during COVID-19 pandemic. It is necessary that relevant departments pay more attention to people with poor health such as men, only-child, urban people, workers and farmers, and groups with high education degree during and after pandemic stabilization. [ABSTRACT FROM AUTHOR]

In order to meet the requirements of smooth connection and gradual load transfer between power supply and ship’s power grid. A control strategy based on an AC/DC/AC converter topology is studied in this paper. Rectification of the grid side by a double closed-loop control model using SVPWM (Space Vector Pulse Width Modulation). The V/f control strategy combined with pre-synchronization control is adopted for grid connection, in order to reduce the shock. A droop control strategy is used after grid connection. Generator gradually exits operation. The output power of the power supply increases gradually. The load is transferred in this way.

Abstract Background The purpose of this study was to implement and evaluate a deep learning (DL) approach for automatically detecting shallow anterior chamber depth (ACD) from two-dimensional (2D) overview anterior segment photographs. Methods We trained a DL model using a dataset of anterior segment photographs collected from Shanghai Aier Eye Hospital from June 2018 to December 2019. A Pentacam HR system was used to capture a 2D overview eye image and measure the ACD. Shallow ACD was defined as ACD less than 2.4 mm. The DL model was evaluated by a five-fold cross-validation test in a hold-out testing dataset. We also evaluated the DL model by testing it against two glaucoma specialists. The performance of the DL model was calculated by metrics, including accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Results A total of 3753 photographs (1720 shallow AC and 2033 deep AC images) were assigned to the training dataset, and 1302 photographs (509 shallow AC and 793 deep AC images) were held out for two internal testing datasets. In detecting shallow ACD in the internal hold-out testing dataset, the DL model achieved an AUC of 0.86 (95% CI, 0.83–0.90) with 80% sensitivity and 79% specificity. In the same testing dataset, the DL model also achieved better performance than the two glaucoma specialists (accuracy of 80% vs. accuracy of 74 and 69%). Conclusions We proposed a high-performing DL model to automatically detect shallow ACD from overview anterior segment photographs. Our DL model has potential applications in detecting and monitoring shallow ACD in the real world. Trial registration http://clinicaltrials.gov , NCT04340635 , retrospectively registered on 29 March 2020.

Abstract Optical coherence tomography (OCT) images is widely used in ophthalmic examination, but their qualities are often affected by noises. Shearlet transform has shown its effectiveness in removing image noises because of its edge-preserving property and directional sensitivity. In the paper, we propose an adaptive denoising algorithm for OCT images. The OCT noise is closer to the Poisson distribution than the Gaussian distribution, and shearlet transform assumes additive white Gaussian noise. We hence propose a square-root transform to redistribute the OCT noise. Different manufacturers and differences between imaging objects may influence the observed noise characteristics, which make predefined thresholding scheme ineffective. We propose an adaptive 3D shearlet image filter with noise-redistribution (adaptive-SIN) scheme for OCT images. The proposed adaptive-SIN is evaluated on three benchmark datasets using quantitative evaluation metrics and subjective visual inspection. Compared with other algorithms, the proposed algorithm better removes noise in OCT images and better preserves image details, significantly outperforming in terms of both quantitative evaluation and visual inspection. The proposed algorithm effectively transforms the Poisson noise to Gaussian noise so that the subsequent shearlet transform could optimally remove the noise. The proposed adaptive thresholding scheme optimally adapts to various noise conditions and hence better remove the noise. The comparison experimental results on three benchmark datasets against 8 compared algorithms demonstrate the effectiveness of the proposed approach in removing OCT noise.

A direct drive wave power generation system (DDWPGS) has the advantages of a simple structure and easy deployment, and is the first choice to provide electricity for islands and operation platforms in the deep sea. However, due to the off-grid, the source and load cannot be matched, so accommodation is an important issue. Hydrogen storage is the optimal choice for offshore wave energy accommodation. Therefore, aiming at the source-load mismatch problem of the DDWPGS, an electric-hydrogen hybrid energy storage system (HESS) for the DDWPGS is designed in this paper. Based on the characteristics of the devices in the electric-hydrogen HESS, a new dynamic power allocation strategy and its control strategy are proposed. Firstly, empirical mode decomposition (EMD) is utilized to allocate the power fluctuations that need to be stabilized. Secondly, with the state of charge (SOC) of the battery and the operating characteristics of the alkaline electrolyzer being considered, the power assignments of the battery and the electrolyzer are determined using the rule-based method. In addition, model predictive control (MPC) with good tracking performance is used to adjust the output power of the battery and electrolyzer. Finally, the supercapacitor (SC) is controlled to maintain the DC bus voltage while also balancing the system’s power. A simulation was established to verify the feasibility of the designed system. The results show that the electric-hydrogen HESS can stabilize the power fluctuations dynamically when the DDWPGS captures instantaneous power. Moreover, its control strategy can not only reduce the start-stop times of the alkaline electrolyzer but also help the energy storage devices to maintain a good state and extend the service life.

Abstract The mammalian cochlea possesses unique acoustic sensitivity due to a mechanoelectrical ‘amplifier’, which requires the metabolic support of the cochlear lateral wall. Loud sound exposure sufficient to induce permanent hearing damage causes cochlear blood flow reduction, which may contribute to hearing loss. However, sensory epithelium involvement in the cochlear blood flow regulation pathway is not fully described. We hypothesize that genetic manipulation of the mechanoelectrical transducer complex will abolish sound induced cochlear blood flow regulation. We used salsa mice, a Chd23 mutant with no mechanoelectrical transduction, and deafness before p56. Using optical coherence tomography angiography, we measured the cochlear blood flow of salsa and wild-type mice in response to loud sound (120 dB SPL, 30 minutes low-pass filtered noise). An expected sound induced decrease in cochlear blood flow occurred in CBA/CaJ mice, but surprisingly the same sound protocol induced cochlear blood flow increases in salsa mice. Blood flow did not change in the contralateral ear. Disruption of the sympathetic nervous system partially abolished the observed wild-type blood flow decrease but not the salsa increase. Therefore sympathetic activation contributes to sound induced reduction of cochlear blood flow. Additionally a local, non-sensory pathway, potentially therapeutically targetable, must exist for cochlear blood flow regulation.

We propose a novel laser configuration that can output 3.5-μm nanosecond laser pulses based on a simple and monolithic fiber structure. Cascade-gain-switching (CGS) converts the wavelength of nanosecond pulses from 1.55 to 3.5 μm by two successive gain-switching processes. CGS eliminates the requirement of using bulky free-space modulators for Q-switching. With a well-established theoretical model, we investigated the feasibility of this novel configuration and thoroughly explored its characteristics. In single-shot regime, the pulse width of the 1.55-μm pump has major impact on the temporal shape of the intermediate 1.97-μm pulse while has neglected influence on the generated 3.5-μm pulse. On the other hand, increasing the continuous-wave (CW) pump power can significantly improve the output peak power and shorten the pulse when the pump power is less than ~4 W. In the repetitive-pulse regime, we found the maximum repetition rate is positively correlated the CW pump power. With a typical CW pump power of 5 W, the 3.5-μm pulse train can be stably outputted when the repetition rate is

We describe passively Q-switched Er:LuAG laser characteristics at 1.65 μm for the first time, with MoS2 and WS2 as the saturable absorber, respectively. The saturable absorbers were both prepared with the liquid phase exfoliation method. A shortest pulse width of 1.1 μ s was attained with the pulse repetition frequency of 41.6 kHz for the MoS2 saturable absorber, resulting in the highest peak power of 4.33 W. For the WS2 saturable absorber, a minimum pulse of 1.6 μs was gained with the pulse repetition frequency of 34.2 kHz and the calculated peak power of 4.13 W.

In this paper, we present the theoretical modeling and characterization of the gain spectra at ~1600-2100 nm from thulium-doped fiber amplifiers (TDFAs) for the first time. Our theoretical model was validated through the comparison with the experiments on the widely tunable TDFAs and thulium-doped fiber lasers using in-band pumping (3H6 →3F4) and 79 χ-nm pumping (3H6 →3H4) schemes. Different emission and absorption cross sections of the commercial thulium-doped fibers were employed for comparison and comprehensive demonstration. We then calculated the performance of the in-band-pumped TDFAs under different spectral cross section profiles and amplifier configurations. It shows, without the restriction of the loss induced by the fiber-optic components, that high optical gains (> 20 dB in small signal regime and > 3 dB in saturation regime) can be achieved over an ultrabroad spectrum ranging from ~1580 to ~2080 nm. We also demonstrate, although it is rarely used in the experiments of the broadband TDFAs, that the 79x-nm cladding pumping scheme can effectively avoid the strong reabsorption at short wavelengths when long gain fibers are used.