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Background Continuous renal replacement therapy (CRRT) is commonly used for the treatment of acute kidney injury (AKI) in critically ill neonates. This study investigated the effectiveness and feasibility of CRRT for AKI in neonates who weigh ≤3 kg.Methods Data from 19 neonates with a weight ≤3 kg and AKI who underwent CRRT at two centres between January 2015 and October 2021 were collected retrospectively. Kidney function, circulatory function, complications and clinical outcomes were recorded. Repeated-measures analyses of variance, t-tests and non-parametric tests were conducted.Results The median patient age at CRRT initiation was 3 days (IQR: 1–7 days). The median patient weight at CRRT initiation was 2.67 kg (IQR: 2.20–2.85 kg). The median CCRT duration was 46 hours (IQR: 32–72 hours). The serum creatinine and blood urea nitrogen levels decreased significantly, and the mean arterial pressure increased significantly after 12 hours of CRRT and at the end of CRRT. The urinary output was significantly increased at the end of CRRT. 11 patients had thrombocytopaenia, 6 had electrolyte disorders and 3 had blocked tubes. Five patients were discharged, six died after their parents chose to discontinue treatment and eight died after active treatment. Weight at CRRT initiation and urinary output at the end of CRRT were significantly lower among patients who died than among patients who survived.Conclusions CRRT is feasible and effective for AKI in neonates who weigh ≤3 kg when accompanied by elaborate supportive care. Lower body weight and persistent oliguria may be correlated with an increased risk of poor clinical outcomes.

The spatial layout of hospitals shows constant intersection of streamlines with the patients in different kinds of needs finding their path to various service facilities. Along with COVID pandemic, low-trust psychology raises among social relationships, which has brought significant changes during space planning process. This paper aimed at the lack of specific technical methods for flow simulation and spatial layout for hospital buildings. To simulate hospital crowd behaviors, this paper first proposes a novel low-trust social force model. Then, based on medical process analysis, hospital space survey, and infection theory, the simulation model was established. After that, the original and planned layouts were simulated, and key performance metrics were calculated. Results are visualized and the impact of different forms of hospital space layout and service facility layout are analyzed. Finally, optimization suggestions are proposed, which can provide a basis for hospital space and facility layout evaluation while reducing the cost of frequent hospital renovations. Based on computer simulation with new LtSFM, this method has the advantage of accurate patient crowd prediction and lead to effective space layout planning. Applications in a real-world hospital showed that the proposed method can predict the bottleneck of the layout capacity of hospital space facilities and propose corresponding improvement measures, thereby reducing the hidden risk of passenger flow gathering, improving the service level of facilities, and reducing overall infection risks.

In mammals, 17-beta hydroxysteroid dehydrogenase 2 (Hsd17b2) enzyme specifically catalyzes the oxidation of the C17 hydroxyl group and efficiently regulates the activities of estrogens and androgens to prevent diseases induced by hormone disorders. However, the functions of the hsd17b2 gene involved in animal sex differentiation are still largely unclear. The ricefield eel (Monopterus albus), a protogynous hermaphroditic fish with a small genome size (2n = 24), is usually used as an ideal model to study the mechanism of sex differentiation in vertebrates. Therefore, in this study, hsd17b2 gene cDNA was cloned and its mRNA expression profiles were determined in the ricefield eel. The cloned cDNA fragment of hsd17b2 was 1230 bp, including an open reading frame of 1107 bp, encoding 368 amino acid residues with conserved catalytic subunits. Moreover, real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) analysis showed that hsd17b2 mRNA expressed strongly in the ovaries at early developmental stages, weakly in liver and intestine, and barely in testis and other tissues. In particular, hsd17b2 mRNA expression was found to peak in ovaries of young fish and ovotestis at the early stage, and eventually declined in gonads from the late ovotestis to testis. Likewise, chemical in situ hybridization results indicated that the hsd17b2 mRNA signals were primarily detected in the cytoplasm of oogonia and oocytes at stage I–II, subsequently concentrated in the granulosa cells around the oocytes at stage Ⅲ–Ⅳ, but undetectable in mature oocytes and male germ cells. Intriguingly, in ricefield eel ovaries, hsd17b2 mRNA expression could be significantly reduced by 17β-estradiol (E2) or tamoxifen (17β-estradiol inhibitor, E2I) induction at a low concentration (10 ng/mL) and increased by E2I induction at a high concentration (100 ng/mL). On the other hand, both the melatonin (MT) and flutamide (androgen inhibitor, AI) induction could significantly decrease hsd17b2 mRNA expression in the ovary of ricefield eel. This study provides a clue for demonstrating the mechanism of sexual differentiation in fish. The findings of our study imply that the hsd17b2 gene could be a key regulator in sexual differentiation and modulate sex reversal in the ricefield eel and other hermaphroditic fishes.

In this study, by doping the iridium (III) double ((4,6-difluorobenzene) -pyridine-N, C2’Pyridinformate (FIrpic) into 4,4′, 4″ three (carbazole) trioxilamine (TcTa) and 9 (4 tert-butyl-benzene) −3,6 double (triphenylsilyl) -9H carbazole (CzSi) layers as light emitting layers (EMLs) to achieve sky blue phosphor organic electroluminescence (EL) devices with very low efficiency roll-off. The dependence of the EL performance on the doping concentration of the light-emitting molecules and the different EML thicknesses are studied in detail. Experimental data show that the thin-film-doped TcTa layer is very important for the efficiency of the device. Finally, the optimal device achieves extremely high power efficiency, current efficiency, and external quantum efficiency (EQE), reaching 74.82 lm/W, 66.68 cd/A, and 31.9 %, respectively. At a certain luminance of 2000 cd/m2 (3.4 V), the same device retained power efficiency with current efficiency and external quantum efficiency of 57.71 lm/W, 62.46 cd/A and 29.3 %, respectively, based on theoretical discussion, the improved EL efficiency was attributed to the energy levels of the host and luminescent molecules, which helps to balance the charge carrier in the emitter molecule distribution and expand the recombination region.

Abstract Clostridium perfringens ε-toxin (ETX) is the main toxin leading to enterotoxemia of sheep and goats and is classified as a potential biological weapon. In addition, no effective treatment drug is currently available in clinical practice for this toxin. We developed membrane-camouflaged nanoparticles (MNPs) with different membrane origins to neutralize ETX and protect the host from fatal ETX intoxication. We evaluated the safety and therapeutic efficacy of these MNPs in vitro and in vivo. Compared with membranes from karyocytes, such as Madin-Darby canine kidney (MDCK) cells and mouse neuroblastoma N2a cells (N2a cells), membrane from erythrocytes, which do not induce any immune response, are superior in safety. The protective ability of MNPs was evaluated by intravenous injection and lung delivery. We demonstrate that nebulized inhalation is as safe as intravenous injection and that both modalities can effectively protect mice against ETX. In particular, pulmonary delivery of nanoparticles more effectively treated the challenge of inhaled toxins than intravenously injected nanoparticles. Moreover, MNPs can alter the biological distribution of ETX among different organs in the body, and ETX was captured, neutralized and slowly delivered to the liver and spleen, where nanoparticles with ETX could be phagocytized and metabolized. This demonstrates how MNPs treat toxin infections in vivo. Finally, we injected the MNPs into mice in advance to find out whether MNPs can provide preventive protection, and the results showed that the long-cycle MNPs could provide at least a 3-day protection in mice. These findings demonstrate that MNPs provide safe and effective protection against ETX intoxication, provide new insights into membrane choices and delivery routes of nanoparticles, and new evidence of the ability of nanoparticles to provide preventive protection against infections. Graphical Abstract

Neutrophils display heterogeneity and plasticity with different subgroups and immune-regulatory functions under various surrounding conditions. Neutrophils induced by IL-23/IL-18 (referred to N(IL-23+IL-18) neutrophils) have a unique gene-expression profile, with highly expressing IL-17, MHC-II, and costimulatory molecules. The adoptive transfer of N(IL-23+IL-18) neutrophils significantly increased the pathogenesis in a renal ischemia–reperfusion injury mouse model. N(IL-23+IL-18) neutrophils directly and efficiently induced allogeneic T cell proliferation in vitro. N(IL-23+IL-18) neutrophils enhanced the syngeneic T cell response to allogeneic antigens in mixed-lymphocyte reaction assays. The adoptive transfer of the donor or host N(IL-23+IL-18) neutrophils significantly enhanced the antidonor antibody production in an allogeneic-skin-transplanted mouse model, accompanied by increased Tfh cells in the spleens. Therefore, the neutrophil subset induced by IL-23/IL-18 promotes tissue injury and antidonor humoral response in the allogeneic transplantation mouse model.

Variants in the MAGED2 may cause antenatal transient Bartter syndrome, which is characterised by polyhydramnios, preterm labour, postnatal polyuria, hypokalaemia and metabolic alkalosis. Transient gross hematuria and acute kidney injury in such cases have not been reported previously. The patient, a boy, was born at a gestational age of 27 + 5 weeks. Polyhydramnios has been detected at 24 weeks of gestation. Polyuria, hyponatraemia, hypokalaemia, weight loss, transient hematuria and acute kidney injury occur after birth. The urinary ultrasonography showed no abnormality, and after a month of treatment with liquid electrolytes and nutritional management, the clinical symptoms improved. Whole-exome sequencing revealed a variant in MAGED2: c.1426C > T, p.Arg476X, inherited from the mother, who was healthy. During the 1-year follow-up, the child grew and developed with normal renal function and electrolyte levels. This is the first report of transient antenatal Bartter syndrome caused by a MAGED2 variant in China in an extremely preterm infant who exhibited previously unreported symptoms: transient hematuria and acute kidney injury. This newly found variant expands the spectrum of genetic variants associated with antenatal Bartter syndrome; it can be detected by early genetic testing and overmedication, thereby avoided.

Nowadays, digital construction has become popular when bringing convenience and efficiency to the traditional building construction industry. The primary tool of digital construction is the building information model (BIM). However, from the perspective of general contractors, unresolved puzzles still hinder obtaining the benefits of digital construction. When establishing a unified BIM from submodels provided by subcontractors, there will possibly be incomplete or inconsistent data during model merging. But extracting submodels from unified BIM often includes redundant data, thus making models less usable for subcontractors. It is also difficult for general contractors to effectively and accurately utilize resource information and submodel changes. This paper proposed solutions that depend on the widely adopted industry foundation classes standard to ensure the universality of our methods. First, a model merging algorithm is proposed to support the continuous merge of submodels created by different subcontractors. Second, an instance-level model extraction method based on strongly related entities is proposed, which extracts model instances to the minimum submodel and meets the subcontractor requirements at the same time. Third, the new model storage and indexing method are designed to reduce the complexity of model data and support rapid data retrieval, and a new BIM change detection method based on object metadata is provided. The proposed methods were applied by the general contractor of a large airport project during the construction stage. The application results proved that the proposed methods could ensure the quality of established deepening design models and extracted submodels and significantly reduce human labor by improving efficiency when utilizing BIM, which in turn supported key scenarios throughout the digital construction workflow.

Abstract Background Lethal respiratory failure is primarily caused by a deficiency of pulmonary surfactant, and is the main cause of neonatal death among preterm infants. Pulmonary surfactant metabolism dysfunction caused by variants in the ABCA3 gene is a rare disease with very poor prognosis. Currently, the mechanisms associated with some ABCA3 variants have been determined, including protein mistrafficking and impaired phospholipid transport. However, some novel variants and their underlying pathogenesis has not been fully elucidated yet. In this study we aimed to identify the genetic features in a family with lethal respiratory failure. Methods We studied members of two generations of a Chinese family, including a female proband, her parents, her monozygotic twin sister, and her older sister. Trio whole exome sequencing (WES) were used on the proband and her parents to identify the ABCA3 variants. Sanger sequencing and real-time quantitative polymerase chain reaction (PCR) were used on the monozygotic twin sister of proband to validate the ABCA3 synonymous variant and exon deletion, respectively. The potential pathogenicity of the identified synonymous variant was predicted using the splice site algorithms dbscSNV11_AdaBoost, dbscSNV11_RandomForest, and Human Splicing Finder (HSF). Results All patients showed severe respiratory distress, which could not be relieved by mechanical ventilation, supplementation of surfactant, or steroid therapy, and died at an early age. WES analysis revealed that the proband had compound heterozygous ABCA3 variants, including a novel synonymous variant c.G873A (p.Lys291Lys) in exon 8 inherited from the mother, and a heterozygous deletion of exons 4–7 inherited from the father. The synonymous variant was consistently predicted to be a cryptic splice donor site that may lead to aberrant splicing of the pre-mRNA by three different splice site algorithms. The deletion of exons 4–7 of the ABCA3 gene was determined to be a likely pathogenic variant. The variants were confirmed in the monozygotic twin sister of proband by Sanger sequencing and qPCR respectively. The older sister of proband was not available to determine if she also carried both ABCA3 variants, but it is highly likely based on her clinical course. Conclusions We identified a novel synonymous variant and a deletion in the ABCA3 gene that may be responsible for the pathogenesis in patients in this family. These results add to the known mutational spectrum of the ABCA3 gene. The study of ABCA3 variants may be helpful for the implementation of patient-specific therapies.

In the quality analysis of polysilicon ingot batching, a two-stage genetic algorithm (NRS-SVM-GA) combining the NRS-SVM model with genetic algorithm (GA) was proposed to solve the problem of neighborhood radius and SVM parameter values in the processing of continuous data of polysilicon ingot batting with rough set-support vector machine (NRS-SVM) model. The first stage of the algorithm, by searching for a new neighborhood radius, a better reduction set is obtained. In the second stage the attribute reduction results from the first stage are adopted to, by searching the new parameters of SVM, train the classification model with higher accuracy. According to the purpose of each stage, the corresponding fitness function and termination conditions are put forward. The distinctive features of this method is to implement the NRS-SVM automatic feature extraction and classification prediction, and run the two stages independently to avoid the time consumption for the evaluation of reduction by classifiec. The experimental results of polysilicon ingot batching data set show that this method has shorter running time, stable output, less features, and higher classification accuracy than the standard genetic algorithm.

The potentially pathogenic species of the genus Vibrio pose a threat to both humans and animals, creating medical burdens and economic losses to the mariculture industry. Improvements in surveillance and diagnosis are needed to successfully manage vibriosis outbreaks. Matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) can provide rapid diagnosis and has been widely used in the identification of Vibrio spp. The main weakness of this technology is the limited number of strains and species of Vibrio in the existing commercial database. Here, we develop a new in-house database named PVBase containing 790 main spectra projections (MSP) of ten Vibrio species that come from various regions of China and include abundant clinical and environmental strains. PVBase was validated through a blind test of 65 Vibrio strains. The identification accuracy and scoring of Vibrio strains was greatly improved through the addition of PVBase. Identification accuracy increased from 73.4 to 100%. The number of strains with identification scores above 2.2 increased from 53.1% to 96.9% and 53.1% of strains had an identification score above 2.59. Moreover, perfect discrimination was obtained when using all of the MSPs created for the Vibrio species, even for very closely related species such as V. cholerae, V. albensis, and V. mimicus or V. alginolyticus, V. parahaemolyticus, and V. harveyi. In addition, we used phyloproteomic analysis to study whether there are differences in protein fingerprints of different regions or pathogenic strains. We found that MSP characteristics of Vibrio species were not related to their region or source. With the construction of PVBase, the identification efficiency of potentially pathogenic Vibrio species has been greatly improved, which is an important advance for epidemic prevention and control, and aquaculture disease detection.

Following the occurrence of a typhoon, quick damage assessment can facilitate the quick dispatch of house repair and disaster insurance works. Employing a deep learning method, this study used aerial photos of the Chiba prefecture obtained following Typhoon Faxai in 2019, to automatically detect and evaluate the roof damage. This study comprised three parts: training a deep learning model, detecting the roof damage using a trained model, and classifying the level of roof damage. The detection object comprised a roof outline, blue tarps, and a completely destroyed roof. The roofs were divided into three categories: without damage, with blue tarps, and completely destroyed. The F value obtained using the proposed method was higher than those obtained using other methods. In addition, it can be further divided into five levels from levels 0 to 4. Finally, the spatial distribution of the roof damage was analyzed using ArcGIS tools. The proposed method is expected to provide a certain reference for real-time detection of roof damage after the occurrence of a typhoon.

Hospital buildings usually contain sophisticated facility systems and special medical equipment, strict security requirements, and business systems. Traditional methods such as BIM are becoming less capable of real-time updates of building status and big data volume. By proposing innovations both in technique and management—a “continuous lifecycle integration” method based on the concept of Digital Twin (DT) and “early movement” of the general contractor, this paper reported a successful project case in a large hospital in China. The case realized continuous, scheduled integration of static data and dynamic data of more than 20 management systems from the design, construction, pre-O&M phase up to the O&M phase. Then, a DT software system with real-time visual management and artificial intelligent diagnosis modules was developed and deployed in a newly built DT control center. Managers have the ability to grasp the detailed status of the whole hospital by visual management and receive timely facility diagnosis and operation suggestions that are automatically sent back from the digital building to reality. The case has been steadily running for more than a year in the hospital and achieved desired performance by reducing energy consumption, avoiding facility faults, reducing the number of requested repairs, and enhancing the quality of daily maintenance work.

Comparative experiments were conducted with two different structures to study the mechanism of aluminum foam sandwich attenuating blast shock wave. The sandwich structure is composed of “steel–aluminum foam–steel,” and the mild steel structure is composed of “steel–steel.” In the experiment, the polyvinylidene fluoride transducers were used to directly test the load of stress wave between different interfaces of sandwich and mild steel structures. The strain of back sheet was simultaneously measured using high-precision strain gauge. The accuracy of the test results was verified by Henrych’s formula. Experimental results show that the wave attenuation rate on the mild steel structure is only 11.3%, whereas the wave attenuation rate on the sandwich structure can exceed 90%. The interface effect is clearly a more crucial factor in the wave attenuation. The peak value of back sheet strain in the mild steel structure is much higher than the sandwich structure. The apparent overall “X” crushing band is produced in the aluminum foam core, and scanning electron microscope (SEM) observation clearly shows the collapse of the cell wall. Experiments on the sandwich structure with different aluminum foam densities indicate that increasing the relative density results in increased attenuation capability of the aluminum foam and decreased attenuation capability of the sandwich structure. Experiments on the sandwich structure with different aluminum foam thickness indicate that increasing the thickness results in increased attenuation capability of the aluminum foam and the sandwich structure.

During the first-stage project of the main channel of Ningbo-Zhoushan Port’s Shipu Harbor, underwater shock waves were monitored. By analyzing a typical measured pressure time history curve, the characteristics of underwater shock waves in an engineering context were obtained. We obtained a traditional exponential attenuation formula for underwater shock waves based on the measured data, simplified the model of underwater drilling blasting based on engineering practice, deduced a revised formula for underwater shock wave peak overpressure on the basis of dimensional analysis, established a linear fitting model, and obtained the undetermined coefficients of the revised formula using a linear regression analysis. In addition, the accuracies of the two formulas used to predict underwater shock wave peak overpressure and the significance order of influence and influence mechanism of factors included in the revised formula on the underwater shock wave peak overpressure were discussed.

Lighthouses are the most important hydraulic structures that should be protected during underwater drilling blasting. Thus, the effect of blasting vibration on lighthouse should be studied. On the basis of the dimensional analysis, we deduced a revised formula for water depth based on Sodev’s empirical formula and established the linear fitting model. During the underwater reef project in the main channel of Shipu Harbor in the Ningbo–Zhoushan Port, the blasting vibration data of the lighthouse near the underwater blasting area were monitored. The undetermined coefficient, resolvable coefficient, and F value of the two formulas were then obtained. The comparison of the data obtained from the two formulas showed that they can effectively predict the blasting vibration on the lighthouse. The correction formula that considers water depth can obviously reduce prediction errors and accurately predict blasting vibration.