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ABSTRACT: Objectives: The objective is to explore the correlation between rectal swab culture and the overall 30-d survival of hematologic patients diagnosed with carbapenem-resistant organism (CRO) bloodstream infection. Methods: A total of 434 haematological patients who were complicated with Gram-negative bacilli (GNB) bloodstream infections (BSIs) caused by Gram-negative bacteria between January 2020 and December 2021 were included in our retrospective study. Based on their drug susceptibility results, we classified patients into CRO BSIs and non-CRO BSIs cases. Through group comparison, to uncover the correlation between the positive screening of rectal swabs and reducing the mortality of CRO BSI in patients with haematological diseases. Results: Among the 434 cases of Gram-negative bacteria bloodstream infection, 96 were identified as carbapenem-resistant bloodstream infection, which consisted of 57 cases of carbapenem-resistant Klebsiella pneumoniae (CR-KP), 19 cases of carbapenem-resistant Pseudomonas aeruginosa (CR-PA), 11 cases of carbapenem-resistant Escherichia coli (CR-CO), 5 cases of carbapenem-resistant Acinetobacter baumannii (CR-AB), and 4 cases of other Enterobacteriaceae. Before the onset of CRO bloodstream infection, rectal swab cultures were conducted on 36 patients, and the positive result rate was 75.0% (27/36), with 20 cases of CR-KP, 6 cases of CR-CO, and one case of carbapenem-resistant Enterobacter cloacae. It was observed that the rectal and blood cultures had matching outcomes in 75.0% of cases. The mortality rate within 30 d for CRO BSIs was 53.1% (51/96), while for carbapenem-resistant Enterobacteriaceae (CRE) BSIs it was 62.5% (45/72). Univariate analysis showed that 30-d mortality was significantly reduced when there were positive rectal culture results preceding bloodstream infection (P < 0.001), as well as preemptive anti-infection treatment (P < 0.001). Multivariate analysis demonstrated that preemptive adjustment to an effective antibiotic regimen, guided by positive rectal culture results, had a significant effect on decreasing 30-d mortality following CRO BSIs (P = 0.002). Furthermore, for the management of CRE BSIs, antibiotic treatments utilising ceftazidime/avibactam (CAV/AVI) may be more beneficial compared to those that use tigecycline (TGC) or polymyxin (PMB). Conclusion: CRO BSI, especially CRE BSI, can be life-threatening for those with haematological diseases. Utilising rectal culture can effectively identify CRO strains with high sensitivity and specificity. Adjusting antibiotic treatment based on the preemptive positive rectal culture results may significantly decrease 30-d mortality rates for haematological patients with CRO BSIs.

Ships are traditionally powered by fossil fuels such as heavy fuel oil (HFO) and marine diesel oil (MDO), where the emissions, such as particulates, hydrocarbons (HC), carbon monoxide (CO), nitrogen oxides (NOX) and carbon dioxide (CO2), negatively affect the environment and human health. The International Maritime Organization (IMO) encourages shipping companies to use liquefied natural gas (LNG), which is a green fuel source to power shipping activities and is easy to store, to replace traditional marine fuels. There are three common methods of LNG bunkering: ship-to-ship, truck-to-ship, and port-to-ship. The objective of this study is to determine the optimal bunkering method at a port using an integer linear programming (ILP) model considering three kinds of costs: fixed, variable, and extra. To find the optimal bunkering method, the three methods and their related constraints are modeled into the ILP model. The results indicate that ship-to-ship is the optimal bunkering method for LNG under the scenario of the port considered. Numerical experiments are conducted to validate model performance and generate managerial insights.

IntroductionRapid identification of infected individuals through viral RNA or antigen detection followed by effective personal isolation is usually the most effective way to prevent the spread of a newly emerging virus. Large-scale detection involves mass specimen collection and transportation. For biosafety reasons, denaturing viral transport medium has been extensively used during the SARS-CoV-2 pandemic. However, the high concentrations of guanidinium isothiocyanate (GITC) in such media have raised issues around sufficient GITC supply and laboratory safety. Moreover, there is a lack of denaturing transport media compatible with SARS-CoV-2 RNA and antigen detection.MethodsHere, we tested whether supplementing media containing low concentrations of GITC with ammonium sulfate (AS) would affect the throat-swab detection of SARS-CoV-2 or a viral inactivation assay targeting coronavirus and other enveloped and non-enveloped viruses. The effect of adding AS to the media on RNA stability and its compatibility with SARS-CoV-2 antigen detection were also tested.Results and discussionWe found that adding AS to the denaturing transport media reduced the need for high levels of GITC, improved SARS-COV-2 RNA detection without compromising virus inactivation, and enabled the denaturing transport media compatible with SARS-CoV-2 antigen detection.

The Bohai Sea and its surrounding areas are rich in oil and natural gas and play an important role in industry, agriculture and the economy. However, the Bohai Sea suffers severely from sea ice in the winter. While previous research has predominantly focused on methods for retrieving sea ice parameters in the Bohai Sea, analyses of their long-term statistical patterns have been limited. The Geostationary Ocean Color Imager (GOCI) is the first geostationary satellite for ocean color remote sensing, offering high spatial and temporal resolution, which greatly facilitates the extraction of Bohai Sea ice parameters. Utilizing GOCI data, we systematically extracted relevant sea ice parameters for the Bohai Sea region from 2011 to 2021. These parameters include sea ice concentration, sea ice thickness, and sea ice drift. We conducted a comprehensive statistical analysis of the long-term sea ice changes in the Bohai Sea and found that the development process of winter sea ice area is different from the sea ice thickness, and the direction of sea ice drift is basically unchanged. Then we developed statistical models linking sea ice parameters with ocean dynamic factors such as temperature, wind, and drift currents. Among them, the correlation coefficient between the predicted value and the measured value of the sea ice area model is the highest, reaching 0.8382. Furthermore, we examined the previously unexplored relationship between daily sea ice area, sea ice thickness, and accumulated temperature with their respective starting temperatures and accumulation periods. This study provides critical data to support Bohai Sea ice monitoring and marine environmental research. The results of this study contribute to a better understanding of sea ice change trends in the Bohai Sea and inform the development of disaster prevention and mitigation measures.

Background & Aims: The investigational first-generation core inhibitor vebicorvir (VBR) demonstrated safety and antiviral activity over 24 weeks in two phase IIa studies in patients with chronic HBV infection. In this long-term extension study, patients received open-label VBR with nucleos(t)ide reverse transcriptase inhibitors (NrtIs). Methods: Patients in this study (NCT03780543) previously received VBR + NrtI or placebo + NrtI in parent studies 201 (NCT03576066) or 202 (NCT03577171). After receiving VBR + NrtI for ≥52 weeks, stopping criteria (based on the treatment history and hepatitis B e antigen status in the parent studies) were applied, and patients either discontinued both VBR + NrtI, discontinued VBR only, or continued both VBR + NrtI. The primary efficacy endpoint was the proportion of patients with HBV DNA

Proper preventive maintenance can improve equipment reliability and prolong equipment life to a certain extent. Aimed at the problems that the decision granularity of the current preventive maintenance strategy is too large and the maintenance effect of preventive maintenance on different types of failures is rarely considered, the imperfect sequential preventive maintenance strategy of the meta-action unit is studied. Taking the meta-action unit as the research carrier, the failures are divided into damage failure and essential fatigue failure according to the difference of preventive maintenance effect. Based on the generalized geometric process, a sequential preventive maintenance optimization model is established. The research shows that the overall maintenance cost rate will be underestimated without considering the differences in preventive maintenance effectiveness. At the same time, various types of maintenance costs, the proportion factor of damage-type failures and intrinsic fatigue-type failures, and the preventive maintenance effect parameter have a significant influence on the formulation of maintenance strategy. This research has a certain guiding role in formulating the sequential preventive maintenance strategy of meta-action unit and reducing its maintenance cost.

Abstract Insufficient drug loading and leakage of payload remain major challenges in designing liposome-based drug delivery systems. These phenomena can limit duration of effect and cause toxicity. Targeting the rate-limiting step in drug release from liposomes, we modify (aromatized) them to have aromatic groups within their lipid bilayers. Aromatized liposomes are designed with synthetic phospholipids with aromatic groups covalently conjugated onto acyl chains. The optimized aromatized liposome increases drug loading and significantly decreases the burst release of a broad range of payloads (small molecules and macromolecules, different degrees of hydrophilicity) and extends their duration of release. Aromatized liposomes encapsulating the anesthetic tetrodotoxin (TTX) achieve markedly prolonged effect and decreased toxicity in an application where liposomes are used clinically: local anesthesia, even though TTX is a hydrophilic small molecule which is typically difficult to encapsulate. Aromatization of lipid bilayers can improve the performance of liposomal drug delivery systems.

Abstract Systemic infusion is a prevalent administration method for mesenchymal stromal cells (MSCs) in clinical trials. However, the inability to deliver a large number of therapeutic cells to diseased tissue is a substantial barrier. Here, we demonstrate that surface engineering of MSCs with polyvalent antibodies can effectively improve the targeting efficiency of MSCs to diseased tissue. The polyvalent antibody is directly synthesized on the cell surface via DNA template-directed biomolecule assembly. The data show that engineered MSCs exhibit superior adhesion to inflamed endothelium in vitro and in vivo. In female mouse models of acute inflammation and inflammatory bowel disease, engineered MSCs show enhanced targeting efficiency and therapeutic efficacy in damaged tissues. Notably, the entire procedure for polyvalent functionalization only requires the simple mixing of cells and solutions under physiological conditions within a few hours, which significantly reduces preparation processes and manufacturing costs and minimizes the impact on the cells. Thus, our study provides a strategy for improved MSC-based regenerative medicine.

Machine learning (ML) techniques are extensively applied to practical maritime transportation issues. Due to the difficulty and high cost of collecting large volumes of data in the maritime industry, in many maritime studies, ML models are trained with small training datasets. The relative predictive performances of these trained ML models are then compared with each other and with the conventional model using the same test set. The ML model that performs the best out of the ML models and better than the conventional model on the test set is regarded as the most effective in terms of this prediction task. However, in scenarios with small datasets, this common process may lead to an unfair comparison between the ML and the conventional model. Therefore, we propose a novel process to fairly compare multiple ML models and the conventional model. We first select the best ML model in terms of predictive performance for the validation set. Then, we combine the training and the validation sets to retrain the best ML model and compare it with the conventional model on the same test set. Based on historical port state control (PSC) inspection data, we examine both the common process and the novel process in terms of their ability to fairly compare ML models and the conventional model. The results show that the novel process is more effective at fairly comparing the ML models with the conventional model on different test sets. Therefore, the novel process enables a fair assessment of ML models' ability to predict key performance indicators in the context of limited data availability in the maritime industry, such as predicting the ship fuel consumption and port traffic volume, thereby enhancing their reliability for real-world applications.

Abstract Background work alienation is receiving increasing attention as a psychological risk at work, and little is known about the mechanisms of role ambiguity and work alienation in nurses in the context of the COVID-19 pandemic. This article aims to examine how role ambiguity affects work alienation among Chinese nurses during the two years after COVID-19 pandemic and verify emotional exhaustion as mediators. Methods A cross-sectional study design was used to recruit 281 Chinese nurses. Nurses completed online questionnaires containing demographic characteristics, role ambiguity, emotional exhaustion, and work alienation, and SPSS 26.0 and AMOS 24.0 were used for data analysis and structural equation modelling. Results work alienation scores were (34.64 ± 10.09), work alienation was correlated with role ambiguity and emotional exhaustion (r1 = 0.521, r2 = 0.755; p

Tripartite motif (TRIM) proteins, comprising a family of over 100 members with conserved motifs, exhibit diverse biological functions. Several TRIM proteins influence viral infections through direct antiviral mechanisms or by regulating host antiviral innate immune responses. To identify TRIM proteins modulating hepatitis B virus (HBV) replication, we assessed 45 human TRIMs in HBV-transfected HepG2 cells. Our study revealed that ectopic expression of 12 TRIM proteins significantly reduced HBV RNA and subsequent capsid-associated DNA levels. Notably, TRIM65 uniquely downregulated viral pregenomic (pg) RNA in an HBV-promoter-specific manner, suggesting a targeted antiviral effect. Mechanistically, TRIM65 inhibited HBV replication primarily at the transcriptional level via its E3 ubiquitin ligase activity and intact B-box domain. Though HNF4α emerged as a potential TRIM65 substrate, disrupting its binding site on the HBV genome did not completely abolish TRIM65’s antiviral effect. In addition, neither HBx expression nor cellular MAVS signaling was essential to TRIM65-mediated regulation of HBV transcription. Furthermore, CRISPR-mediated knock-out of TRIM65 in the HepG2-NTCP cells boosted HBV infection, validating its endogenous role. These findings underscore TRIM proteins’ capacity to inhibit HBV transcription and highlight TRIM65’s pivotal role in this process.

Abstract Background COVID-19 infection continues all over the world, causing serious physical and psychological impacts to patients. Patients with COVID-19 infection suffer from various negative emotional experiences such as anxiety, depression, mania, and alienation, which seriously affect their normal life and is detrimental to the prognosis. Our study is aimed to investigate the effect of psychological capital on alienation among patients with COVID-19 and the mediating role of social support in this relationship. Methods The data were collected in China by the convenient sampling. A sample of 259 COVID-19 patients completed the psychological capital, social support and social alienation scale and the structural equation model was adopted to verify the research hypotheses. Results Psychological capital was significantly and negatively related to the COVID-19 patients’ social alienation (p

Accumulating studies suggest that, as the subway is one of the important means of transport in cities, airborne microorganisms in its system have potential effects on human health, but previous studies have mainly focused on some foreign cities. We reviewed the spatio-temporal distribution characteristics of airborne microorganisms in subway stations in different cities, including diurnal, weekly, and seasonal variations, and the distribution of microorganisms in different regions of the world. The factors affecting airborne microorganisms, such as human activities, temperature and humidity, ventilation, and particulate matter, were presented. The potential health effects were described. Although there was no significant risk of infection from using subway, many pathogens do exist in the air. The influence of microorganisms in subway air on health has become a public health problem that cannot be ignored.

A deep understanding of the underlying mechanisms of the built environment on commuting behavior along with rail transit is considered of great importance for both TOD land use and formulation of transport policies. The impact of the built environmental factors on commuting behavior has been already explored in the literature. However, the main focus has been laid on the separate effects of each factor and the interactions among these factors have been neglected. Along these lines, taking Hefei, China as the case, this work filled this gap by employing a social ecological model to systematically investigate the interactive effects of the built environment and urban rail transit on commuting behavior. From our analysis, it was demonstrated that land-use intensity was negatively correlated with car commuting, and mixed land use was positively related to metro commuting. Additionally, rail access near the workplace plays a key role in reducing car commuting than residential neighborhoods. This work revealed also some interesting findings on the association between rail transit and commuting behavior, which were significantly affected by land use intensity and mixed land-use. Our work provides valuable insights for the TOD land use to effectively reduce car commuting.

A rotary kiln is a central piece of equipment for the calcination of clinker in the production of cement. Biomass energy has been applied to rotary kilns, and solar energy has been introduced to assist the energy supply. Coupled optimization results for biomass energy and solar energy applications are compared to the single fossil energy used in the base period. A field survey and statistical analysis and integration of cement clinker production sites in China’s Central Plains Economic Zone revealed a negative linear correlation between the consumption of raw coal in the cement production process and the environmental temperature and humidity parameters of the production lines. The energy consumption is large and the energy utilization of the system is low, with goodness of fit of R=0.962. Coupled solar and biomass energy use in the audit period and single energy use in the base period comparison revealed a 19.5% reduction in electricity consumption, a 25.4% reduction in coal consumption and a 4.39% increase in heavy oil consumption. From 2017 to 2020, the average annual consumption cost of electricity and raw coal decreased, while the average annual consumption cost of heavy fuel oil slowly increased. After verification during the audit period, compared with the base period, the total production cost of the case enterprise can be reduced approximately 5.17%, in which the energy cost decreased 0.9%.