The Performance of Spot Photoscreener in 6 to 10 Weeks Infants in China: A Cross-Sectional Study.

Purpose: To compare the refractive errors measured by the Spot photoscreener (with or without cycloplegia) to cycloplegic retinoscopy in 6- to 10-week-old infants. Materials and Methods: 101 right eyes from 101 healthy infants aged 6 to 10 weeks were recruited for this cross-sectional observational study. Refractive errors were measured using Spot photoscreener before and after cycloplegia, as well as cycloplegic retinoscopy. Comparisons between the refractive measurements were performed using one-way ANOVA with the post hoc Tukey HSD test or Kruskal-Wallis test with the Steel-Dwass test according to the data normality. Pearson's correlation test and 95% confidence intervals were calculated. The agreement was evaluated using a Bland-Altman plot with 95% limits of agreement of the differences. Results: Spot photoscreener was found to underestimate the spherical equivalent by 2.33 Diopters (D) in these infants. Following the induction of cycloplegia, the spherical equivalent measured by Spot photoscreener was in excellent agreement with cycloplegic retinoscopy with the mean difference of 0.01 D. Spot photoscreener overestimated cylindrical parameter by 0.2 D with poor agreement with cycloplegic retinoscopy no matter whether cycloplegia was induced. It had good agreement with cycloplegic retinoscopy in the J0 vector than the J45 vector measurement. Conclusions: With the induction of cycloplegia, Spot photoscreener can accurately evaluate spherical equivalent in hyperopic infants with mild-to-moderate astigmatism. While it may provide valuable measurements of astigmatism, discrepancies in cylinder and axis should be taken into account.

Machine learning model for the prediction of gram-positive and gram-negative bacterial bloodstream infection based on routine laboratory parameters.

BACKGROUND: Bacterial bloodstream infection is responsible for the majority of cases of sepsis and septic shock. Early recognition of the causative pathogen is pivotal for administration of adequate empiric antibiotic therapy and for the survival of the patients. In this study, we developed a feasible machine learning (ML) model to predict gram-positive and gram-negative bacteremia based on routine laboratory parameters. METHODS: Data for 2118 patients with bacteremia were obtained from the Medical Information Mart for Intensive Care dataset. Patients were randomly split into the training set and test set by stratified sampling, and 374 routine laboratory blood test variables were retrieved. Variables with missing values in more than 40% of the patients were excluded. Pearson correlation test was employed to eliminate redundant features. Five ML algorithms were used to build the model based on the selected features. Additionally, 132 patients with bacteremia who were treated at Qilu Hospital of Shandong University were included in an independent test cohort to evaluate the model. RESULTS: After feature selection, 32 variables remained. All the five ML algorithms performed well in terms of discriminating between gram-positive and gram-negative bacteremia, but the performance of convolutional neural network (CNN) and random forest (RF) were better than other three algorithms. Consider of the interpretability of models, RF was chosen for further test (ROC-AUC = 0.768; 95%CI = 0.715-0.798, with a sensitivity of 75.20% and a specificity of 63.79%). To expand the application of the model, a decision tree (DT) was built utilizing the major variables, and it achieved an AUC of 0.679 (95%CI = 0.632-0.723), a sensitivity of 66%, and a specificity of 67.82% in the test cohort. When tested in the Qilu Hospital cohort, the ROC-AUC of the RF and DT models were 0.666 (95%CI = 0.579-0.746) and 0.615 (95%CI = 0.526-0.698), respectively. Finally, a software was developed to make the RF- and DT-based prediction models easily accessible. CONCLUSION: The present ML-based models could effectively discriminate between gram-positive and gram-negative bacteremia based on routine laboratory blood test results. This simple model would be beneficial in terms of guiding timely antibiotic selection and administration in critically ill patients with bacteremia before their pathogen test results are available.

Demystifying the life domain in work-life balance: A Malaysian perspective.

Traditionally, the word 'life' in the concept of work-life balance focuses on family obligations. This conceptual paper sets out to present the notion that "life" goes beyond family responsibilities and is unique to employees of different demographics. Given the impending difference in how "life" is viewed by different groups of employees, this study reviews the literature and argues for the need to distinguish between different dimensions of the non-work domain. The discussion is centered on the transformation taking place within the Malaysian workforce. Recent trends indicate that "life" and "family" are indeed distinct domains. There is a need for organizations to acknowledge this distinction and provide relevant support to attain a balance between work, life, and family. The paper will help strengthen the knowledge about the "life" in the concept of work-life balance and employers better understand the conceptualization of "life" in work-life balance so that they can strategize and enhance employee well-being and eventually gain competitive advantage. Currently, the terms work-life balance and work-family balance are used interchangeably to represent a balance between the family and work domain. This is especially evident in collectivist countries such as Malaysia. However, the emphasis on family without due consideration to the needs of employees with different demographic configurations may result in work-life backlash. Hence, this study argues that the non-work domain is not limited to family obligations and should encompass both family obligations and personal activities. The emphasis on striking a balance between work and family domain should not be done at the expense of the well-being of employees with lesser or no family obligations.

Addressing the COVID-19 Shock: The Potential Job Creation in China by the RCEP.

In 2020, coronavirus disease (COVID-19) left around 81% of the global workforce, nearly 2.7 billion workers, affected. Employment in China was the first to be hit by COVID-19. The Regional Comprehensive Economic Partnership (RCEP) is expected to bring dynamism to China's employment market in an era of long COVID-19. This study aims to examine the number of sectoral jobs that the RCEP will create in China, with the number of skilled or unskilled labour employed in each sector. The exogenous shocks to the RCEP can be reflected in the number of jobs created through multipliers based on a social accounting matrix compiled from China's input-output tables in 2017, combined with the employment satellite accounts compiled. The results show that the RCEP is expected to create over 17 million potential jobs in China, with unskilled labour accounting for 10.44 million and skilled labour for 6.77 million. It is even expected that there will be job losses in the metalworking machinery sector. The contribution of this paper can serve as a reference for policies to protect vulnerable sectors, further open up trade markets and strengthen cooperation among RCEP members as important measures to address the employment impact of long COVID-19.

Consumption Pattern and Mental Health of Employees Based on Big Data Analysis.

With the development of big data concept and technology, big data has an important impact on human development. This paper studies the relationship between the consumption pattern and mental health of enterprise employees under the normalization of epidemic prevention and control. Starting from the consumption structure and behavior of enterprise employees, it defines the meaning of enterprise employees' consumption and the connotation of enterprise employees' health psychology and analyzes the relationship between consumption behavior and consumption psychology and the elements of enterprise employees' health psychology. Based on the change of employees' income structure and consumption patterns, this paper speculates the relationship between employees' consumption patterns and mental health, analyzes the correlation between employees' consumption patterns and mental health through a questionnaire survey, and calculates the Correlation Clustering statistical results. It plays an important role in building a good enterprise staff consumption culture under the normalization of epidemic prevention and control and effectively realizes the significance of purifying the social consumption environment.

Intercalation of Zinc Monochloride Cations by Deep Eutectic Solvents for High-Performance Rechargeable Non-aqueous Zinc Ion Batteries.

Zinc ion batteries have been extensively studied with an aqueous electrolyte system. However, the batteries suffer from a limited potential window, gas evolution, cathode dissolution, and dendrite formation on the anode. Considering these limitations, we developed an alternative electrolyte system based on deep eutectic solvents (DESs) because of their low cost, high stability, biodegradability, and non-flammability, making them optimal candidates for sustainable batteries. The DES electrolyte enables reversible Zn plating/stripping and effectively suppresses zinc dendrite formation. Furthermore, in-depth characterizations reveal that the energy storage mechanism can be attributed to [ZnCl]+ ion intercalation and the intermediate complex ion plays a pivotal role in electrochemical reactions, which deliver a high reversible capacity of 310 mAh g-1 at 0.1 A g-1and long-term stability (167 mAh g-1 at a current density of 0.3 A g-1 after 300 cycles, Coulombic efficiency: ∼98%). Overall, this work represents our new finding in rechargeable batteries with the DES electrolyte.

Geographical discrimination of ethanol based on stable isotope ratio analysis coupled with statistical methods: The Chinese case study.

The demand for the effective traceability of hazardous chemicals is crucial for preventing and controlling chemical spills and other accidents involving hazardous chemicals. The aim of the study was to investigate the correlation between the geographical location of ethanol-producing industrial sites and the carbon, hydrogen, and oxygen stable isotope ratios of the Chinese-manufactured ethanol using statistical classification analysis to enable the traceability of the ethanol. The isotopic data of 54 ethanol samples obtained from 18 different ethanol manufacturing plants in China between 2019 and 2020. The results of the statistical analysis demonstrated that the δ18O values of the ethanol positively correlated with latitudes of the production plants but negatively correlated with the δ13C values of the ethanol. A small number of samples derived from sites that were geographically close to each other could not be visually distinguished by PCA and HCA. However, by applying and comparing the results of classification by LDA, K-NN and Ensemble, an optimal classification model was obtained. Upon application of these models, 96.3% of the ethanol samples were correctly classified based on their geographical origin, indicating that the combination of isotopic ratios and latitude data is practical and effective for measuring the traceability of ethanol.

Role of economic growth and innovative technologies in the outlook of energy and environmental efficiency: a way forward for developing Asian economies.

Energy consumption is widely regarded as the primary driver of economic development and environmental degradation. The current study examines how energy use is related to technological innovation, human resources, energy pricing, economic development, and trade openness. For this context, the data set of OECD economies' indicators as mentioned above has been compiled for the period 1991-2019. Three estimators were used in this study from the family of autoregressive distributed lag (ARDL): the mean group (MG), the dynamic fixed effect (DFE), and the pooled mean group (PMG). According to empirical research, technical advances, human resources, and energy pricing all have a negative impact on OECD countries' long-run energy consumption. In the short term, however, these variables have a negligible or inverse effect on energy consumption. On the other hand, economic growth and trade openness in OECD economies all contribute positively to energy demand in the short and long run. Based on the empirical findings, this study recommends a policy structure for emerging economies.

Platelet membrane and stem cell exosome hybrid enhances cellular uptake and targeting to heart injury.

Exosomes from mesenchymal stem cells have been largely studied as therapeutics to treat myocardial infarctions. However, exosomes injected for therapeutic purposes face a number of challenges, including competition from exosomes already in circulation, and the internalization/clearance by the mononuclear phagocyte system. In this study, we hybrid exosomes with platelet membranes to enhance their ability to target the injured heart and avoid being captured by macrophages. Furthermore, we found that encapsulation by the platelet membranes induces macropinocytosis, enhancing the cellular uptake of exosomes by endothelial cells and cardiomyocytes strikingly. In vivo studies showed that the cardiac targeting ability of hybrid exosomes in a mice model with myocardial infarction injury. Last, we tested cardiac functions and performed immunohistochemistry to confirm a better therapeutic effect of platelet membrane modified exosomes compared to non-modified exosomes. Our studies provide proof-of-concept data and a universal approach to enhance the binding and accumulation of exosomes in injured tissues.

[Conception and framework of land ecological restoration for a new stage in China.] / 新时期我国国土空间生态修复理念与模式探讨.

Based on the theories of geography and landscape ecology, land ecological restoration is an important strategy to promote ecological civilization and build a beautiful China. Land ecological restoration in China has the characteristics of multi-disciplinary theoretical system, diverse work mode, integration of technology and methods, and diversified practice and exploration. The overall effectiveness of the work coexists with arduous tasks. Based on the new challenges in land ecological restoration, we summarized the overall framework and technical path of land ecological restoration, the working mechanism and mode of regional land ecological restoration, the content system and technical standards of land ecological restoration. In the new stage, the top-level design of land ecological restoration in China should focus on the work system, business boundary and institutional system, identify the responsibility boundary of different business processes, and realize the closed management of the whole work chain from the perspective of theory, system, engineering and technology. Rural settlement area, urban built-up area, industrial and mining gathering area, ecological function area and blue ocean area are the five major elements of regional scale land space, which correspond to five different ecological restoration modes, namely, comprehensive land improvement, urban renewal and double repair, mine geological environment restoration, mountain-river-forest-farmland-lake-grassland restoration, and blue bay restoration. It is necessary to comprehensively use the thinking of "Three Integrations" (information, technology, and process) to build a set of regional land ecological restoration work mode covering the integration of investigation, monitoring and evaluation, land space planning, project implementation, project acceptance and ecosystem monitoring and evaluation.

Exosome-eluting stents for vascular healing after ischaemic injury.

Drug-eluting stents implanted after ischaemic injury reduce the proliferation of endothelial cells and vascular smooth muscle cells and thus neointimal hyperplasia. However, the eluted drug also slows down the re-endothelialization process, delays arterial healing and can increase the risk of late restenosis. Here we show that stents releasing exosomes derived from mesenchymal stem cells in the presence of reactive oxygen species enhance vascular healing in rats with renal ischaemia-reperfusion injury, promoting endothelial cell tube formation and proliferation, and impairing the migration of smooth muscle cells. Compared with drug-eluting stents and bare-metal stents, the exosome-coated stents accelerated re-endothelialization and decreased in-stent restenosis 28 days after implantation. We also show that exosome-eluting stents implanted in the abdominal aorta of rats with unilateral hindlimb ischaemia regulated macrophage polarization, reduced local vascular and systemic inflammation, and promoted muscle tissue repair.

Design of Core-Shell Quantum Dots-3D WS2 Nanowall Hybrid Nanostructures with High-Performance Bifunctional Sensing Applications.

Transition metal dichalcogenides (TMDCs) have recently attracted a tremendous amount of attention owing to their superior optical and electrical properties as well as the interesting and various nanostructures that are created by different synthesis processes. However, the atomic thickness of TMDCs limits the light absorption and results in the weak performance of optoelectronic devices, such as photodetectors. Here, we demonstrate the approach to increase the surface area of TMDCs by a one-step synthesis process of TMDC nanowalls from WOx into three-dimensional (3D) WS2 nanowalls. By utilizing a rapid heating and rapid cooling process, the formation of 3D nanowalls with a height of approximately 150 nm standing perpendicularly on top of the substrate can be achieved. The combination of core-shell colloidal quantum dots (QDs) with three different emission wavelengths and 3D WS2 nanowalls further improves the performance of WS2-based photodetector devices, including a photocurrent enhancement of 320-470% and shorter response time. The significant results of the core-shell QD-WS2 hybrid devices can be contributed by the high nonradiative energy transfer efficiency between core-shell QDs and the nanostructured material, which is caused by the spectral overlap between the emission of core-shell QDs and the absorption of WS2. Besides, outstanding NO2 gas-sensing performance of core-shell QDs/WS2 devices can be achieved with an extremely low detection limit of 50 ppb and a fast response time of 26.8 s because of local p-n junctions generated by p-type 3D WS2 nanowalls and n-type core-shell CdSe-ZnS QDs. Our work successfully reveals the energy transfer phenomenon in core-shell QD-WS2 hybrid devices and shows great potential in commercial multifunctional sensing applications.

Dermal exosomes containing miR-218-5p promote hair regeneration by regulating ß-catenin signaling.

The progression in the hair follicle cycle from the telogen to the anagen phase is the key to regulating hair regrowth. Dermal papilla (DP) cells support hair growth and regulate the hair cycle. However, they gradually lose key inductive properties upon culture. DP cells can partially restore their capacity to promote hair regrowth after being subjected to spheroid culture. In this study, results revealed that DP spheroids are effective at inducing the progression of the hair follicle cycle from telogen to anagen compared with just DP cell or minoxidil treatment. Because of the importance of paracrine signaling in this process, secretome and exosomes were isolated from DP cell culture, and their therapeutic efficacies were investigated. We demonstrated that miR-218-5p was notably up-regulated in DP spheroid-derived exosomes. Western blot and immunofluorescence imaging were used to demonstrate that DP spheroid-derived exosomes up-regulated ß-catenin, promoting the development of hair follicles.

Misdiagnosis of Bell's palsy: Case series and literature review.

Although Bell's palsy is a common etiology for isolated facial paralysis, it is important clinicians perform a complete neurologic examination to avoid misdiagnosis. Multiple cranial neuropathy is often caused by tumor or infection.

Three-Dimensional Molybdenum Diselenide Helical Nanorod Arrays for High-Performance Aluminum-Ion Batteries.

The rechargeable aluminum-ion battery (AIB) is a promising candidate for next-generation high-performance batteries, but its cathode materials require more development to improve their capacity and cycling life. We have demonstrated the growth of MoSe2 three-dimensional helical nanorod arrays on a polyimide substrate by the deposition of Mo helical nanorod arrays followed by a low-temperature plasma-assisted selenization process to form novel cathodes for AIBs. The binder-free 3D MoSe2-based AIB shows a high specific capacity of 753 mAh g-1 at a current density of 0.3 A g-1 and can maintain a high specific capacity of 138 mAh g-1 at a current density of 5 A g-1 with 10 000 cycles. Ex situ Raman, XPS, and TEM characterization results of the electrodes under different states confirm the reversible alloying conversion and intercalation hybrid mechanism during the discharge and charge cycles. All possible chemical reactions were proposed by the electrochemical curves and characterization. Further exploratory works on interdigital flexible AIBs and stretchable AIBs were demonstrated, exhibiting a steady output capacity under different bending and stretching states. This method provides a controllable strategy for selenide nanostructure-based AIBs for use in future applications of energy-storage devices in flexible and wearable electronics.

Nanoprobing of MoS2 by Synchrotron Radiation When van der Waals Epitaxy Is Locally Invalid.

In this work, we demonstrated nano-scaled Laue diffractions by a focused polychromatic synchrotron radiation beam to discover what happens in MoS2 when van der Waals epitaxy is locally invalid. A stronger exciton recombination with a local charge depletion in the density of 1 × 1013 cm-2, extrapolated by Raman scattering and photoluminescence, occurs in grains, which exhibits a preferred orientation of 30° rotation with respect to the c-plane of a sapphire substrate. Else, the charge doping and trion recombination dominate instead. In addition to the breakthrough in extrapolating mesoscopic crystallographic characteristics, this work opens the feasibility to manipulate charge density by the selection of the substrate-induced disturbances without external treatment and doping. Practically, the 30° rotated orientation in bilayer MoS2 films is promoted on inclined facets in the patterned sapphire substrate, which exhibits a periodic array of charge depletion of about 1.65 × 1013 cm-2. The built-in manipulation of carrier concentrations could be a potential candidate to lateral and large-area electronics based on 2D materials.

High-Performance Rechargeable Aluminum-Selenium Battery with a New Deep Eutectic Solvent Electrolyte: Thiourea-AlCl3.

Aluminum-sulfur batteries (ASBs) have attracted substantial interest due to their high theoretical specific energy density, low cost, and environmental friendliness, while the traditional sulfur cathode and ionic liquid have very fast capacity decay, limiting cycling performance because of the sluggishly electrochemical reaction and side reactions with the electrolyte. Herein, we demonstrate, for the first time, excellent rechargeable aluminum-selenium batteries (ASeBs) using a new deep eutectic solvent, thiourea-AlCl3, as an electrolyte and Se nanowires grown directly on a flexible carbon cloth substrate (Se NWs@CC) by a low-temperature selenization process as a cathode. Selenium (Se) is a chemical analogue of sulfur with higher electronic conductivity and lower ionization potential that can improve the battery kinetics on the sluggishly electrochemical reaction and the reduction of the polarization where the thiourea-AlCl3 electrolyte can stabilize the side reaction during the reversible conversion reaction of Al-Se alloying processes during the charge-discharge process, yielding a high specific capacity of 260 mAh g-1 at 50 mA g-1 and a long cycling life of 100 times with a high Coulombic efficiency of nearly 93% at 100 mA g-1. The working mechanism based on the reversible conversion reaction of the Al-Se alloying processes, confirmed by the ex situ Raman, XRD, and XPS measurements, was proposed. This work provides new insights into the development of rechargeable aluminum-chalcogenide (S, Se, and Te) batteries.

An off-the-shelf artificial cardiac patch improves cardiac repair after myocardial infarction in rats and pigs.

Cell therapy has been a promising strategy for cardiac repair after injury or infarction; however, low retention and engraftment of transplanted cells limit potential therapeutic efficacy. Seeding scaffold material with cells to create cardiac patches that are transplanted onto the surface of the heart can overcome these limitations. However, because patches need to be freshly prepared to maintain cell viability, long-term storage is not feasible and limits clinical applicability. Here, we developed an off-the-shelf therapeutic cardiac patch composed of a decellularized porcine myocardial extracellular matrix scaffold and synthetic cardiac stromal cells (synCSCs) generated by encapsulating secreted factors from isolated human cardiac stromal cells. This fully acellular artificial cardiac patch (artCP) maintained its potency after long-term cryopreservation. In a rat model of acute myocardial infarction, transplantation of the artCP supported cardiac recovery by reducing scarring, promoting angiomyogenesis, and boosting cardiac function. The safety and efficacy of the artCP were further confirmed in a porcine model of myocardial infarction. The artCP is a clinically feasible, easy-to-store, and cell-free alternative to myocardial repair using cell-based cardiac patches.

Tumor cell-derived exosomes home to their cells of origin and can be used as Trojan horses to deliver cancer drugs.

Cancer is the second leading cause of death worldwide and patients are in urgent need of therapies that can effectively target cancer with minimal off-target side effects. Exosomes are extracellular nano-shuttles that facilitate intercellular communication between cells and organs. It has been established that tumor-derived exosomes contain a similar protein and lipid composition to that of the cells that secrete them, indicating that exosomes might be uniquely employed as carriers for anti-cancer therapeutics. Methods: We isolated exosomes from two cancer cell lines, then co-cultured each type of cancer cells with these two kinds of exosomes and quantified exosome. HT1080 or Hela exosomes were systemically injected to Nude mice bearing a subcutaneous HT1080 tumor to investigate their cancer-homing behavior. Moreover, cancer cell-derived exosomes were engineered to carry Doxil (a common chemotherapy drug), known as D-exo, were used to detect their target and therapeutic efficacy as anti-cancer drugs. Exosome proteome array analysis were used to reveal the mechanism underly this phenomenon. Results: Exosomes derived from cancer cells fuse preferentially with their parent cancer cells, in vitro. Systemically injected tumor-derived exosomes home to their original tumor tissues. Moreover, compared to Doxil alone, the drug-loaded exosomes showed enhanced therapeutic retention in tumor tissues and eradicated them more effectively in nude mice. Exosome proteome array analysis revealed distinct integrin expression patterns, which might shed light on the underlying mechanisms that explain the exosomal cancer-homing behavior. Conclusion: Here we demonstrate that the exosomes' ability to target the parent cancer is a phenomenon that opens up new ways to devise targeted therapies to deliver anti-tumor drugs.