The clinical trajectory of peripheral blood immune cell subsets, T-cell activation, and cytokines in septic patients.

OBJECTIVE AND DESIGN: Changes in the immune status of patients with sepsis may have a major impact on their prognosis. Our research focused on changes in various immune cell subsets and T-cell activation during the progression of sepsis. METHODS AND SUBJECTS: We collected data from 188 sepsis patients at the First Affiliated Hospital of Zhejiang University School of Medicine. The main focus was on the patient's immunocyte subset typing, T-cell activation/Treg cell analysis, and cytokine assay, which can indicate the immune status of the patient. RESULTS: The study found that the number of CD4+ T cells, CD8+ T cells, NK cells, and B cells decreased early in the disease, and the decrease in CD4+ and CD8+ T cells was more pronounced in the death group. T lymphocyte activation was inhibited, and the number of Treg cells increased as the disease progressed. T lymphocyte inhibition was more significant in the death group, and the increase in IL-10 was more significant in the death group. Finally, we used patients' baseline conditions and immunological detection indicators for modeling and found that IL-10, CD4+ Treg cells, CD3+HLA-DR+ T cells, and CD3+CD69+ T cells could predict patients' prognosis well. CONCLUSION: Our study found that immunosuppression occurs in patients early in sepsis. Early monitoring of the patient's immune status may provide a timely warning of the disease.

Automated Patient Note Grading: Examining Scoring Reliability and Feasibility.

PURPOSE: Scoring postencounter patient notes (PNs) yields significant insights into student performance, but the resource intensity of scoring limits its use. Recent advances in natural language processing (NLP) and machine learning allow application of automated short answer grading (ASAG) for this task. This retrospective study evaluated psychometric characteristics and reliability of an ASAG system for PNs and factors contributing to implementation, including feasibility and case-specific phrase annotation required to tune the system for a new case. METHOD: PNs from standardized patient (SP) cases within a graduation competency exam were used to train the ASAG system, applying a feed-forward neural networks algorithm for scoring. Using faculty phrase-level annotation, 10 PNs per case were required to tune the ASAG system. After tuning, ASAG item-level ratings for 20 notes were compared across ASAG-faculty (4 cases, 80 pairings) and ASAG-nonfaculty (2 cases, 40 pairings). Psychometric characteristics were examined using item analysis and Cronbach's alpha. Inter-rater reliability (IRR) was examined using kappa. RESULTS: ASAG scores demonstrated sufficient variability in differentiating learner PN performance and high IRR between machine and human ratings. Across all items the ASAG-faculty scoring mean kappa was .83 (SE ± .02). The ASAG-nonfaculty pairings kappa was .83 (SE ± .02). The ASAG scoring demonstrated high item discrimination. Internal consistency reliability values at the case level ranged from a Cronbach's alpha of .65 to .77. Faculty time cost to train and supervise nonfaculty raters for 4 cases was approximately $1,856. Faculty cost to tune the ASAG system was approximately $928. CONCLUSIONS: NLP-based automated scoring of PNs demonstrated a high degree of reliability and psychometric confidence for use as learner feedback. The small number of phrase-level annotations required to tune the system to a new case enhances feasibility. ASAG-enabled PN scoring has broad implications for improving feedback in case-based learning contexts in medical education.

Mechanistic insights into photoinduced energy and charge transfer dynamics between magnesium-centered tetrapyrroles and carbon nanotubes.

Functionalizing single-walled carbon nanotubes (SWNTs) with light-harvesting molecules is a facile way to construct donor-acceptor nanoarchitectures with intriguing optoelectronic properties. Magnesium-centered bacteriochlorin (MgBC), chlorin (MgC), and porphyrin (MgP) are a series of tetrapyrrole macrocycles comprising a central metal and four coordinated aromatic or antiaromatic five-membered rings linked by methine units, which show excellent visible light absorption. To delineate the effects of the aromaticity of coordinated rings on the optoelectronic properties of the nanocomposites, the photoinduced energy and charge transfer dynamics between Mg-centered tetrapyrroles and SWNTs are explored. The results show that excited energy transfer (EET) can occur within MgP@SWNT ascribed to the stabilization of the highest occupied molecular orbital (HOMO) in MgP with the increase of aromatic coordinated rings, while only electron transfer can take place in MgBC@SWNT and MgC@SWNT. Non-adiabatic dynamics simulations demonstrate that electron and hole transfer from MgP to SWNT is asynchronous. The electron transfer is ultrafast with a timescale of ca. 50 fs. By contrast, the hole transfer is significantly suppressed, although it can be accelerated to some extent when using a lower excitation energy of 2.2 eV as opposed to 3.1 eV. Further analysis reveals that the large energy gaps between charge-donor and charge-acceptor states play a crucial role in regulating photoexcited state relaxation dynamics. Our theoretical insights elucidate the structure-functionality interrelations between Mg-centered tetrapyrroles and SWNTs and provide a comprehensive understanding of the underlying charge transfer mechanism within MgP@SWNT nanocomposites, which paves the way for the forthcoming development of SWNT-based photo-related functional materials with targeted applications.

[Deep learning method for magnetic resonance imaging fluid-attenuated inversion recovery image synthesis].

Magnetic resonance imaging(MRI) can obtain multi-modal images with different contrast, which provides rich information for clinical diagnosis. However, some contrast images are not scanned or the quality of the acquired images cannot meet the diagnostic requirements due to the difficulty of patient's cooperation or the limitation of scanning conditions. Image synthesis techniques have become a method to compensate for such image deficiencies. In recent years, deep learning has been widely used in the field of MRI synthesis. In this paper, a synthesis network based on multi-modal fusion is proposed, which firstly uses a feature encoder to encode the features of multiple unimodal images separately, and then fuses the features of different modal images through a feature fusion module, and finally generates the target modal image. The similarity measure between the target image and the predicted image in the network is improved by introducing a dynamic weighted combined loss function based on the spatial domain and K-space domain. After experimental validation and quantitative comparison, the multi-modal fusion deep learning network proposed in this paper can effectively synthesize high-quality MRI fluid-attenuated inversion recovery (FLAIR) images. In summary, the method proposed in this paper can reduce MRI scanning time of the patient, as well as solve the clinical problem of missing FLAIR images or image quality that is difficult to meet diagnostic requirements.

Recent advances in enzymatic properties, preparation methods, and functions of glycoside hydrolase from Bifidobacterium: a review.

Bifidobacterium is a major probiotic of intestinal gut flora and exerts many physiological activities, and it is widely applied in the fields of food and medicine. As an important part of Bifidobacterium, glycoside hydrolase plays a role in its physiological activity. With the continuous development and improvement of genetic engineering technology, research on this type of enzyme will play a crucial role in promoting the further development of Bifidobacterium in the field of probiotics. In this review, the preparation methods, enzymatic properties, and functions of glycoside hydrolase extracted from Bifidobacterium are described and summarized. The common method for preparing glycoside hydrolase derived from Bifidobacterium is heterologous expression in Escherichia coli BL21. The optimal pH range for these glycoside hydrolase enzymes is between 4.5 and 7.5; the optimal temperature is between 30 and 50 °C, which is close to the optimal growth condition of Bifidobacterium. Based on substrate specificity, these glycoside hydrolase could hydrolyze synthetic substrates and natural oligosaccharides, including a series of pNP artificial substrates, disaccharide, and trisaccharides, while they have little ability to hydrolyze polysaccharide substrates. This review will be expected to provide a basis for the development of Bifidobacterium as a probiotic element.

Adsorption Kinetics of Poly(benzyl acrylate) Chains onto Alumina Interface during the Flow-Driven Translocation through Cylindrical Nanochannels.

In this work, the adsorption kinetics of the PBAN/AAO system under flushing condition has been investigated, where PBAN and AAO represent poly(benzyl acrylate) and anodic alumina oxide (AAO, average pore radius R0 ≈ 10 nm) nanochannel, respectively. Our specially designed double-pump flushing system is proved to eliminate the overshoot phenomenon and in situ monitor transmembrane pressure (ΔP) as a function of flushing time (t) and flow rate (Q), which gives the effective pore radius (R), cross-sectional coverage factor (χ = [1 - (R/R0)2]), and characteristic ratio (rc) of the increments of χ during each adsorption/desorption cycle at a given bulk solution concentration (Cbulk). Our findings include: (1) by gradient increasing Cbulk from 10 to 200 mg/L at Q = 10 mL/h, the shortest PBA40 displays a saturation adsorption behavior when Cbulk ≥ 80 mg/L and t ≥ 2000 s, which agrees well with the prediction of blob model, whereas for the longer PBAN chains, the chain length (N) and concentration-dependent adsorption tendency get stronger as N increases from 40 to 620 at t ≥ 2000 s, in particular, R/R0 ∼ N-0.20 is observed at Cbulk = 140 mg/L; (2) by focusing on the platform χ in the saturation adsorption regime (χsat), the longer PBAN displays a stronger adsorption trend with partially reversible feature at Q = 5.0 mL/h, namely, as N increases from 40 to 620, χsat increases from 0.15 to 0.83 at Cbulk = 100 mg/L, where rc changes from 0.25 ± 0.10 to 0.80 ± 0.10 as the adsorption/desorption flushing cycle increases from 1 to 8 at Cbulk = 100 mg/L; (3) by further assuming a solvent nonpenetrating and nondraining adsorption layer, χsat determined in the case of curved surface can be comparable to the physical meaning of adsorption thickness (Δad) in the case of flat-surface adsorption, and the fitting result indicates χsat ∼ Δad ∼ N0.58, falling between Δad ∼ N1/2 and Δad ∼ N1.0 predicted by the mean-field and scaling theories for real multichain adsorption, respectively. Overall, the present work not only clarifies some controversies but also provides unambiguous evidence supporting the existence of tightly adsorbed internal and loosely adsorbed external layers.

Chitosan-based hydrogel wound dressing: From mechanism to applications, a review.

As promising biomaterials, hydrogels are widely used in the medical engineering field, especially in wound repairing. Compared with traditional wound dressings, such as gauze and bandage, hydrogel could absorb and retain more water without dissolving or losing its three-dimensional structure, thus avoiding secondary injury and promoting wound healing. Chitosan and its derivatives have become hot research topics for hydrogel wound dressing production due to their unique molecular structure and diverse biological activities. In this review, the mechanism of wound healing was introduced systematically. The mechanism of action of chitosan in the first three stages of wound repair (hemostasis, antimicrobial properties and progranulation), the effect of chitosan deacetylation and the molecular weight on its performance are analyzed. Additionally, the recent progress in intelligent and drug-loaded chitosan-based hydrogels and the features and advantages of chitosan were discussed. Finally, the challenges and prospects for the future development of chitosan-based hydrogels were discussed.

Analysis of Structure and Antioxidant Activity of Polysaccharides from Aralia continentalis.

We extracted, purified, and characterized three neutral and three acidic polysaccharides from the roots, stems, and leaves of Aralia continentalis Kitigawa. The results of the analysis of monosaccharide composition indicated that the polysaccharides from the roots and stems were more similar to each other than they were to the polysaccharides from the leaves. The in vitro antioxidant results demonstrated that the acidic polysaccharides had stronger antioxidant activity than the neutral fractions. Therefore, we investigated the primary purified acidic polysaccharide fractions (WACP(R)-A-c, WACP(S)-A-c, and WACP(L)-A-d) by NMR and enzymatic analysis. The structural analytical results indicated that WACP(R)-A-c contained homogalacturonan (HG); WACP(S)-A-c contained HG and rhamnogalacturonan II (RG-II), and WACP(L)-A-d contained HG, RG-II, and rhamnogalacturonan I (RG-I) domains. Our findings offer insights into the screening of natural polysaccharide-based antioxidants and provide a theoretical basis for the application of A. continentalis.

Lethal diquat poisoning manifests as acute central nervous system injury and circulatory failure: A retrospective cohort study of 50 cases.

Background: The mortality rate of patients with diquat (DQ) poisoning is extremely high due to insufficient understanding of DQ-induced injury. This study aimed to summarize the characteristics of DQ poisoning as well as analyse the correlation between plasma DQ concentration and patient outcomes, thus providing a new strategy for diagnosis and treatment. Methods: This single-centre retrospective cohort study was conducted at the Emergency Department of the First Affiliated Hospital, Zhejiang University School of Medicine, China, between Oct 9, 2019 and March 10, 2022. 50 patients, whose plasma or urine samples tested positive for diquat and negative for paraquat by high performance liquid chromatography-tandem mass spectrometry, were included in the study. Findings: The mortality rate of acute DQ poisoning was 25 (50%) of 50. Compared with the survival group, the death group presented significantly higher initial plasma DQ concentration (Cp1), aspartate aminotransferase, alanine aminotransferase, serum creatinine, and creatine kinase-MB (P < 0.05). We found that six (24.0%) patients died of central nervous system injury, six (24.0%) patients died of refractory circulatory failure, and 13 (52.0%) patients died of central nervous system injury combined with circulatory failure. Receiver operator characteristic curve analysis showed that the area under the curve of Cp1 was 0.967 (95% CI: 0.911, 1.000), and the cut-off value was 3516.885 ng/mL (sensitivity, 90.9%; specificity, 96.0%). Interpretation: Lethal DQ poisoning is primarily associated with serious brain and vascular injury, as well as a high rate of mortality. Further research into the mechanisms of refractory circulatory failure and central nerve system damage could help reduce mortality. Funding: There are no funding sources to declare.

The Molecular Mechanism of Hemocyte Immune Response in Marsupenaeus japonicus Infected With Decapod Iridescent Virus 1.

As a new type of shrimp lethal virus, decapod iridescent virus 1 (DIV1) has caused huge economic losses to shrimp farmers in China. Up to now, DIV1 has been detected in a variety of shrimps, but there is no report in Marsupenaeus japonicus. In the current study, we calculated the LC50 to evaluate the toxicity of DIV1 to M. japonicus and determined through nested PCR that M. japonicus can be the host of DIV1. Through enzyme activity study, it was found that DIV1 can inhibit the activities of superoxide dismutase, catalase, lysozyme, and phenoloxidase, which could be a way for DIV1 to achieve immune evasion. In a comprehensive study on the transcriptomic changes of M. japonicus in response to DIV1 infection, a total of 52,287 unigenes were de novo assembled, and 20,342 SSR markers associated with these unigenes were obtained. Through a comparative transcriptomic analysis, 6,900 differentially expressed genes were identified, including 3,882 upregulated genes and 3,018 downregulated genes. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that some GO terms related to virus invasion, replication, and host antiviral infection were promoted under DIV1 infection, such as carbohydrate binding, chitin binding, chitin metabolic process, and DNA replication initiation, and some KEGG pathways related to immune response were significantly influenced by DIV1 infection, including Toll and IMD signaling pathway, JAK-STAT signaling pathway, IL-17 signaling pathway, C-type lectin receptor signaling pathway, complement and coagulation cascades, antigen processing and presentation, necroptosis, apoptosis, NOD-like receptor signaling pathway, apoptosis-multiple species, and TNF signaling pathway. Further analysis showed that STAT, Dorsal, Relish, heat shock protein 70 (HSP70), C-type lectins, and caspase play an important role in DIV1 infection. This is the first detailed study of DIV1 infection in M. japonicus, which initially reveals the molecular mechanism of DIV1 infection in M. japonicus by using the transcriptome analysis of hemocytes combined with enzyme activity study.

Fault diagnosis for three-phase PWM rectifier based on deep feedforward network with transient synthetic features.

Three-phase PWM rectifiers are adopted extensively in industry because of their excellent properties and potential advantages. However, while the IGBT has an open-circuit fault, the system does not crash suddenly, the performance will be reduced for instance voltages fluctuation and current harmonics. A fault diagnosis method based on deep feedforward network with transient synthetic features is proposed to reduce the dependence on the fault mathematical models in this paper, which mainly uses the transient phase current to train the deep feedforward network classifier. Firstly, the features of fault phase current are analyzed in this paper. Secondly, the historical fault data after feature synthesis is employed to train the deep feedforward network classifier, and the average fault diagnosis accuracy can reach 97.85% for transient synthetic fault data, the classifier trained by the transient synthetic features obtained more than 1% gain in performance compared with original transient features. Finally, the online fault diagnosis experiments show that the method can accurately locate the fault IGBTs, and the final diagnosis result is determined by multiple groups results, which has the ability to increase the accuracy and reliability of the diagnosis results.

Effect of Short-Term Aging on Asphalt Modified Using Microwave Activation Crumb Rubber.

Effective approaches are required to be developed to solve the poor compatibility and thermal stability problems of crumb rubber-modified asphalt (CRMA). This study focuses on a method called microwave activation. However, seldom researches pay attention to the properties of MACRMA after aging. The objective of this study was to prepare microwave-activated CRMA (MACRMA) and investigate the performance of asphalt after aging. The samples were subjected to thin-film oven test (TFOT) at different times and temperatures. The effect of heat aging on the properties of MACRMA was evaluated by three indicator tests: viscosity, dynamic shear rheology test (DSR), and repeat creep recovery test (RCRT). The test results indicated that the MACRMA after two aging conditions had noticeably lower performance values (e.g., penetration, ductility) compared to unaged samples, and thus, the need to control temperature and time for mixing and construction was verified to be important. In addition, the G*/sin δ and phase angle values were largely influenced by the TFOT aging temperature and time. The MACRMA's ability to recover was improved after aging. Compared with the aging temperature, the aging time had a more significant effect on the deformation and recovery ability of MACRMA.