Slow Well-Being Gardening: Creating a Sensor Network for Radiation Therapy Patients via Horticultural Therapeutic Activity.

Well-being can reflect people's psychological conditions and be used alongside physiological parameters to evaluate patients' physical and mental health. The modern medical environment increasingly incorporates digital carriers, human-computer interaction devices, sensible spaces, and the execution of suitable algorithms. Slow design in healthy human-computer interaction is often used to reflect people's dependence on or support from behaviors or objects, promoting the stability of behaviors as well as meaningful and positive changes. Therefore, in this study, we propose a slow sensing model, develop a Slow Well-Being Gardening system, and use it to evaluate behavioral data from radiation therapy patients during treatment sessions and horticultural therapy. This study is based on SENS and slow design, setting the hospital lounge as a sensible space and establishing a sensor system. After a 10-day inspection, the process was evaluated and verified. Ultimately, data from facial detection (smile) and HRV showed that the patients in the experimental group experienced a significant improvement in their well-being, feeling better than those in the control group who maintained the most common state in normal treatment. Therefore, it can be inferred that the Slow Well-Being Gardening model is indeed valid and can be further developed.

Study on coal pulverization characteristics and gas desorption mechanism based on impact crushing experiment.

The coal's particle size distribution properties after pulverization and the gas desorption behavior driven by pulverization are of profound meaning to the study of coal and gas outburst mechanism. In this paper, based on the impact crushing experiment, the tectonic coal and primary coal are crushed under different impact energy conditions. After screening the broken coal, the particle size distribution law is analyzed, and the characterization function suitable for the particle size distribution of coal particles after crushing is determined. The relationship between crushing work and new surface area and fractal dimension of coal body is discussed. The consequences indicated that the mass proportion of tectonic coal below 0.074 mm particle size is much huger than that of raw coal. G-S, R-R, and fractal distribution model describe the best particle size distribution of the two coals in the scope of 0.074∼4 mm. The new surface area added increases with the crushing work, and the tectonic coal is 1.34-1.96 times that of the raw coal. The fractal dimension diminishes first and then increases with the crushing work ratio. In addition, the gas desorption amount of coal particles with different particle sizes after coal pulverization was measured, and a dynamic model suitable for coal pulverization-driven gas desorption was established, and the experimental results were verified. The research results of this paper can provide experimental and theoretical basis for the analysis of energy dissipation in coal and gas outburst.

Characterization of Coal Particle Methane Desorption and Optimization of Desorption Model Based on Desorption Damage.

In view of the current situation where most studies on gas desorption characteristics are limited to the atmospheric pressure desorption environment, we have independently developed a coal methane desorption instrument to test the nonatmospheric pressure desorption characteristics for coal particle gas beneath the condition of desorption damage. The instrument can arbitrarily adjust the gas pressure in the range of measurement while controlling the instantaneous release of excess gas to keep the desorption environment pressure constant. We measured the methane desorption amount of coal samples with different desorption times within 3 h and calculated the desorption velocity. The results show that the final desorption amount and desorption velocity of gas scale up with the increase of times, and the final desorption amount of coal sample W-01 increases the most, which is 18.5%. With the passage of time, the diffusion coefficient decreases gradually, and the number of desorption times is directly proportional to the diffusion coefficient. Its relative deviation of diffusion coefficient between different desorption times of the same coal sample can reach up to 40%, and the desorption time in the range of 5 to 30 min is the area with high relative deviation. A quantitative index Ki of a double-parameter damage model based on desorption conditions and adsorption pressure is proposed, and the damage extent of each sample is evaluated. The damage quantitative index of coal sample W-01 is the highest, which is 0.87. The methane desorption model of coal under the condition of desorption damage is constructed, and more than 30 groups of experiments are verified.

Factors Determining Testicular Torsion and Consequent Orchiectomy in Pediatric Patients Presenting With Scrotal Pain.

OBJECTIVE: Factors associated with testicular torsion (TT) and consequent orchiectomy in patients presenting to pediatric emergency departments (PEDs) with scrotal pain (SP) are not well described. We report the factors predicting TT and consequent orchiectomy in children with SP. METHODS: The data on patients (aged ≤18 years) who presented with SP to PEDs at 4 branches of the Chang Gung Hospital through 10 years were analyzed. RESULTS: In all, 256 pediatric patients presented with SP. Their mean age was 11.60 ± 4.61 years and 72.7% (n = 186) were aged 10 to 18 years. The pain was left-sided in 54.7% (n = 140) and the interval between SP onset and PED arrival was 22.45 ± 31.27 hours. Overall, 84 (32.8%) patients needed surgery and 72 (28.1%) had TT. Of the patients with TT, 28 (38.9%) patients needed an orchiectomy. After analysis, TT and consequent orchiectomy were associated with a longer interval between SP onset and PED arrival, absent of testicular ultrasonic blood flow, interval between SP onset and surgery of more than 24 hours, and a high degree of TT. None of them experienced recurrent SP symptoms or TT again. CONCLUSIONS: The rate of TT in patients presenting to PEDs with an SP was 28.1%, and 38.9% of the patients with TT needed an orchiectomy. Early diagnosis and intervention helped to prevent subsequent orchiectomy in pediatric patients with TT.

Improving people's health by burning low-pollution coal to improve air quality for thermal power generation.

Eliminating the NOx emission after coal combustion is a critical task for thermal power plants to reduce threats to the human body, such as respiratory diseases, heart disease, lung disease and even lung cancer. To this end, various treatments have been taken to optimize, monitor and control the combustion process. However, optimizing the coal composition prior to combustion can further reduce possible NOx emissions. This topic was rarely discussed in the past. To fill this gap, this study proposes a fuzzy big data analytics approach. The proposed methodology combines recursive feature elimination, fuzzy c-means, XG Boost, support vector regression, random forests, decision trees and deep neural networks to predict post-combustion NOx emission based on coal composition and specification. Subsequently, additional treatments can be implemented to optimize boiler configuration and combustion conditions with pollution prevention equipment. In other words, the method proposed in this study is a kind of pretreatment. The proposed methodology has been applied to the real case of a thermal power plant in Taiwan. Experimental results showed that the prediction accuracy using the proposed methodology was significantly better than several existing methods. The forecasting error, measured in terms of root mean square error and mean absolute percentage error, was only 14.55 ppm and 8.9%, respectively.

BNT162b2 immunization-related myocarditis in adolescents and consequent hospitalization: Report from a medical center.

BACKGROUND: To investigate Pfizer-BioNTech 162b2 mRNA COVID-19 vaccine (BNT162b2) immunization-related myocarditis and describe the risk factors for consequent hospitalization in the pediatric intensive care unit (PICU) in children between 12 and 18 years. METHODS: Children and adolescents 12 years of age and older who presented with discomfort after BNT162b2 immunization (BNTI) and visited pediatric emergency room (PER) at Chang Gung Memorial Hospital from September 22, 2021 to March 21, 2022, were included for analysis. RESULTS: 681 children presented with discomfort after BNTI and visited our PER. The mean age was 15.1 ± 1.7 years. Three hundred and ninety-four (57.9%) and 287 (42.1%) events were after 1st and 2nd dose, respectively. 58.4% (n = 398) were male. The most common complaints were chest pain (46.7%) and chest tightness (27.0%). The median (interquartile range [IQR]) interval of discomfort after BNTI was 3.0 (1.0-12.0) days. BNTI-related pericarditis, myocarditis and myopericarditis were diagnosed in 15 (2.2%), 12 (1.8%) and 2 (0.3%) patients, respectively. Eleven (1.6%) needed hospitalization in PICU. The median (IQR) hospital stay was 4.0 (3.0-6.0) days. There was no mortality. More patients were diagnosed myocarditis (p = 0.004) after 2nd dose BNTI. PICU admission occurred more commonly after 2nd dose BNTI (p = 0.007). Risk factors associated with hospitalization in PICU were abnormal EKG findings (p = 0.047) and abnormal serum troponin levels (p = 0.003) at PER. CONCLUSION: Myocarditis in children aged 12-18 years occurred more commonly following 2nd dose BNTI. Most cases were of mild or intermediate severity without death. Factors predicting BNTI-related myocarditis and consequent hospitalization in PICU were abnormal EKG findings and abnormal serum troponin levels at PER in this study.

SENS+: A Co-Existing Fabrication System for a Smart DFA Environment Based on Energy Fusion Information.

In factories, energy conservation is a crucial issue. The co-fabrication space is a modern-day equivalent of a new factory type, and it makes use of Internet of Things (IoT) devices, such as sensors, software, and online connectivity, to keep track of various building features, analyze data, and produce reports on usage patterns and trends that can be used to improve building operations and the environment. The co-fabrication user requires dynamic and flexible space, which is different from the conventional user's usage. Because the user composition in a co-fabrication space is dynamic and unstable, we cannot use the conventional approach to assess their usage and rentals. Prototyping necessitates a specifically designed energy-saving strategy. The research uses a "seeing-moving-seeing" design thinking framework, which enables designers to more easily convey their ideas to others through direct observation of the outcomes of their intuitive designs and the representation of their works through design media. The three components of human behavior, physical manufacture, and digital interaction are primarily the focus of this work. The computing system that connects the physical machine is created through communication between the designer and the digital interface, giving the designer control over the physical machine. It is an interactive fabrication process formed by behavior. The Sensible Energy System+ is an interactive fabrication process of virtual and real coexistence created by combining the already-existing technology, the prototype fabrication machine, and SENS. This process analyzes each step of the fabrication process and energy, fits it into the computing system mode to control the prototype fabrication machine, and reduces the problem between virtual and physical fabrication and energy consumption.

Clinical characteristics of pediatric intussusception and predictors of bowel resection in affected patients.

Background: Surgery is required for the treatment of intussusception when enema reduction is unsuccessful, or when the patient develops peritonitis, bowel perforation, or intestinal damage. We aimed to evaluate the clinical and laboratory parameters that may be used to predict the need for bowel resection in children with intussusception. Methods: This observational retrospective study included children who were admitted to the pediatric emergency department with intussusception. Univariate and multivariate logistic regression models were used to evaluate factors associated with bowel resection. Results: In total, 584 children with intussusception were admitted to the pediatric emergency department; 129 of these children underwent surgery. Multivariate analysis revealed the following independent predictors of bowel resection for intussusception: symptoms for at least 2 days before surgery (OR = 6.863; p = 0.009), long intussusception (OR = 5.088; p = 0.014), pathological lead point (OR = 6.926; p = 0.003), and intensive care unit admission (OR = 11.777; p = 0.001) were factors independently associated with bowel resection. Conclusion: Symptoms for at least 2 days before surgery, long intussusception, pathological lead, and intensive care unit admission were predictors of bowel resection in children with intussusception. These findings can be used to identify patients at high risk of needing surgery and bowel resection.

Political ideology predicts preventative behaviors and infections amid COVID-19 in democracies.

Can one's political ideology predict his or her testing positive for COVID-19 and how? The present study leveraged a recent (April-May 2020) survey of 27,260 individuals across 27 democracies to investigate the associations between political ideology and coronavirus infections. Our individual-level data and mediation analyses allow us to tease out different correlational paths according to which one's political ideology affects his or her infection. We found a more right-leaning attitude to be associated with a higher probability of testing positive both directly and indirectly through conspiracy theory beliefs and physical distancing. Moreover, our cross-national investigation also found that becoming more right-leaning in ideology was associated with a higher level of perceived risk of COVID-19 infection, which made one less likely to test positive. Combined, we provide a more nuanced understanding of the role played by political ideology in the current pandemic, on which the design of a more effective risk communication strategy can be based.

Association Between Patient-Clinician Relationships and Adherence to Antihypertensive Medications Among Black Adults: An Observational Study Design.

Background We assessed the associations between patient-clinician relationships (communication and involvement in shared decision-making [SDM]) and adherence to antihypertensive medications. Methods and Results The 2010 to 2017 Medical Expenditure Panel Survey (MEPS) data were analyzed. A retrospective cohort study design was used to create a cohort of prevalent and new users of antihypertensive medications. We defined constructs of patient-clinician communication and involvement in SDM from patient responses to the standard questionnaires about satisfaction and access to care during the first year of surveys. Verified self-reported medication refill information collected during the second year of surveys was used to calculate medication refill adherence; adherence was defined as medication refill adherence ≥80%. Survey-weighted multivariable-adjusted logistic regression models were used to measure the odds ratio (OR) and 95% CI for the association between both patient-clinician constructs and adherence. Our analysis involved 2571 Black adult patients with hypertension (mean age of 58 years; SD, 14 years) who were either persistent (n=1788) or new users (n=783) of antihypertensive medications. Forty-five percent (n=1145) and 43% (n=1016) of the sample reported having high levels of communication and involvement in SDM, respectively. High, versus low, patient-clinician communication (OR, 1.38; 95% CI, 1.14-1.67) and involvement in SDM (OR, 1.32; 95% CI, 1.08-1.61) were both associated with adherence to antihypertensives after adjusting for multiple covariates. These associations persisted among a subgroup of new users of antihypertensive medications. Conclusions Patient-clinician communication and involvement in SDM are important predictors of optimal adherence to antihypertensive medication and should be targeted for improving adherence among Black adults with hypertension.

Prevalence and quality of antihypertensive therapy among hypertension patients enrolled in the Ghana National Health Insurance Scheme.

BACKGROUND: Hypertension is a leading cause of morbidity in Ghana. However, there is insufficient data on the prevalence and quality of antihypertensive therapy. OBJECTIVES: To describe the prevalence of use and quality of antihypertensive therapy. METHODS: A cross-sectional study design was used to analyze the 2015 Ghana National Health Insurance Scheme (NHIS) electronic claims data. Hypertension diagnosis was defined using ICD-10 codes. The primary outcomes assessed were the prevalence of use and quality of antihypertensive therapy. Quality of antihypertensive therapy was defined as the use of antihypertensive agents recommended for treating hypertension patients with comorbid heart failure, myocardial Infarction/Coronary Artery Disease, diabetes, chronic kidney disease or stroke. We used multivariable logistic regression models to identify predictors of antihypertensive use and quality of therapy. RESULTS: Antihypertensive medication use was very high (86%) among the 161 873 hypertension patients covered under the Ghana NHIS. Only a third (32%) of hypertension patients received guideline-concordant therapy. Angiotensin receptor blockers were consumed at the highest dosages of 120 (Interquartile Range [IQR]: 60, 180) daily defined doses over a year. Males (odds ratio [OR] = 0.60; 95% Confidence Interval [CI]:0.58, 0.61) and those with comorbid stroke (OR = 0.91, 95% CI:0.84, 0.99), diabetes (OR = 0.72; 95% CI:0.69, 0.74) and stroke (OR = 0.74, 95%CI:0.68, 0.80) were less likely to use antihypertensives, all other predictors were associated with higher use. CONCLUSION: Antihypertensive medication use was very high among hypertension patients covered under the Ghana NHIS. However, there was indication of suboptimal quality of the antihypertensive therapy provided.

Low acuity paediatric emergency visits under single-payer universal health insurance in Taiwan, 2000-2015: a population-based repeated cross-sectional design.

OBJECTIVES: Emergency services utilisation is a critical policy concern. The paediatric population is the main user of emergency department (ED) services, and the main contributor to low acuity (LA) ED visits. We aimed to describe the trends of ED and LA ED visits under a comprehensive, universal health insurance programme in Taiwan, and to explore factors associating with potentially unnecessary ED utilisation. DESIGN AND SETTING: We used a population-based, repeated cross-sectional design to analyse the full year of 2000, 2005, 2010 and 2015 National Health Insurance claims data individually for individuals aged 18 years and under. PARTICIPANTS: We identified 5 538 197, 4 818 213, 4 401 677 and 3 841 174 children in 2000, 2005, 2010 and 2015, respectively. PRIMARY AND SECONDARY OUTCOME MEASURES: We adopted a diagnosis grouping system and severity classification system to define LA paediatric ED (PED) visits. Generalised estimating equation was applied to identify factors associated with LA PED visits. RESULTS: The annual LA PED visits per 100 paediatric population decreased from 10.32 in 2000 to 9.04 in 2015 (12.40%). Infectious ears, nose and throat, dental and mouth diseases persistently ranked as the top reasons for LA visits (55.31% in 2000 vs 33.94% in 2015). Physical trauma-related LA PED visits increased most rapidly between 2000 and 2015 (0.91-2.56 visits per 100 population). The dose-response patterns were observed between the likelihood of incurring LA PED visit and either child's age (OR 1.06-1.35 as age groups increase, p<0.0001) or family socioeconomic status (OR 1.02-1.21 as family income levels decrease, p<0.05). CONCLUSION: Despite a comprehensive coverage of emergency care and low cost-sharing obligations under a single-payer universal health insurance programme in Taiwan, no significant increase in PED utilisation for LA conditions was observed between 2000 and 2015. Taiwan's experience may serve as an important reference for countries considering healthcare system reforms.

Outcomes of Dura Splitting Decompression Versus Posterior Fossa Decompression With Duraplasty in the Treatment of Chiari I Malformation: A Systematic Review and Meta-analysis.

BACKGROUND: Surgery is the definitive treatment option for symptomatic Chiari malformation I (CMI), but there is no clear consensus as to the preferred surgical method. This study aimed to quantitatively assess and compare the effect and safety of dura splitting decompression (DSD) and posterior fossa decompression with duraplasty (PFDD) in treating patients with CMI. METHODS: A literature search of EMBASE, MEDLINE, PubMed, Cochrane Library, and Web of Science databases was conducted. References from January 1990 to September 2020 were retrieved. We only included papers containing original data, comparing the use of DSD and PFDD in CMI patients. RESULTS: Overall, 11 relevant studies were identified, wherein 443 patients treated for CMI by DSD were compared with 261 patients treated by PFDD. No difference was observed between PFDD and PFD in terms of clinical improvement (P = 0.69), syringomyelia improvement (P = 0.90), or reoperation (P = 0.22). DSD was associated with shorter operation durations (P = 0.0007), shorter length of stay (P = 0.0007), and shorter overall postoperative complications (P < 0.0001) (especially cerebrospinal fluid [CSF] leak [P = 0.005], meningitis [P = 0.002], and pseudomeningocele [P = 0.002]), as compared with PFDD. CONCLUSIONS: This study confirmed that dura splitting decompression has clinical and syringomyelia improvement outcomes comparable to posterior fossa decompression with duraplasty. Compared with PFDD, DSD not only significantly shortened the operation time and length of stay, but also significantly reduced the overall complication rate, especially those related to incidence of CSF-related complications. More evidence from advanced multicenter studies are needed to require to validate the findings.

Concussion-Related Health Care Utilization Among Medicaid Insured Children in Ohio: Rural and Urban Differences.

PURPOSE: The current study examines rural-urban differences in trends in rates and type of concussion-related health care utilization over time from 2008 to 2016 among Medicaid insured children in Ohio. METHODS: We analyzed Medicaid claims for health care utilization for diagnosed concussions among children aged ≤18 years between April 1, 2008, and December 31, 2016. We compared the trends in rates of concussion-related health care utilization between children who lived in rural and urban areas using Poisson regressions. We examined trends in the type of concussion-related health care utilization by location of residence using linear regressions. FINDINGS: We found a significant increase in health care utilization for concussion over time, with rates of treated concussion consistently higher in rural children compared to urban children (P < .0001) throughout the study period. Although initial care at the Emergency Department (ED) remained the most common type of initial concussion-related health care utilization for rural children throughout the study period, the most common type of initial care sought by urban children shifted over time from the ED to primary care providers (PCPs). For both rural and urban children, PCPs remained the most common type of follow-up care sought throughout the study period, with no significant rural-urban differences in the trends of follow-up care sought through PCPs over time. CONCLUSIONS: We observed significant rural-urban differences in the trends in rates and types of concussion-related health care utilization over time from 2008 to 2016. Future studies are needed to further our understanding of the effect of these observed rural-urban differences on concussion recovery.

A Network Sensor Fusion Approach for a Behaviour-Based Smart Energy Environment for Co-Making Spaces.

User behaviour and choice is a significant parameter in the consumption patterns of energy in the built environment. This paper introduces a behavior-based approach for developing smart energy applications. With the rapid development of wireless sensor networks and the Internet of Things (IoT), human-computer interfaces can be created through the mapping of user experiences. These applications can provide users with dynamic feedback on their energy consumption patterns in their built environment. The paper describes a "Sensible Energy System" (SENS) that is based on user experience design methods with sensor network technology. Through SENS, solar energy simulation is combined with device consumption data in order to achieve an IoT network to facilitate the interaction between user behaviors and electricity consumption. The interaction between users and devices through SENS can not only optimize power consumption, but also provide consumers with additional choice and dynamic decision making regarding their consumption. This article provides an (1) understanding and analysis of users' spatial interaction, explains the (2) planning of the new smart environment design and user experiences, discusses (3) designing a suitable Wireless sensor network (WSN) agent and energy connection, describes (4) the information that has been collected, and (5) incorporates a rooftop solar potential simulation for predicting energy outputs into the sensor network model.

Structural and Social Determinants of Health Factors Associated with County-Level Variation in Non-Adherence to Antihypertensive Medication Treatment.

BACKGROUND: Non-adherence to antihypertensive medication treatment (AHM) is a complex health behavior with determinants that extend beyond the individual patient. The structural and social determinants of health (SDH) that predispose populations to ill health and unhealthy behaviors could be potential barriers to long-term adherence to AHM. However, the role of SDH in AHM non-adherence has been understudied. Therefore, we aimed to define and identify the SDH factors associated with non-adherence to AHM and to quantify the variation in county-level non-adherence to AHM explained by these factors. METHODS: Two cross-sectional datasets, the Centers for Disease Control and Prevention (CDC) Atlas of Heart Disease and Stroke (2014-2016 cycle) and the 2016 County Health Rankings (CHR), were linked to create an analytic dataset. Contextual SDH variables were extracted from the CDC-CHR linked dataset. County-level prevalence of AHM non-adherence, based on Medicare fee-for-service beneficiaries' claims data, was extracted from the CDC Atlas dataset. The CDC measured AHM non-adherence as the proportion of days covered (PDC) with AHM during a 365 day period for Medicare Part D beneficiaries and aggregated these measures at the county level. We applied confirmatory factor analysis (CFA) to identify the constructs of social determinants of AHM non-adherence. AHM non-adherence variation and its social determinants were measured with structural equation models. RESULTS: Among 3000 counties in the U.S., the weighted mean prevalence of AHM non-adherence (PDC < 80%) in 2015 was 25.0%, with a standard deviation (SD) of 18.8%. AHM non-adherence was directly associated with poverty/food insecurity (ß = 0.31, P-value < 0.001) and weak social supports (ß = 0.27, P-value < 0.001), but inversely with healthy built environment (ß = -0.10, P-value = 0.02). These three constructs explained one-third (R2 = 30.0%) of the variation in county-level AHM non-adherence. CONCLUSION: AHM non-adherence varies by geographical location, one-third of which is explained by contextual SDH factors including poverty/food insecurity, weak social supports and healthy built environments.

Discovery of M Protease Inhibitors Encoded by SARS-CoV-2.

The coronavirus (CoV) disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome CoV-2 (SARS-CoV-2) is a health threat worldwide. Viral main protease (Mpro, also called 3C-like protease [3CLpro]) is a therapeutic target for drug discovery. Herein, we report that GC376, a broad-spectrum inhibitor targeting Mpro in the picornavirus-like supercluster, is a potent inhibitor for the Mpro encoded by SARS-CoV-2, with a half-maximum inhibitory concentration (IC50) of 26.4 ± 1.1 nM. In this study, we also show that GC376 inhibits SARS-CoV-2 replication with a half-maximum effective concentration (EC50) of 0.91 ± 0.03 µM. Only a small portion of SARS-CoV-2 Mpro was covalently modified in the excess of GC376 as evaluated by mass spectrometry analysis, indicating that improved inhibitors are needed. Subsequently, molecular docking analysis revealed that the recognition and binding groups of GC376 within the active site of SARS-CoV-2 Mpro provide important new information for the optimization of GC376. Given that sufficient safety and efficacy data are available for GC376 as an investigational veterinary drug, expedited development of GC376, or its optimized analogues, for treatment of SARS-CoV-2 infection in human is recommended.

Zika Virus NS3 Protease Pharmacophore Anchor Model and Drug Discovery.

Zika virus (ZIKV) of the flaviviridae family, is the cause of emerging infections characterized by fever, Guillain-Barré syndrome (GBS) in adults and microcephaly in newborns. There exists an urgent unmet clinical need for anti-ZIKV drugs for the treatment of infected individuals. In the current work, we aimed at the promising virus drug target, ZIKV NS3 protease and constructed a Pharmacophore Anchor (PA) model for the active site. The PA model reveals a total of 12 anchors (E, H, V) mapped across the active site subpockets. We further identified five of these anchors to be critical core anchors (CEH1, CH3, CH7, CV1, CV3) conserved across flaviviral proteases. The ZIKV protease PA model was then applied in anchor-enhanced virtual screening yielding 14 potential antiviral candidates, which were tested by in vitro assays. We discovered FDA drugs Asunaprevir and Simeprevir to have potent anti-ZIKV activities with EC50 values 4.7 µM and 0.4 µM, inhibiting the viral protease with IC50 values 6.0 µM and 2.6 µM respectively. Additionally, the PA model anchors aided in the exploration of inhibitor binding mechanisms. In conclusion, our PA model serves as a promising guide map for ZIKV protease targeted drug discovery and the identified 'previr' FDA drugs are promising for anti-ZIKV treatments.

Clinical Features and Risk Factors for Mortality in Children With Acute Encephalitis Who Present to the Emergency Department.

Acute encephalitis is an important pediatric emergency that tends to be associated with neurological morbidity, critical illness, and mortality. Few data have specifically focused on evaluating various early clinical parameters in the pediatric emergency department as candidate predictors of mortality. The present retrospective study assessed the clinical, laboratory, and neuroimaging findings of children with acute encephalitis who presented to the emergency department. Of 158 patients diagnosed with encephalitis, 7 (4.4%) had mortality. Compared to the survivors, a multivariate analysis revealed that an initial Glasgow Coma Scale score ≤ 5 (odds ratio [OR]: 8.3, P = .022), acute necrotizing encephalitis (OR: 12.1, P = .01), white blood count level ≤ 5.2 × 109 cells/L (OR: 28.7, P < .001), aspartate aminotransferase level > 35 U/L (OR: 14.3, P = .022), and influenza A infection (OR: 7.7, P = .027) were significantly associated with mortality. These results indicate that the early recognition of preliminary clinical features and the development of more specific etiologies for encephalitis are important for early treatment strategies.