Artificial intelligence promotes shared decision-making through recommending tests to febrile pediatric outpatients

BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.

Relationship between preoperative psychological stress and shortterm prognosis in elderly patients with femoral neck fracture

BACKGROUND Older adults are at high risk of femoral neck fractures(FNFs).Elderly patients face and adapt to significant psychological burdens,resulting in different degrees of psychological stress response.Total hip replacement is the preferred treatment for FNF in elderly patients;however,some patients have poor postoperative prognoses,and the underlying mechanism is unknown.We speculated that the postoperative prognosis of elderly patients with FNF may be related to preoperative psychological stress.AIM To explore the relationship between preoperative psychological stress and the short-term prognosis of elderly patients with FNF.METHODS In this retrospective analysis,the baseline data,preoperative 90-item Symptom Checklist score,and Harris score within 6 months of surgery of 120 elderly patients with FNF who underwent total hip arthroplasty were collected.We analyzed the indicators of poor short-term postoperative prognosis and the ability of the indicators to predict poor prognosis and compared the correlation between the indicators and the Harris score.RESULTS Anxiety,depression,garden classification of FNF,cause of fracture,FNF reduction quality,and length of hospital stay were independent influencing factors for poor short-term postoperative prognoses in elderly patients with FNF(P<0.05).The areas under the curve for anxiety,depression,and length of hospital stay were 0.742,0.854,and 0.749,respectively.The sensitivities of anxiety,depression,garden classification of FNF,and prediction of the cause of fracture were 0.857,0.786,0.821,and 0.821,respectively.The specificities of depression,FNF quality reduction,and length of hospital stay were the highest at 0.880,0.783,and 0.761,respectively.Anxiety,depression,and somatization scores correlated moderately with Harris scores(r=-0.523,-0.625,and-0.554;all P<0.001).CONCLUSION Preoperative anxiety,depression,and somatization are correlated with poor short-term prognosis in elderly patients with FNF and warrant consideration.

Inguinal endometriosis: Ten case reports and review of literature

BACKGROUND To describe the characteristics,diagnosis and surgical treatment of inguinal endometriosis(IEM).CASE SUMMARY We retrospectively analyzed 10 patients diagnosed with IEM at Beijing Chao-Yang Hospital from 2011 to 2019.Relevant features,symptoms,images,surgical treatment,hormonal therapy and follow-up were collected and discussed.A total of 10 cases of IEM diagnosed by surgery and pathology were characterized by a lesion on the right side(9/11);five patients had symptoms related to the menstrual cycle,and only 3 patients were clearly diagnosed before surgery.Ultrasonography was of little assistance in confirming the diagnosis,but magnetic resonance imaging showed specific,high-intensity patterns.Anatomically,most of the IEM lesions were located in the extraperitoneal ligament(10/11);nine patients had inguinal hernias(IH),five had concurrent or prior pelvic endometriosis,and four had infertility.The clinical results from extensive resection were satisfactory.CONCLUSION IEM is an extremely rare condition that can easily be misdiagnosed prior to surgery.A right IH may contribute to the formation of right-sided IEM,and extensive resection involving the round ligament and hernia sac is essential to prevent recurrence.

A Multi-UCAV cooperative occupation method based on weapon engagement zones for beyond-visual-range air combat

Recent advances in on-board radar and missile capabilities,combined with individual payload limitations,have led to increased interest in the use of unmanned combat aerial vehicles(UCAVs)for cooperative occupation during beyond-visual-range(BVR)air combat.However,prior research on occupational decision-making in BVR air combat has mostly been limited to one-on-one scenarios.As such,this study presents a practical cooperative occupation decision-making methodology for use with multiple UCAVs.The weapon engagement zone(WEZ)and combat geometry were first used to develop an advantage function for situational assessment of one-on-one engagement.An encircling advantage function was then designed to represent the cooperation of UCAVs,thereby establishing a cooperative occupation model.The corresponding objective function was derived from the one-on-one engagement advantage function and the encircling advantage function.The resulting model exhibited similarities to a mixed-integer nonlinear programming(MINLP)problem.As such,an improved discrete particle swarm optimization(DPSO)algorithm was used to identify a solution.The occupation process was then converted into a formation switching task as part of the cooperative occupation model.A series of simulations were conducted to verify occupational solutions in varying situations,including two-on-two engagement.Simulated results showed these solutions varied with initial conditions and weighting coefficients.This occupation process,based on formation switching,effectively demonstrates the viability of the proposed technique.These cooperative occupation results could provide a theoretical framework for subsequent research in cooperative BVR air combat.

甘草酸对大鼠急性肺水肿的影响

目的探讨甘草酸对大鼠急性肺水肿呼吸指数的调控。方法将18只大鼠随机分为正常组、模型组、甘草酸组。大鼠腹腔注射6%氯化铵复制急性肺水肿模型,通过肺功能仪测定大鼠的肺功能指标,湿重/干重衡量水肿程度,HE染色观察肺组织病理损伤情况。结果模型组肺功能残气量、最大变化压力、最大变化体积、低于正常组和甘草酸组(P<0.05)。各组大鼠阻塞时间比较,差异无统计学意义(P>0.05)。模型组弦性顺应性、深吸气量、肺活量低于正常组、甘草酸组(P<0.05)。模型组最大呼气流速、用力呼吸残气量、100毫秒用力呼气容积高于正常组(P<0.05),但低于甘草酸组(P<0.05),模型组用力肺活量低于正常组、甘草酸组(P<0.05)。各组大鼠20毫秒用力呼气容积比较,差异无统计学意义(P>0.05)。模型组肺组织含水率高于正常组、甘草酸组(P<0.05)。HE染色结果显示,肺组织水肿程度明显降低,肺泡间隔缩小。结论甘草酸可通过改善肺通气量,减弱肺表面的水肿程度来缓解大鼠急性肺水肿,减少炎症细胞浸润。

Damping of Magnetorheological Elastomers

The damping property of magnetorheological （MR） elastomers is characterized by a modified dynamic mechanical-magnetic coupled analyzer. The influences of the external magnetic flux density, damping of the matrix, content of iron particles, dynamic strain, and driving frequency on the damping properties of MR elastomers were investigated experimentally. The experimental results indicate that the damping properties of MR elastomers greatly depend on the interfacial slipping between the inner particles and the matrix. Different from general composite materials, the interracial slipping in MR elastomers is affected by the external applied magnetic field.

Copper ions-me diate d dynamic re dox-responsive microgels synergize with silicone for efficient and sustainable antibacterial properties

The antifouling of marine facilities placed below the waterline is a key constraint to the development of the marine economy.Currently,commercial Cu_(2)O-based antifouling coatings still have defects such as agglomeration,oxidation,short duration and high dosage.For this reason,we developed for the first time a triple antifouling system consisting of Cu_(2)O@poly(NIPAM-co-DAm)(Cu_(2)O@PND)dynamic redox micro-gels triggered by copper ions and polydimethylsiloxane(PDMS).The catechol groups of PND nanogels can chelate Cu^(2+)and reduce it in situ to obtain Cu_(2)O@PND microgels,which guarantees the stable release of Cu^(+).Furthermore,Cu_(2)O remains stable and free from oxidation because of the electron transfer between PND and Cu^(2+).Finally,superior antifouling performance was achieved by combining the stable Cu^(+)re-leased from Cu_(2)O,in situ conversion of PND to hydrogel,and its oxidation to produce active substances and H_(2)O_(2),and PDMS coating with low surface energy.

Aging behavior of large area MCP–PMT

The Institute of High Energy Physics, Chinese Academy of Sciences have designed a new type of photomultiplier tube(PMT) based on microchannel plates(MCPs) with large area photocathode, known as large area microchannel plate photomultiplier tube(MCP–PMT). The aging characteristics of the large area MCP–PMTs are different from dynode PMTs and small proximity-focus MCP–PMT. In this work, a prototype large area MCP–PMT was aged by operating with nearly 1000 photoelectrons per pulse for 3 months, and aging process of the MCP–PMT was discussed based on the aging curve.

Studies on the testicular toxicity of 2-bromopropane,an environmental endocrine disrupter

Aim: 2-bromopropane (2-BP) is known as an environmentalendocrine disrupter. Recently its reproductive and hematopoitic tox-icity has aroused the attention of the toxicologists. The presentstudy was designed to study its testicular toxicity in male rats.Methods; Forty male SD rats were divided into four groups of10 rats each. 2-BP was administered intraperitoneally at doses of1800 mg, 600 mg or 200 mg per kg body weight per day for 5days. The control rats were given a similar volume of the vehicle.The animals were sacrificed two days after the last dose. Results: With increasing doses, the seminiferous tubular damage wasgradually increased and the percentage of spermatogonia in the totalgerm cells gradually decreased ( P < 0. 05). The seminiferoustubular area of rats taking 1800 mg/kg was also reduced significant-ly . The body weight, testicular weight and relative testicular weightof rats taking the highest dose level were all significantly decreasedas compared with the controls. (Reprod Contracep 2001; 21; 157-60)

Self-assembled Conformations of a Core-shell Comb-like Chain with Adjustable Architectural Parameters

Combining Brownian dynamics simulations and self-consistent field theory,we demonstrate that the architectural parameters of coreshell comb-like chains have a decisive influence on their final self-assembled conformations.When the ratio of hydrophilic and hydrophobic segments is N_(g,g)∶N_(g,r)=3∶1,no core-shell structure is observed,and unsegregated chains or clusters are substituted.When N_(g,g)∶N_(g,r)=3∶2or 3∶3,the core-shell comb-like chains can be assembled into single micelles or structures where several small micelles are strung together by the backbone,which is similar to the pearl-necklace structure formed by the polyelectrolytes in poor solvent.With the increase of backbone length or grafting density,the probability of forming single micelles becomes lower,but the structures of two,three or more small micelles strung together are more observed.Our results indicate how to obtain the desired self-assembled structures of core-shell comb-like chains by regulating the architectural parameters,which could provide insights for the optimization of molecular design in various applications.

Oleophobic interaction mediated slippery organogels with ameliorated mechanical performance and satisfactory fouling-resistance

Owing to their inherent semi-solid property and lubricant ability,organogels manifest various unique characteristics and serve as promising candidates for antifouling.However,the poor mechanical properties of organogels often limit their practical applications.Herein,we report a simple and effective method to prepare organogels with reinforced mechanical performance and surface lubricant ability with the synergistic roles played by oleophobic and oleophilic chains.The rigid oleophobic chains have a poor affinity to lubricating solvent,which gives rise to high oleophobic interactions between polymer networks;the soft oleophilic chains possess a high affinity to the low surface energy solvent,which lead to high solvent content to maintain the satisfactory lubricant capacity.The organogel of oleophobic methyl methacrylate(MMA)and oleophilic lauryl methacrylate(LMA)is chosen as a representative example to illustrate this concept.With the optimal composition,the as-prepared organogels offer satisfactory tensile fracture stress,fracture strain,Young’s modulus,toughness,and tearing fracture energy of 480 k Pa,550%,202 k Pa,1.14 MJ m,and 5.14 k J m,respectively,which are far beyond the classical PLMA organogels.Furthermore,the biofouling resistance tests demonstrate 4 to 9-fold reduction of protein and bacteria adhesion on the reinforced organogels surface in comparison to the glass substrate and solvent-free dry organogels.This simple and effective approach to toughen organogels,we hope,can be applied in various fields with different practical functional requirements in the future.

中国改革开放以来的高分子物理和表征研究

本综述介绍了改革开放四十多年来中国大陆学者在高分子物理和表征领域所取得的部分成就.按照时间顺序,分别从概念的突破、理论的发展和技术的创新三个方面选取具有代表性研究成果进行简短的介绍,以期展示当代中国学者在这一基础研究领域所表现出来的拼搏意志和创新精神,激励新一代学者共同努力,勇攀科学高峰,为国民经济和社会发展作出更大的贡献.

A chemometric analysis on the fluorescent dissolved organic matter in a full-scale sequencing batch reactor for municipal wastewater treatment

Rapid monitoring of water quality is crucial to the operation of municipal wastewater treatment plants （WWTPs）. Fluorescence excitation-emission matrix （EEM） in combination with parallel lhctor analysis （PARAFAC） has been used as a powerful tool for the characterization of dissolved organic matter （DOM） in WWTPs. However, a recent work has revealed the drawback of PARAFAC analysis, i.e., overestimating the component number. A novel method, parallel lhctor framework-clustering analysis （PFFCA）,＂has been cleveloped in our earlier work to resolve this drawback of PARAFAC. In the present work, both PARAFAC and PFFCA were used to analyze the EEMs of water samples from a full-scale WWTP from a practical application point of view. The component number and goodness-of- fit from these two methods were compared and the relationship between the relative score change of component and the actual concentration was investigated to evaluate the estimation error introduced by 9 both methods. PFFCA score and actual concentration exhibited a higher correlation coefficient （R- = 0.870） compared with PARAFAC （R2〈 0.771）, indicating that PFFCA provided a more accurate relative change estimation than PARAFAC. The results suggest that use of PARAFAC may cause confusion in selecting the component number, while EEM-PFFCA is a more reliable alternative approach for monitoring water quality in WWTPs.

Starch Synthesis and Programmed Cell Death during Endosperm Development in Triticale(× Triticosecale Wittmack)

Triticale （x TriticosecaleWittmack） grains synthesize and accumulate starch as their main energy source. Starch accumulation rate and synthesis activities of ADP-glucose pyrophosphorylase, soluble starch synthases, granule-bound starch synthase and starch-branching enzyme showed similar pattern of unimodal curves during endosperm development. There was no significant difference in activity of the starch granule-bound protein isolated from total and separated starch granules at different developmental stages after anthesis in triticale. Evans Blue staining and analysis of DNA fragmentation indicated that cells of triticale endosperm undergo programmed cell death during its development. Dead cells within the endosperm were detected at 6 d post anthesis （DPA）, and evidence of DNA fragmentation was first observed at 21 DPA. The period between initial detection of PCD to its rapid increase overlapped with the key stages of rapid starch accumulation during endosperm development. Cell death occurred stochastically throughout the whole endosperm, meanwhile, the activities of starch biosynthetic enzymes and the starch accumulation rate decreased in the late stages of grain filling. These results suggested that the timing and progression of PCD in triticale endosperm may interfere with starch synthesis and accumulation.

Electrophoretic-deposited HAP nano-layer as a QCM-D sensor coating:effects of suspension concentration and electric-field strength

This study investigates the fabrication of hydroxyapatite(HAP)nano-coating on a gold-quartz crystal sensor used for quartz crystal microbalance with dissipation(QCM-D)measur ement using an electr ophoretic deposition technique.Surface morphology and thickness of the HAP coating are examined via scanning electron microscopy and nano-indention testing.Its repeatability is verified via QCM-D testing.Results show that electrophor etic deposition with ultr asonic treatment is feasible and cost-effective for fabricating nano-thick HAP coatings on a QCM-D gold-quartz crystal sensor surface.Both suspension concentration and electric-field str ength influence the compactness of HAP coatings.There exists a non-linear re lationship between HAP coating compactness and the suspension concentration/electric-field strength.When the HAP suspension concentration is 30 g/and the applied electric-field strength is 150 V/cm,the HAP coating on the QCM-D gold-quartz crystal sensor surface is uniform and compact with a thickness of 35 nm and is tightly bonded to the sensor surface.The obtained HAP-coated sensor is thus suitable for QCM-D measurement.