Development of Rules and Algorithms for an Intelligent and Integrated Older Care Model.

To break through the current bottleneck in home-based older care globally, we developed an intelligent and integrated older care model (SMART model) to facilitate integrated care for home-dwelling older people. As a knowledge-based clinical decision support system, the SMART model relies on rules and algorithms to ensure its transparent and well-supported decision-making process with clear rationales. Therefore, we conducted a mixed study combining qualitative research, literature review of the latest literature and guidelines, and expert consultation. Following the intervention mapping framework and nursing process, we determined 138 care problems along with their diagnostic criteria and care goals. Building upon this, we curated 450 evidence-informed methods, each accompanied by at least one implementation approach. Two sets of IF-THEN rules and algorithms including diagnostic rules and method trigger rules were employed to trigger appropriate care problems and customized methods and implementation approaches.

Association Between Serum Zinc and Non-Alcoholic Fatty Liver Disease and Advanced Liver Fibrosis: NHANES 2011-2016.

Limited and inconclusive evidence exists regarding the correlation between serum zinc levels and non-alcoholic fatty liver disease (NAFLD) and advanced fibrosis. The objective of this cross-sectional study was to investigate the association between serum zinc concentration and both NAFLD and advanced liver fibrosis among the United States (US) adults. 3398 subjects from National Health and Nutrition Examination Survey (NHANES) 2011-2016 were included. Serum zinc concentration was measured by inductively coupled plasma dynamic reaction cell mass spectrometry (ICP-DRC-MS). NAFLD was diagnosed with Hepatic Steatosis Index (HSI), and advanced fibrosis risk was assessed by NAFLD Fibrosis Score (NFS). Weighted logistic regression and restricted cubic splines (RCS) were used to examine the association between serum zinc concentration and NAFLD and advanced fibrosis. Linear trend tests were conducted by incorporating the median of serum zinc quartiles as a continuous variable in the models. We employed sensitivity analysis and subgroup analysis to enhance the robustness of our results. The results from the RCS regression revealed no evident nonlinear relationship between serum zinc concentration and the presence of NAFLD and advanced fibrosis (p-nonlinear > 0.05). Compared with those in the lowest quartile (Q1) of serum zinc concentrations, the odds ratios (95% confidence intervals) of NAFLD were 1.49 (0.89,2.49) in Q2, 0.99 (0.68,1.45) in Q3, and 2.00 (1.40,2.86) in Q4 (p-trend = 0.002). Similarly, the odds ratios (95% confidence intervals) for advanced fibrosis in Q2-4 compared to Q1 were 0.86 (0.50,1.47), 0.60 (0.26,1.39), and 0.41 (0.21,0.77), respectively (p-trend = 0.006). Subgroup analyses and sensitivity analyses reinforce the same conclusion. The investigation revealed a positive linear relationship between serum zinc concentrations and the probability of developing NAFLD. Conversely, an inverse correlation was observed between serum zinc concentrations and the incidence of advanced liver fibrosis among individuals diagnosed with NAFLD.

Genotypes and Phylogenetic Analysis of Human Adenovirus in Hospitalized Pneumonia and Influenza-Like Illness Patients in Jiangsu Province, China (2013-2021).

Background: Human adenovirus (HAdV) is common pathogens that cause various respiratory diseases. The genetic diversity of viruses caused by recombination is considered to be the main source of emerging outbreaks. The aim of this study is to explore the evolutionary relationship and recombination events of HAdV genome in respiratory tract infections in Jiangsu Province. Methods: Whole-genome sequencing (WGS) technology was used to sequence 66 patients with HAdV infection (37 patients with influenza-like illness (ILI) and 29 hospitalized patients with pneumonia) from Jiangsu Province. Epidemiological analysis was performed on hospitalized pneumonia and ILI patients infected with HAdV. Subsequently, phylogenetic, recombination, and nucleotide and amino acid identity analyses were performed. Results: Epidemiological analysis of patients undergoing WGS showed that 75.7% of ILI patients were infected with the HAdVB strain and 69.0% of hospitalized pneumonia patients were infected with the HAdVC strain. Moreover, the hospitalized pneumonia and ILI patients infected with HAdV were different in region and time. The strains of HAdVB3 and HAdVB7 genotypes were mainly infected in 2015 and 2017, and the strains of HAdVC1 and HAdVC2 genotypes were mainly infected in 2020. The results of histogram analysis showed that the HAdV strain mainly infected children under 5 years old. In addition, 36 novel recombinant strains were identified. The discovery of these recombinant strains may contribute to understanding the epidemiology of HAdV and research on related vaccines. Furthermore, the percentage of nucleotide and amino acid identities revealed a high level of genetic conservation within isolates from HAdVB3, HAdVB7, HAdVC1, HAdVC2 and HAdVC5 genotypes. Conclusion: The WGS analysis reveals the evolutionary relationships and recombination events of HAdV strains in Jiangsu Province, which is helpful to deepen the understanding of HAdV epidemiology and evolution. In addition, it provides a basis for the formulation of public health strategies in Jiangsu Province.

Attention affects the perception of self-motion direction from optic flow.

Many studies have demonstrated that attention affects the perception of many visual features. However, previous studies show conflicting results regarding the effect of attention on the perception of self-motion direction (i.e., heading) from optic flow. To address this question, we conducted three behavioral experiments and found that estimation accuracies of large headings (>14°) decreased with attention load, discrimination thresholds of these headings increased with attention load, and heading estimates were systematically compressed toward the focus of attention. Therefore, the current study demonstrated that attention affected heading perception from optic flow, showing that the perception is both information-driven and cognitive.

Attention influences the effects of the previous form orientation on the current motion direction estimation.

Recent studies have found that the estimates of motion directions are biased toward the previous form orientations, showing serial dependence, and the serial dependence does not involve cognitive abilities. In the current study, we conducted two experiments to investigate whether and how attention-a cognitive ability-affected the serial dependence. The results showed that serial dependence was present in the current study, reproducing the previous findings. Importantly, when the attentional load reduced the reliability (i.e., estimation accuracy and precision) of previous form orientations (Experiment 1), the serial dependence decreased, meaning that the biases of motion direction estimates toward previous form orientations were reduced; in contrast, when the attentional load reduced the reliability of current motion directions (Experiment 2), the serial dependence increased, meaning that the biases of motion direction estimates toward previous form orientations were increased. These trends were well consistent with the prediction of the Bayesian inference theory. Therefore, the current study revealed the involvement of attention in the serial dependence of current motion direction estimation on the previous form orientation, demonstrating that the serial dependence was cognitive and the attentional effect can be a Bayesian inference process, initially revealing its computational mechanism.

Molecular characterization of a novel thermostable laccase PPLCC2 from the brown rot fungus Postia placenta MAD-698-R

Background Laccase has been considered important for the degradation of lignocellulose by wood rot fungi. The properties and functions of laccase in white rot fungi have been investigated extensively, but those from brown rot fungi remain largely unknown. In this paper, a laccase isoform Pplcc2 from the brown rot fungus Postia placenta MAD-698-R was expressed heterologously in Pichia pastoris GS115, purified and the properties of the enzyme were determined. Results The molecular weight of the protein was determined to be 67 kDa using SDS-PAGE. It cannot oxidize syringaldazine (SGZ), but it can oxidize 2,2'-azino-di-(3-ethylbenzothialozin-6-Sulfonic acid) (ABTS) and 2,6-dimethoxyphenol (DMP). Specific activity for ABTS was 1960 ± 19 Unit/mg. The catalytic constant (k cat) was 1213 ± 18.3 s-1 for ABTS and 293.2 ± 21.9 s-1 for DMP. Km was 22.08 µM for ABTS and 11.62 µM for DMP. The optimal pH for the oxidation of ABTS and DMP was 3.5 and 5.0 respectively. The optimal temperature for the oxidation of ABTS and DMP was 60°C. Conclusions This is the first identified thermo activated and thermostable laccase in brown rot fungi. This investigation will contribute to understanding the roles played by laccases in brown rot fungi.