Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency.

BACKGROUND: Vitamin D deficiency is associated with mortality and morbidity in critically ill patients. This study investigated the safety and effectiveness of enteral high-dose vitamin D supplementation in intensive care unit (ICU) patients in Asia. METHODS: This was a multicenter, prospective, randomized-controlled study. Eligible participants with vitamin D deficiency were randomly assigned to the control or vitamin D supplementation group. In the vitamin D supplementation group, the patients received 569,600 IU vitamin D. The primary outcome was the serum 25(OH)D level on day 7. RESULTS: 41 and 20 patients were included in the vitamin D supplementation and control groups, respectively. On day 7, the serum 25(OH)D level was significantly higher in the vitamin D supplementation group compared to the control group (28.5 [IQR: 20.2-52.6] ng/mL and 13.9 [IQR: 11.6-18.8] ng/mL, p < 0.001). Only 41.5% of the patients achieved serum 25(OH)D levels higher than 30 ng/mL in the supplementation group. This increased level was sustained in the supplementation group on both day 14 and day 28. There were no significant adverse effects noted in the supplementation group. Patients who reached a serum 25(OH)D level of >30 ng/mL on day 7 had a significantly lower 30-day mortality rate than did those who did not (5.9% vs 37.5%, p < 0.05). CONCLUSIONS: In our study, less than half of the patients reached adequate vitamin D levels after the enteral administration of high-dose vitamin D. A reduction in 30-day mortality was noted in the patients who achieved adequate vitamin D levels. TRIAL REGISTRATION CLINICALTRIALS. GOV ID: NCT04292873, Registered, March 1, 2020.

Drying of probiotics to enhance the viability during preparation, storage, food application, and digestion: A review.

Functional food products containing viable probiotics have become increasingly popular and demand for probiotic ingredients that maintain viability and stability during processing, storage, and gastrointestinal digestions. This has resulted in heightened research and development of powdered probiotic ingredients. The aim of this review is to overview the development of dried probiotics from upstream identification to downstream applications in food. Free probiotic bacteria are susceptible to various environmental stresses during food processing, storage, and after ingestion, necessitating additional materials and processes to preserve their activity for delivery to the colon. Various classic and emerging thermal and nonthermal drying technologies are discussed for their efficiency in preparing dehydrated probiotics, and strategies for enhancing probiotic survival after dehydration are highlighted. Both the formulation and drying technology can influence the microbiological and physical properties of powdered probiotics that are to be characterized comprehensively with various techniques. Furthermore, quality control during probiotic manufacturing and strategies of incorporating powdered probiotics into liquid and solid food products are discussed. As emerging technologies, structure-design principles to encapsulate probiotics in engineered structures and protective materials with improved survivability are highlighted. Overall, this review provides insights into formulations and drying technologies required to supplement viable and stable probiotics into functional foods, ensuring the retention of their health benefits upon consumption.

Fabrication of glass-based analytical devices by immobilizing nanomaterials on glass substrate with a fluorescent glue for the highly sensitive determination of mercury ions.

A facile method is reported to develop glass-based analytical devices (GADs) based on immobilizing nanomaterials on a glass substrate with fluorescent glue. The fluorescent glue was first prepared by coupling bovine serum albumin (BSA)-protected Au nanoclusters (NCs) and sugars (i.e., ascorbic acid, AA). The glue was then used to immobilize carbon dots (C-dots) on glass substrates to fabricate the portable GADs. The liquid glue-C-dots mixture and probable GADs were developed for Hg2+ detection. Under 365-nm excitation wavelength, the emission at 652 nm from the glue is gradually quenched with increasing concentrations of Hg2+. This quenching is explained in terms of the Stern-Volmer equation and is ascribed to static quenching. The fluorescent color of the glue and GADs gradually changes from pink to blue, with increasing concentrations of Hg2+. The limits of detection (LODs) for Hg2+ determination by bare eyes are 1 nM both for the glue and GADs, suggesting an uncompromised sensing capability even after immobilization. The detection sensitivity of GADs shows a significant improvement compared with the same material-based papers (5 µM). A linear relationship is observed between the total Euclidean distances (EDs) and Hg2+ concentration in the range 0-100 nM, providing the potential for Hg2+ quantification using GADs. The LOD is estimated to be 0.84 nM. To show a potentially practical application, the GADs were used to detect Hg2+ in certified reference material and lake water.

Transmit-Receive Sparse Synthesis of Linear Frequency Diverse Array in Range-Angle Space Using Genetic Algorithm.

Unlike conventional phased array (PA), frequency diversity array (FDA) can perform the beampattern synthesis not only in an angle dimension but also in a range dimension by introducing an additional frequency offset (FO) across the array aperture, thus greatly enhancing the beamforming flexibility of an array antenna. Nevertheless, an FDA with uniform inter-element spacing that consists of a huge number of elements is required when a high resolution is needed, which results in a high cost. To substantially reduce the cost while almost maintaining the antenna resolution, it is important to conduct a sparse synthesis of FDA. Under these circumstances, this paper investigated the transmit-receive beamforming of a sparse-fda in range and angle dimensions. In particular, the joint transmit-receive signal formula was first derived and analyzed to resolve the inherent time-varying characteristics of FDA based on a cost-effective signal processing diagram. In the sequel, the GA-based low sidelobe level (SLL) transmit-receive beamforming of the sparse-fda was proposed to generate a focused main lobe in a range-angle space, where the array element positions were incorporated into the optimization problem. Numerical results showed that 50% of the elements can be saved for the two linear FDAs with sinusoidally and logarithmically varying frequency offsets, respectively termed as sin-FO linear-FDA and log-FO linear-FDA, with only a less than 1 dB increment in SLL. The resultant SLLs are below -9.6 dB, and -12.9 dB for these two linear FDAs, respectively.

Spectrum Sensing Method Based on Residual Dense Network and Attention.

To address the problems of gradient vanishing and limited feature extraction capability of traditional CNN spectrum sensing methods in deep network structures and to effectively avoid network degradation issues under deep network structures, this paper proposes a collaborative spectrum sensing method based on Residual Dense Network and attention mechanisms. This method involves stacking and normalizing the time-domain information of the signal, constructing a two-dimensional matrix, and mapping it to a grayscale image. The grayscale images are divided into training and testing sets, and the training set is used to train the neural network to extract deep features. Finally, the test set is fed into the well-trained neural network for spectrum sensing. Experimental results show that, under low signal-to-noise ratios, the proposed method demonstrates superior spectral sensing performance compared to traditional collaborative spectrum sensing methods.

Thromboembolic Presentations among Patients Hospitalized to the Intensive Care Unit for Coronavirus Disease 2019 (COVID-19) - A Northern Taiwan Single Center Experience.

Coronavirus Disease 2019 (COVID-19) has been associated with a high thromboembolic risk among patients in intensive care units. Asian populations may share a similar thromboembolic risk, but with a higher prevalence of arterial thromboembolism than venous thromboembolism. To clarify this risk in Taiwan, this single-center retrospective study collected 27 consecutive intensive care unit patients with COVID-19 confirmed by polymerase chain reaction, with a median age of 67.6 years (male 81.5%). Twenty-three patients received prophylactic anticoagulation (85.2%), and there were four bleeding events (14.8%). Nine patients had thromboembolism (33.3%), including three with deep vein thrombosis, two with peripheral artery thromboembolism, and four with ischemic stroke. There were no significant clinical differences between the patients with or without thromboembolism. Initial serum ferritin [adjusted odds ratio (OR): 13.19, 95% confidence interval (CI): 1.01-172.07] and peak serum procalcitonin (adjusted OR: 18.93, 95% CI: 1.08-330.91) were associated with a higher risk of thromboembolism. Furthermore, prophylactic anticoagulation (adjusted OR: 0.01, 95% CI: < 0.001-0.55) was associated with a lower risk of thromboembolism. All cases of deep vein thrombosis and one peripheral artery thromboembolism occurred at intravascular catheter locations. No association between thromboembolism and survival was found (age-adjusted hazard ratio: 0.55, 95% CI: 0.10-2.95). In conclusion, the prevalence of COVID-19 thromboembolism among Taiwanese patients in intensive care units was high, even with prophylactic anticoagulation. Serum ferritin and procalcitonin may identify high-risk populations. Prophylactic anticoagulation may reduce the risk of thromboembolism with a manageable bleeding risk. Larger prospective studies are needed to clarify the risk of COVID-19 thromboembolism and its risk factors in the post-Omicron era.

HPMC improves protective effects of naringenin and isonicotinamide co-crystals against abdominal aortic aneurysm.

PURPOSE: Abdominal aortic aneurysm (AAA) rupture is one of the most common causes of mortality in cardiovascular diseases, but currently there is no approved drug for AAA treatment or prevention in the clinic. Naringenin (NGN) has been reported to have anti-AAA effects. However, water solubility and in vivo absorption of NGN are not satisfactory, which leads to its low bioavailability, thus affecting its pharmacological effects. In this project, the improving effects of isonicotinamide (INT) co-crystal and hydroxy propyl methyl cellulose (HPMC) or polyvinyl pyrrolidone (PVP) on the solubility, in vivo absorption, and anti-AAA effects of NGN were evaluated. METHODS: In the current study, co-crystals of naringenin-isonicotinamide (NGN-INT) were prepared, and effects of PVP or HPMC on precipitation rate, supersaturation, and bioavailability of NGN were explored. In addition, with or without HPMC supply, the effects of NGN-INT co-crystal on anti-AAA efficacy of NGN were investigated on an elastase-induced AAA mouse model, and the results were compared with the efficacy of the NGN crude drug. RESULTS: Our results demonstrate that NGN-INT formulation, compared to the NGN crude drug, enhanced the dissolution rate of NGN and significantly increased Cmax and AUC(0-∞) of NGN by 18 times and 1.97 times, respectively. Addition of PVP or HPMC in NGN-INT co-crystal further increased bioavailability of NGN in NGN-INT. The in vivo pharmacodynamic study showed that NGN-INT with HPMC significantly improved the inhibitory effects of NGN against AAA. CONCLUSION: NGN-INT significantly improved the absorption and aortic protective effects of NGN. The supersaturation-prolonging effect of HPMC further enhanced bioavailability and anti-AAA effects of NGN-INT.

Inactivation of Escherichia coli K12 on raw almonds using supercritical carbon dioxide and thyme oil.

Raw almonds could be contaminated by pathogens, but the current pasteurization practice using propylene oxide in the U.S. has flammability and carcinogenicity concerns. Supercritical carbon dioxide (scCO2) is a water-free technology and is a solvent of essential oils that are effective antimicrobial preservatives. The objective of this study was to investigate the possibility of combining scCO2 and thyme oil (TO) to reduce Escherichia coli K12 inoculated on raw almonds. Raw almonds inoculated with ∼6 log CFU/g E. coli K12 were batch-treated with scCO2 alone or the combination of presoaking in pure TO followed by scCO2 treatments at different combinations of temperature, pressure, and duration. Compared to scCO2 alone treatments, the combination of TO and scCO2 treatments significantly improved the disinfection effectiveness. Temperature had the most significant effect on the log reduction. At 70 °C, the log reduction by the combination treatment was over 4-log CFU/g and the maximum reduction was 5.16 log CFU/g. The findings suggest that the combination of TO and scCO2 may be a potential water-free technology to meet the requirement of over 4-log reduction of target microorganism for almond and other tree nut products.

BoPEP4, a C-Terminally Encoded Plant Elicitor Peptide from Broccoli, Plays a Role in Salinity Stress Tolerance.

Plant peptide hormones play various roles in plant development, pathogen defense and abiotic stress tolerance. Plant elicitor peptides (Peps) are a type of damage-associated molecular pattern (DAMP) derived from precursor protein PROPEPs. In this study, we identified nine PROPEP genes in the broccoli genome. qRT-PCR analysis indicated that the expression levels of BoPROPEPs were induced by NaCl, ABA, heat, SA and P. syringae DC3000 treatments. In order to study the functions of Peps in salinity stress response, we synthesized BoPep4 peptide, the precursor gene of which, BoPROPEP4, was significantly responsive to NaCl treatment, and carried out a salinity stress assay by exogenous application of BoPep4 in broccoli sprouts. The results showed that the application of 100 nM BoPep4 enhanced tolerance to 200 mM NaCl in broccoli by reducing the Na+/K+ ratio and promoting accumulation of wax and cutin in leaves. Further RNA-seq analysis identified 663 differentially expressed genes (DGEs) under combined treatment with BoPep4 and NaCl compared with NaCl treatment, as well as 1776 genes differentially expressed specifically upon BoPep4 and NaCl treatment. GO and KEGG analyses of these DEGs indicated that most genes were enriched in auxin and ABA signal transduction, as well as wax and cutin biosynthesis. Collectively, this study shows that there was crosstalk between peptide hormone BoPep4 signaling and some well-established signaling pathways under salinity stress in broccoli sprouts, which implies an essential function of BoPep4 in salinity stress defense.

Incidence and management of metabolic acidosis with sodium bicarbonate in the ICU: An international observational study.

BACKGROUND: Metabolic acidosis is a major complication of critical illness. However, its current epidemiology and its treatment with sodium bicarbonate given to correct metabolic acidosis in the ICU are poorly understood. METHOD: This was an international retrospective observational study in 18 ICUs in Australia, Japan, and Taiwan. Adult patients were consecutively screened, and those with early metabolic acidosis (pH < 7.3 and a Base Excess < -4 mEq/L, within 24-h of ICU admission) were included. Screening continued until 10 patients who received and 10 patients who did not receive sodium bicarbonate in the first 24 h (early bicarbonate therapy) were included at each site. The primary outcome was ICU mortality, and the association between sodium bicarbonate and the clinical outcomes were assessed using regression analysis with generalized linear mixed model. RESULTS: We screened 9437 patients. Of these, 1292 had early metabolic acidosis (14.0%). Early sodium bicarbonate was given to 18.0% (233/1292) of these patients. Dosing, physiological, and clinical outcome data were assessed in 360 patients. The median dose of sodium bicarbonate in the first 24 h was 110 mmol, which was not correlated with bodyweight or the severity of metabolic acidosis. Patients who received early sodium bicarbonate had higher APACHE III scores, lower pH, lower base excess, lower PaCO2, and a higher lactate and received higher doses of vasopressors. After adjusting for confounders, the early administration of sodium bicarbonate was associated with an adjusted odds ratio (aOR) of 0.85 (95% CI, 0.44 to 1.62) for ICU mortality. In patients with vasopressor dependency, early sodium bicarbonate was associated with higher mean arterial pressure at 6 h and an aOR of 0.52 (95% CI, 0.22 to 1.19) for ICU mortality. CONCLUSIONS: Early metabolic acidosis is common in critically ill patients. Early sodium bicarbonate is administered by clinicians to more severely ill patients but without correction for weight or acidosis severity. Bicarbonate therapy in acidotic vasopressor-dependent patients may be beneficial and warrants further investigation.

Mine MIMO Depth Receiver: An Intelligent Receiving Model Based on Densely Connected Convolutional Networks.

Multiple-input multiple-output (MIMO) systems suffer from high BER in the mining environment. In this paper, the mine MIMO depth receiver model is proposed. The model uses densely connected convolutional networks for feature extraction and constructs multiple binary classifiers to recover the original information. Compared with conventional MIMO receivers, the model has no error accumulation caused by processes such as decoding and demodulation. The experimental results show that the model has better performance than conventional decoding methods under different modulation codes and variations in the number of transmitting terminals. Furthermore, we demonstrate that the model can still achieve effective decoding and recover the original information with some data loss at the receiver.

An Optimized Approach to Channel Modeling and Impact of Deteriorating Factors on Wireless Communication in Underground Mines.

The environment of underground coal mines has challenging properties that makes this zone inadaptable for a stable communication system. Additionally, various deteriorating physical parameters strongly affect the performance of wireless networks, which leads to limited network coverage and poor quality of data communication. This study investigates the communication capability in underground coal mines by optimizing the wireless link to develop a stable network for an underground hazardous environment. A hybrid channel-modeling scheme is proposed to characterize the environment of underground mines for wireless communication by classifying the area of a mine into the main gallery and sub-galleries. The complex segments of mine are evaluated by categorizing the wireless links for the line-of-sight (LOS) zones and hybrid modeling is employed to examine the characteristics of electromagnetic signal propagation. For hybrid channel modeling, the multimode waveguide model and geometrical optic (GO) model are used for developing an optimal framework that improves the accessibility of the network in the critical time-varying environment of mines. Moreover, the influence of various deteriorating factors is analyzed using 2.4 GHz to 5 GHz frequency band to study its relationship with the vital constraints of an underground mine. The critical factors such as path loss, roughness loss, delay spread, and shadow fading are examined under detailed analysis with variation in link structure for the mine.

Do-not-attempt resuscitation independently predict in-hospital mortality in septic patients.

INTRODUCTION: Sepsis patients require timely and appropriate treatment in an intensive care setting. However, "do-not-attempt resuscitation" (DNAR) status may affect physicians' priorities and treatment preferences. The aim of this study was to evaluate whether DNAR status affects the outcomes of septic patients. METHODS: This was a retrospective cohort study included septic patients admitted to the emergency department intensive care unit (ED-ICU) in a university-based teaching hospital during April-November 2015. Septic patients admitted to the ED-ICU were included. RESULTS: Of the 132 eligible patients, 49.2% (65/132) had DNAR status (median age 80 years old, IQR, 73-86). The overall in-hospital mortality rate was 28.8% (38/132). Non-survivors had a higher percentage of receiving inotropes/vasopressors (52.6% vs 34.0%, p = 0.048), higher median Charlson comorbidity index scores [8.5 (IQR, 7-11.75) vs 8 (IQR, 6-9), p = 0.012], higher APACHE II score [25 (IQR, 20-30.25) vs 20 (IQR, 17-25), p = 0.002], and higher SOFA score [7 (IQR, 6-11) vs 6 (IQR,4-8), p = 0.012]. There was no significant difference in intubation among the two groups. In a multivariate logistic regression analysis, DNAR status was an independent predictor of in-hospital mortality (odds ratio = 6.22, 95% confidence interval (CI) = (2.71-17.88), p < 0.001). The area under the ROC curve for the logistic regression model was 0.84 [95% CI = (0.77-0.92), p < 0.001]. In subgroup analysis, DNAR status remained an independent predictor of mortality among age ≥65 years and ≥80 years. CONCLUSION: After adjusting for comorbidities, treatments, and illness severity, DNAR status was associated with in-hospital mortality of septic patients. Further studies should evaluate physicians' attitudes toward septic patients with DNAR status.

An Economic Evaluation of the Costs and Benefits of Providing Comprehensive Supports to Students in Elementary School.

There is growing evidence that out-of-school factors, such as physical and mental health, family support, and social and emotional development, significantly affect student learning (Berliner 2009). To address challenges related to poverty, schools are being charged with serving as a focal point in providing and coordinating support services for students and their families (Adelman and Taylor 2002; Dryfoos 2002). In many schools these support services are provided in fragmented ways that do not address the needs of all students or engage teachers in connecting these services to the academic mission of the school (Walsh and DePaul 2008). An emerging school-based model, broadly termed "comprehensive student support" (Walsh et al. 2016), is designed to overcome such fragmentation. In this paper, we build upon previous effectiveness work with an economic evaluation of a successful support model, City Connects. We find that the benefits of the program exceed the costs, indicating that the program is a sound investment and should be considered an option to address the needs of students and to prevent future crises from disrupting their learning.

Pollution exposure and willingness to pay for clean air in urban China.

Rapid industrialization and urbanization are often accompanied by deteriorating air quality that imposes substantial health and productivity costs on the local population. However, existing studies have generally found low marginal willingness to pay (WTP) for mitigating such damages. To understand the determinants and the extent of WTP for air quality improvements, we collected comprehensive socio-demographic and stated preference information from more than 3000 random respondents in three cities in China. Combining the survey data with air quality data from ground-level monitoring stations, we find that exposure to persistent air pollution is a significant determinant of the extent individuals are willing to pay for cleaner air. On average, urban residents are willing to pay 65 CNY (~10 USD) each year to improve air quality to World Health Organization standards. Males and individuals that are younger and more educated tend to have higher WTP. We also find that individuals with more knowledge of sustainability and who engage in more pro-environmental behaviors are willing to pay more. Compared to existing government monetary incentives to reduce air pollution, the public's total WTP for cleaner air is much higher. Overall, these results highlight the potential welfare gain for policymakers to implement more stringent air quality regulations to reduce pollution.

Hydrochlorothiazide ameliorates polyuria caused by tolvaptan treatment of polycystic kidney disease in PCK rats.

BACKGROUND: Tolvaptan is an effective treatment for polycystic kidney disease (PKD), but also causes unfortunate polyuria. Hydrochlorothiazide (HCTZ) has been shown to reduce urine volume in nephrogenic diabetes insipidus, raising the possibility that HCTZ could also be effective in reducing tolvaptan-induced polyuria. In this study, we examined the combined administration of HCTZ and tolvaptan. METHODS: Male PCK rats were divided into four groups of normal chow (Cont), normal chow plus tolvaptan, gavage HCTZ treatment, and tolvaptan + HCTZ. Biochemical examinations of the plasma and urine were performed as well as histological and molecular (mRNA and protein expression) analyses. RESULTS: Groups treated with tolvaptan had significantly higher 24 h urine excretion, which was significantly reduced in the tolvaptan + HCTZ group after 2 weeks. Cyst size, pERK protein expression, and Cyclin D1 mRNA expression were all significantly reduced in both the tolvaptan and tolvaptan + HCTZ groups, indicating that HCTZ did not affect the beneficial functions of tolvaptan. Notably, aquaporin 2 redistribution from the apical to intracellular domains was observed in tolvaptan-treated rats and was partially reversed in the tolvaptan + HCTZ group. The renal glomerular filtration rate was reduced in the tolvaptan + HCTZ group. Significantly lowered mRNA expression of neuronal nitric oxide synthase, prostaglandin E synthase 2 and renin were also found in the medulla, but not in the cortex. CONCLUSION: HCTZ reduces tolvaptan-induced polyuria without altering its beneficial effects on PKD. This novel therapeutic combination could potentially lead to better PKD treatments and improved quality of life for the affected patients.

Characteristics and outcomes of "Do Not Resuscitate" patients admitted to the emergency department-Intensive care unit.

BACKGROUND: Appropriate utilization of intensive care unit (ICU) beds are essential. Patients with critical illness who have do not resuscitate (DNR) have a reduced priority of intensive care. However, the possibility of recovery/survival is ambiguous and multifactorial. OBJECTIVE: To deliberate the characteristics and outcomes of critical illness in patients with prior DNR who were admitted to the emergency department (ED)-ICU. METHOD: This was a retrospective cohort study conducted between April 2015 and November 2015 in a university-based hospital. Non-traumatic patients with DNR admitted to ED-ICU from ED were included. RESULTS: Seventy-eight non-trauma patients with prior DNR status were included in the final analysis. 51.3% (40/78) patients were male with median age 83 (IQR: 75-89) years. The median APACHE II score was 24.5 (IQR: 20-30). 50% (39/78) of the DNR patients survived to discharge. Patients who survived to discharge had lower APACHE II score (23 (IQR: 20-28) vs. 28 (18-38), p = 0.028). There was no significant difference in age, gender, and Charlson index. ROC curves were constructed, generating a cut-off of the APACHE II score at 29.5 for determining survival to discharge (AUC = 0.644, p = 0.028). In multivariate Cox proportional model, APACHE II score above 29.5 was an independent predictor for mortality. (Hazard ratio = 2.46; 95% confidence interval: 1.04-5.83, p = 0.042). CONCLUSION: Our study found that 50% of patients with prior DNR on ICU admission survived to discharge, indicating that aggressive care is not definitely futile. Further prospective studies are required to evaluate the cost-effectiveness and patients' and/or families' satisfaction of the ICU admission of DNR patients.

Red blood cell distribution width is associated with mortality in elderly patients with sepsis.

INTRODUCTION: RDW is a prognostic biomarker and associated with mortality in cardiovascular disease, stroke and metabolic syndrome. For elderly patients, malnutrition and multiple comorbidities exist, which could affect the discrimination ability of RDW in sepsis. The main purpose of our study was to evaluate the prognostic value of RDW in sepsis among elderly patients. METHODS: This was a retrospective cohort study conducted in emergency department intensive care units (ED-ICU) between April 2015 and November 2015. Elderly patients (≥65years old) who were admitted to the ED-ICU with a diagnosis of severe sepsis and/or septic shock were included. The demographic data, biochemistry data, qSOFA, and APACHE II score were compared between survivors and nonsurvivors. RESULTS: A total of 117 patients was included with mean age 81.5±8.3years old. The mean APACHE II score was 21.9±7.1. In the multivariate Cox proportional hazards model, RDW level was an independent variable for mortality (hazard ratio: 1.18 [1.03-1.35] for each 1% increase in RDW, p=0.019), after adjusting for CCI, any diagnosed malignancy, and eGFR. The AUC of RDW in predicting mortality was 0.63 (95% confidence interval [CI]: 0.52-0.74, p=0.025). In subgroup analysis, for qSOFA <2, nonsurvivors had higher RDW levels than survivors (17.0±3.3 vs. 15.3±1.4%, p=0.044). CONCLUSIONS: In our study, RDW was an independent predictor of in-hospital mortality in elderly patients with sepsis. For qSOFA scores <2, higher RDW levels were associated with poor prognosis. RDW could be a potential parameter used alongside the clinical prediction rules.

Research on Flow Field Perception Based on Artificial Lateral Line Sensor System.

In nature, the lateral line of fish is a peculiar and important organ for sensing the surrounding hydrodynamic environment, preying, escaping from predators and schooling. In this paper, by imitating the mechanism of fish lateral canal neuromasts, we developed an artificial lateral line system composed of micro-pressure sensors. Through hydrodynamic simulations, an optimized sensor structure was obtained and the pressure distribution models of the lateral surface were established in uniform flow and turbulent flow. Carrying out the corresponding underwater experiment, the validity of the numerical simulation method is verified by the comparison between the experimental data and the simulation results. In addition, a variety of effective research methods are proposed and validated for the flow velocity estimation and attitude perception in turbulent flow, respectively and the shape recognition of obstacles is realized by the neural network algorithm.