Machine learning model for the prediction of gram-positive and gram-negative bacterial bloodstream infection based on routine laboratory parameters.

BACKGROUND: Bacterial bloodstream infection is responsible for the majority of cases of sepsis and septic shock. Early recognition of the causative pathogen is pivotal for administration of adequate empiric antibiotic therapy and for the survival of the patients. In this study, we developed a feasible machine learning (ML) model to predict gram-positive and gram-negative bacteremia based on routine laboratory parameters. METHODS: Data for 2118 patients with bacteremia were obtained from the Medical Information Mart for Intensive Care dataset. Patients were randomly split into the training set and test set by stratified sampling, and 374 routine laboratory blood test variables were retrieved. Variables with missing values in more than 40% of the patients were excluded. Pearson correlation test was employed to eliminate redundant features. Five ML algorithms were used to build the model based on the selected features. Additionally, 132 patients with bacteremia who were treated at Qilu Hospital of Shandong University were included in an independent test cohort to evaluate the model. RESULTS: After feature selection, 32 variables remained. All the five ML algorithms performed well in terms of discriminating between gram-positive and gram-negative bacteremia, but the performance of convolutional neural network (CNN) and random forest (RF) were better than other three algorithms. Consider of the interpretability of models, RF was chosen for further test (ROC-AUC = 0.768; 95%CI = 0.715-0.798, with a sensitivity of 75.20% and a specificity of 63.79%). To expand the application of the model, a decision tree (DT) was built utilizing the major variables, and it achieved an AUC of 0.679 (95%CI = 0.632-0.723), a sensitivity of 66%, and a specificity of 67.82% in the test cohort. When tested in the Qilu Hospital cohort, the ROC-AUC of the RF and DT models were 0.666 (95%CI = 0.579-0.746) and 0.615 (95%CI = 0.526-0.698), respectively. Finally, a software was developed to make the RF- and DT-based prediction models easily accessible. CONCLUSION: The present ML-based models could effectively discriminate between gram-positive and gram-negative bacteremia based on routine laboratory blood test results. This simple model would be beneficial in terms of guiding timely antibiotic selection and administration in critically ill patients with bacteremia before their pathogen test results are available.

Demystifying the life domain in work-life balance: A Malaysian perspective.

Traditionally, the word 'life' in the concept of work-life balance focuses on family obligations. This conceptual paper sets out to present the notion that "life" goes beyond family responsibilities and is unique to employees of different demographics. Given the impending difference in how "life" is viewed by different groups of employees, this study reviews the literature and argues for the need to distinguish between different dimensions of the non-work domain. The discussion is centered on the transformation taking place within the Malaysian workforce. Recent trends indicate that "life" and "family" are indeed distinct domains. There is a need for organizations to acknowledge this distinction and provide relevant support to attain a balance between work, life, and family. The paper will help strengthen the knowledge about the "life" in the concept of work-life balance and employers better understand the conceptualization of "life" in work-life balance so that they can strategize and enhance employee well-being and eventually gain competitive advantage. Currently, the terms work-life balance and work-family balance are used interchangeably to represent a balance between the family and work domain. This is especially evident in collectivist countries such as Malaysia. However, the emphasis on family without due consideration to the needs of employees with different demographic configurations may result in work-life backlash. Hence, this study argues that the non-work domain is not limited to family obligations and should encompass both family obligations and personal activities. The emphasis on striking a balance between work and family domain should not be done at the expense of the well-being of employees with lesser or no family obligations.

Circulating tumor cells exit circulation while maintaining multicellularity, augmenting metastatic potential.

Metastasis accounts for the majority of all cancer deaths, yet the process remains poorly understood. A pivotal step in the metastasis process is the exiting of tumor cells from the circulation, a process known as extravasation. However, it is unclear how tumor cells extravasate and whether multicellular clusters of tumor cells possess the ability to exit as a whole or must first disassociate. In this study, we use in vivo zebrafish and mouse models to elucidate the mechanism tumor cells use to extravasate. We found that circulating tumor cells exit the circulation using the recently identified extravasation mechanism, angiopellosis, and do so as both clusters and individual cells. We further show that when melanoma and cervical cancer cells utilize this extravasation method to exit as clusters, they exhibit an increased ability to form tumors at distant sites through the expression of unique genetic profiles. Collectively, we present a new model for tumor cell extravasation of both individual and multicellular circulating tumor cells.This article has an associated First Person interview with the first author of the paper.

Geographical discrimination of ethanol based on stable isotope ratio analysis coupled with statistical methods: The Chinese case study.

The demand for the effective traceability of hazardous chemicals is crucial for preventing and controlling chemical spills and other accidents involving hazardous chemicals. The aim of the study was to investigate the correlation between the geographical location of ethanol-producing industrial sites and the carbon, hydrogen, and oxygen stable isotope ratios of the Chinese-manufactured ethanol using statistical classification analysis to enable the traceability of the ethanol. The isotopic data of 54 ethanol samples obtained from 18 different ethanol manufacturing plants in China between 2019 and 2020. The results of the statistical analysis demonstrated that the δ18O values of the ethanol positively correlated with latitudes of the production plants but negatively correlated with the δ13C values of the ethanol. A small number of samples derived from sites that were geographically close to each other could not be visually distinguished by PCA and HCA. However, by applying and comparing the results of classification by LDA, K-NN and Ensemble, an optimal classification model was obtained. Upon application of these models, 96.3% of the ethanol samples were correctly classified based on their geographical origin, indicating that the combination of isotopic ratios and latitude data is practical and effective for measuring the traceability of ethanol.

Antibody-Armed Platelets for the Regenerative Targeting of Endogenous Stem Cells.

Stem cell therapies have shown promise in treating acute and chronic ischemic heart disease. However, current therapies are limited by the low retention and poor integration of injected cells in the injured tissue. Taking advantage of the natural infarct-homing ability of platelets, we engineered CD34 antibody-linked platelets (P-CD34) to capture circulating CD34-positive endogenous stem cells and direct them to the injured heart. In vitro, P-CD34 could bind to damaged aortas and capture endogenous stem cells in whole blood. In a mouse model of acute myocardial infarction, P-CD34 accumulated in the injured heart after intravenous administration, leading to a concentration of endogenous CD34 stem cells in the injured heart for effective heart repair. This represents a new technology for endogenous stem cell therapy.

Platelet-Inspired Nanocells for Targeted Heart Repair After Ischemia/Reperfusion Injury.

Cardiovascular disease is the leading cause of mortality worldwide. While reperfusion therapy is vital for patient survival post-heart attack, it also causes further tissue injury, known as myocardial ischemia/reperfusion (I/R) injury in clinical practice. Exploring ways to attenuate I/R injury is of clinical interest for improving post-ischemic recovery. A platelet-inspired nanocell (PINC) that incorporates both prostaglandin E2 (PGE2)-modified platelet membrane and cardiac stromal cell-secreted factors to target the heart after I/R injury is introduced. By taking advantage of the natural infarct-homing ability of platelet membrane and the overexpression of PGE2 receptors (EPs) in the pathological cardiac microenvironment after I/R injury, the PINCs can achieve targeted delivery of therapeutic payload to the injured heart. Furthermore, a synergistic treatment efficacy can be achieved by PINC, which combines the paracrine mechanism of cell therapy with the PGE2/EP receptor signaling that is involved in the repair and regeneration of multiple tissues. In a mouse model of myocardial I/R injury, intravenous injection of PINCs results in augmented cardiac function and mitigated heart remodeling, which is accompanied by the increase in cycling cardiomyocytes, activation of endogenous stem/progenitor cells, and promotion of angiogenesis. This approach represents a promising therapeutic delivery platform for treating I/R injury.

Seeing pressure in color based on integration of highly sensitive pressure sensor and emission tunable light emitting diode.

We demonstrate a highly sensitive, low-cost, environmental-friendly pressure sensor derived from a wool-based pressure sensor with wide pressure sensing range using wool bricks embedded with a Ag nano-wires. The easy fabrication and light weight allow portable and wearable device applications. Wth the integration of a light-emitting diode possessing multi-wavelength emission, we illustrate a hybrid multi-functional LED-integrated pressure sensor that is able to convert different applied pressures to light emission with different wavelengths. Due to the high sensitivity of the pressure sensor, the demonstration of acoustic signal detection has also been presented using sound of a metronome and a speaker playing a song. This multi-functional pressure sensor can be implemented to technologies such as smart lighting, health care, visible light communication (VLC), and other internet of things (IoT) applications.

Pressure Welding of Silver Nanowires Networks at Room Temperature as Transparent Electrodes for Efficient Organic Light-Emitting Diodes.

In this work, polymethylmethacrylate (PMMA) as a superior mediate for the pressure welding of silver nanowires (Ag NWs) networks as transparent electrodes without any thermal treatment is demonstrated. After a pressing of 200 kg cm-2 , not only the sheet resistance but also the surface roughness of the PMMA-mediated Ag NWs networks decreases from 2.6 kΩ sq-1 to 34.3 Ω sq-1 and from 76.1 to 12.6 nm, respectively. On the other hand, high transparency of an average transmittance in the visible wavelengths of 93.5% together with a low haze value of 2.58% can be achieved. In terms of optoelectronic applications, the promising potential of the PMMA-mediated pressure-welded Ag NWs networks used as a transparent electrode in a green organic light-emitting diode (OLED) device is also demonstrated. In comparison with the OLED based on commercial tin-doped indium oxide electrode, the increments of power efficiency and external quantum efficiency (EQE) from 80.1 to 85.9 lm w-1 and 19.2% to 19.9% are demonstrated. In addition, the PMMA-mediated pressure welding succeeds in transferring Ag NWs networks to flexible polyethylene naphthalate and polyimide substrates with the sheet resistance of 42 and 91 Ω sq-1 after 10 000 times of bending, respectively.

Phase-Engineered PtSe2 -Layered Films by a Plasma-Assisted Selenization Process toward All PtSe2 -Based Field Effect Transistor to Highly Sensitive, Flexible, and Wide-Spectrum Photoresponse Photodetectors.

The formation of PtSe2 -layered films is reported in a large area by the direct plasma-assisted selenization of Pt films at a low temperature, where temperatures, as low as 100 °C at the applied plasma power of 400 W can be achieved. As the thickness of the Pt film exceeds 5 nm, the PtSe2 -layered film (five monolayers) exhibits a metallic behavior. A clear p-type semiconducting behavior of the PtSe2 -layered film (≈trilayers) is observed with the average field effective mobility of 0.7 cm2 V-1 s-1 from back-gated transistor measurements as the thickness of the Pt film reaches below 2.5 nm. A full PtSe2 field effect transistor is demonstrated where the thinner PtSe2 , exhibiting a semiconducting behavior, is used as the channel material, and the thicker PtSe2 , exhibiting a metallic behavior, is used as an electrode, yielding an ohmic contact. Furthermore, photodetectors using a few PtSe2 -layered films as an adsorption layer synthesized at the low temperature on a flexible substrate exhibit a wide range of absorption and photoresponse with the highest photocurrent of 9 µA under the laser wavelength of 408 nm. In addition, the device can maintain a high photoresponse under a large bending stress and 1000 bending cycles.

Phase-Engineered Type-II Multimetal-Selenide Heterostructures toward Low-Power Consumption, Flexible, Transparent, and Wide-Spectrum Photoresponse Photodetectors.

Phase-engineered type-II metal-selenide heterostructures are demonstrated by directly selenizing indium-tin oxide to form multimetal selenides in a single step. The utilization of a plasma system to assist the selenization facilitates a low-temperature process, which results in large-area films with high uniformity. Compared to single-metal-selenide-based photodetectors, the multimetal-selenide photodetectors exhibit obviously improved performance, which can be attributed to the Schottky contact at the interface for tuning the carrier transport, as well as the type-II heterostructure that is beneficial for the separation of the electron-hole pairs. The multimetal-selenide photodetectors exhibit a response to light over a broad spectrum from UV to visible light with a high responsivity of 0.8 A W-1 and an on/off current ratio of up to 102 . Interestingly, all-transparent photodetectors are successfully produced in this work. Moreover, the possibility of fabricating devices on flexible substrates is also demonstrated with sustainable performance, high strain tolerance, and high durability during bending tests.

Transfer-Free Growth of Atomically Thin Transition Metal Disulfides Using a Solution Precursor by a Laser Irradiation Process and Their Application in Low-Power Photodetectors.

Although chemical vapor deposition is the most common method to synthesize transition metal dichalcogenides (TMDs), several obstacles, such as the high annealing temperature restricting the substrates used in the process and the required transfer causing the formation of wrinkles and defects, must be resolved. Here, we present a novel method to grow patternable two-dimensional (2D) transition metal disulfides (MS2) directly underneath a protective coating layer by spin-coating a liquid chalcogen precursor onto the transition metal oxide layer, followed by a laser irradiation annealing process. Two metal sulfides, molybdenum disulfide (MoS2) and tungsten disulfide (WS2), are investigated in this work. Material characterization reveals the diffusion of sulfur into the oxide layer prior to the formation of the MS2. By controlling the sulfur diffusion, we are able to synthesize continuous MS2 layers beneath the top oxide layer, creating a protective coating layer for the newly formed TMD. Air-stable and low-power photosensing devices fabricated on the synthesized 2D WS2 without the need for a further transfer process demonstrate the potential applicability of TMDs generated via a laser irradiation process.

Direct formation of large-scale multi-layered germanene on Si substrate.

Germanene layers with lonsdaleite structure has been synthesized from a SiGe thin film for the first time using a N2 plasma-assisted process in this investigation. Multi-layered germanene can be directly observed, and the derived lattice parameters are nearly consistent with the theoretical results. Furthermore, large-scale multi-layered germanene has also been demonstrated for applications.

The Performance of Spot Photoscreener in 6 to 10 Weeks Infants in China: A Cross-Sectional Study.

Purpose: To compare the refractive errors measured by the Spot photoscreener (with or without cycloplegia) to cycloplegic retinoscopy in 6- to 10-week-old infants. Materials and Methods: 101 right eyes from 101 healthy infants aged 6 to 10 weeks were recruited for this cross-sectional observational study. Refractive errors were measured using Spot photoscreener before and after cycloplegia, as well as cycloplegic retinoscopy. Comparisons between the refractive measurements were performed using one-way ANOVA with the post hoc Tukey HSD test or Kruskal-Wallis test with the Steel-Dwass test according to the data normality. Pearson's correlation test and 95% confidence intervals were calculated. The agreement was evaluated using a Bland-Altman plot with 95% limits of agreement of the differences. Results: Spot photoscreener was found to underestimate the spherical equivalent by 2.33 Diopters (D) in these infants. Following the induction of cycloplegia, the spherical equivalent measured by Spot photoscreener was in excellent agreement with cycloplegic retinoscopy with the mean difference of 0.01 D. Spot photoscreener overestimated cylindrical parameter by 0.2 D with poor agreement with cycloplegic retinoscopy no matter whether cycloplegia was induced. It had good agreement with cycloplegic retinoscopy in the J0 vector than the J45 vector measurement. Conclusions: With the induction of cycloplegia, Spot photoscreener can accurately evaluate spherical equivalent in hyperopic infants with mild-to-moderate astigmatism. While it may provide valuable measurements of astigmatism, discrepancies in cylinder and axis should be taken into account.

Consumption Pattern and Mental Health of Employees Based on Big Data Analysis.

With the development of big data concept and technology, big data has an important impact on human development. This paper studies the relationship between the consumption pattern and mental health of enterprise employees under the normalization of epidemic prevention and control. Starting from the consumption structure and behavior of enterprise employees, it defines the meaning of enterprise employees' consumption and the connotation of enterprise employees' health psychology and analyzes the relationship between consumption behavior and consumption psychology and the elements of enterprise employees' health psychology. Based on the change of employees' income structure and consumption patterns, this paper speculates the relationship between employees' consumption patterns and mental health, analyzes the correlation between employees' consumption patterns and mental health through a questionnaire survey, and calculates the Correlation Clustering statistical results. It plays an important role in building a good enterprise staff consumption culture under the normalization of epidemic prevention and control and effectively realizes the significance of purifying the social consumption environment.

Addressing the COVID-19 Shock: The Potential Job Creation in China by the RCEP.

In 2020, coronavirus disease (COVID-19) left around 81% of the global workforce, nearly 2.7 billion workers, affected. Employment in China was the first to be hit by COVID-19. The Regional Comprehensive Economic Partnership (RCEP) is expected to bring dynamism to China's employment market in an era of long COVID-19. This study aims to examine the number of sectoral jobs that the RCEP will create in China, with the number of skilled or unskilled labour employed in each sector. The exogenous shocks to the RCEP can be reflected in the number of jobs created through multipliers based on a social accounting matrix compiled from China's input-output tables in 2017, combined with the employment satellite accounts compiled. The results show that the RCEP is expected to create over 17 million potential jobs in China, with unskilled labour accounting for 10.44 million and skilled labour for 6.77 million. It is even expected that there will be job losses in the metalworking machinery sector. The contribution of this paper can serve as a reference for policies to protect vulnerable sectors, further open up trade markets and strengthen cooperation among RCEP members as important measures to address the employment impact of long COVID-19.

Intercalation of Zinc Monochloride Cations by Deep Eutectic Solvents for High-Performance Rechargeable Non-aqueous Zinc Ion Batteries.

Zinc ion batteries have been extensively studied with an aqueous electrolyte system. However, the batteries suffer from a limited potential window, gas evolution, cathode dissolution, and dendrite formation on the anode. Considering these limitations, we developed an alternative electrolyte system based on deep eutectic solvents (DESs) because of their low cost, high stability, biodegradability, and non-flammability, making them optimal candidates for sustainable batteries. The DES electrolyte enables reversible Zn plating/stripping and effectively suppresses zinc dendrite formation. Furthermore, in-depth characterizations reveal that the energy storage mechanism can be attributed to [ZnCl]+ ion intercalation and the intermediate complex ion plays a pivotal role in electrochemical reactions, which deliver a high reversible capacity of 310 mAh g-1 at 0.1 A g-1and long-term stability (167 mAh g-1 at a current density of 0.3 A g-1 after 300 cycles, Coulombic efficiency: ∼98%). Overall, this work represents our new finding in rechargeable batteries with the DES electrolyte.

Role of economic growth and innovative technologies in the outlook of energy and environmental efficiency: a way forward for developing Asian economies.

Energy consumption is widely regarded as the primary driver of economic development and environmental degradation. The current study examines how energy use is related to technological innovation, human resources, energy pricing, economic development, and trade openness. For this context, the data set of OECD economies' indicators as mentioned above has been compiled for the period 1991-2019. Three estimators were used in this study from the family of autoregressive distributed lag (ARDL): the mean group (MG), the dynamic fixed effect (DFE), and the pooled mean group (PMG). According to empirical research, technical advances, human resources, and energy pricing all have a negative impact on OECD countries' long-run energy consumption. In the short term, however, these variables have a negligible or inverse effect on energy consumption. On the other hand, economic growth and trade openness in OECD economies all contribute positively to energy demand in the short and long run. Based on the empirical findings, this study recommends a policy structure for emerging economies.

[Conception and framework of land ecological restoration for a new stage in China.] / 新时期我国国土空间生态修复理念与模式探讨.

Based on the theories of geography and landscape ecology, land ecological restoration is an important strategy to promote ecological civilization and build a beautiful China. Land ecological restoration in China has the characteristics of multi-disciplinary theoretical system, diverse work mode, integration of technology and methods, and diversified practice and exploration. The overall effectiveness of the work coexists with arduous tasks. Based on the new challenges in land ecological restoration, we summarized the overall framework and technical path of land ecological restoration, the working mechanism and mode of regional land ecological restoration, the content system and technical standards of land ecological restoration. In the new stage, the top-level design of land ecological restoration in China should focus on the work system, business boundary and institutional system, identify the responsibility boundary of different business processes, and realize the closed management of the whole work chain from the perspective of theory, system, engineering and technology. Rural settlement area, urban built-up area, industrial and mining gathering area, ecological function area and blue ocean area are the five major elements of regional scale land space, which correspond to five different ecological restoration modes, namely, comprehensive land improvement, urban renewal and double repair, mine geological environment restoration, mountain-river-forest-farmland-lake-grassland restoration, and blue bay restoration. It is necessary to comprehensively use the thinking of "Three Integrations" (information, technology, and process) to build a set of regional land ecological restoration work mode covering the integration of investigation, monitoring and evaluation, land space planning, project implementation, project acceptance and ecosystem monitoring and evaluation.

Exosome-eluting stents for vascular healing after ischaemic injury.

Drug-eluting stents implanted after ischaemic injury reduce the proliferation of endothelial cells and vascular smooth muscle cells and thus neointimal hyperplasia. However, the eluted drug also slows down the re-endothelialization process, delays arterial healing and can increase the risk of late restenosis. Here we show that stents releasing exosomes derived from mesenchymal stem cells in the presence of reactive oxygen species enhance vascular healing in rats with renal ischaemia-reperfusion injury, promoting endothelial cell tube formation and proliferation, and impairing the migration of smooth muscle cells. Compared with drug-eluting stents and bare-metal stents, the exosome-coated stents accelerated re-endothelialization and decreased in-stent restenosis 28 days after implantation. We also show that exosome-eluting stents implanted in the abdominal aorta of rats with unilateral hindlimb ischaemia regulated macrophage polarization, reduced local vascular and systemic inflammation, and promoted muscle tissue repair.

Platelet membrane and stem cell exosome hybrid enhances cellular uptake and targeting to heart injury.

Exosomes from mesenchymal stem cells have been largely studied as therapeutics to treat myocardial infarctions. However, exosomes injected for therapeutic purposes face a number of challenges, including competition from exosomes already in circulation, and the internalization/clearance by the mononuclear phagocyte system. In this study, we hybrid exosomes with platelet membranes to enhance their ability to target the injured heart and avoid being captured by macrophages. Furthermore, we found that encapsulation by the platelet membranes induces macropinocytosis, enhancing the cellular uptake of exosomes by endothelial cells and cardiomyocytes strikingly. In vivo studies showed that the cardiac targeting ability of hybrid exosomes in a mice model with myocardial infarction injury. Last, we tested cardiac functions and performed immunohistochemistry to confirm a better therapeutic effect of platelet membrane modified exosomes compared to non-modified exosomes. Our studies provide proof-of-concept data and a universal approach to enhance the binding and accumulation of exosomes in injured tissues.