Remote terahertz wireless power transfer with self-resonating spoof plasmonic structures.

In this paper, we use a pair of self-resonating subwavelength spoof plasmonic structures to achieve remote non-radiative terahertz wireless power transfer, while nearly without affecting the electromagnetic environment of free space around the structure. The resonating frequency and quality factor of the magnetic dipole mode supported by the spoof plasmonic structures can be freely tuned by tailoring the geometric structure. By putting the weak source and detector into the self-resonating structures, we can find that the effective non-radiative terahertz power transferring distance can reach several hundred times the radius of the structures. Finally, we also demonstrate the efficient wireless power transfer capability for the multi-target receiving system. These results may provide a novel approach to the design of non-radiative terahertz wireless power transfer and communications.

Modulating the electronic structures of cobalt-organic frameworks for efficient electrocatalytic oxygen evolution.

The oxygen evolution reaction (OER) is a key process in various energy storage/generation technologies. Tuning the electronic structures of catalysts is an effective approach to improve the catalyst's activity. In this work, we synthesized Ce-doped cobalt-organic frameworks with benzene-1, 4-dicarboxylic acid (BDC) as the ligand as efficient OER electrocatalysts (denoted as Co3Ce1 BDC) with excellent stability and improved catalytic performance. The introduced Ce in Co3Ce1 BDC changes the surface configuration and tunes electronic structures of the active Co site, leading to enhanced interaction between intermediates and catalysts. Besides, the specific surface area, reaction kinetics, charge transfer efficiency, and turnover frequency are also improved in the presence of Ce. As a result, the Co3Ce1 BDC demonstrated excellent performance with a low overpotential of 285 mV at a current of 10 mA·cm-2, a preferable Tafel slope of 56.1 mV·dec-1, and an excellent durability in 1 M KOH, indicating the potential for practical applications in water splitting and other energy storage technologies wherein the OER plays a critical role. Comprehensive theoretical calculations and modeling further identified the key role of Ce in modulating the electronic structure and OER activity of cobalt-organic frameworks. Most importantly, this work provides a new strategy to the development of efficient cobalt-organic framework catalysts in OER-related applications.

Chemically bonding inorganic fillers with polymer to achieve ultra-stable solid-state sodium batteries.

Inorganic/organic composite solid electrolytes (CSEs) have attracted ever-increasing attentions due to their outstanding mechanical stability and processibility. However, the inferior inorganic/organic interface compatibility limits their ionic conductivity and electrochemical stability, which hinders their application in solid-state batteries. Herein, we report a homogeneously distributed inorganic fillers in polymer by in-situ anchoring SiO2 particles in polyethylene oxide (PEO) matrix (I-PEO-SiO2). Compared with ex-situ CSEs (E-PEO-SiO2), SiO2 particles and PEO chains in I-PEO-SiO2 CSEs are closely welded by strong chemical bonds, thus addressing the issue of interfacial compatibility and realizing excellent dendrite-suppression ability. In addition, the Lewis acid-base interactions between SiO2 and salts facilitate the dissociation of sodium salts and increase the concentration of free Na+. Consequently, the I-PEO-SiO2 electrolyte demonstrates an improved Na+ conductivity (2.3 × 10-4 S cm-1 at 60 °C) and Na+ transference number (0.46). The as constructed Na3V2(PO4)3 ‖ I-PEO-SiO2 ‖ Na full-cell demonstrates a high specific capacity of 90.5 mAh g-1 at 3C and an ultra-long cycling stability (>4000 cycles at 1C), outperforming the state-of-the-art literatures. This work provides an effective way to solve the issue of interfacial compatibility, which can enlighten other CSEs to overcome their interior compatibility.

Facile Synthesis of SnNb2 O6 @C Composite with Ultrathin Carbon Layer as Anode Materials for High-Performance Sodium-Ion Batteries.

Niobium-based oxides have attracted a lot of attention as anode materials for sodium-ion batteries (SIBs) due to their high theoretical specific capacity, excellent rate capability and exceptional safety. However, their poor intrinsic electronic conductivity and sluggish sodium ions diffusion kinetics severely hinder their practical applicability. Here, SnNb2 O6 @C was successfully prepared by a simple solid-state reaction technique coupled with carbon coating. HRTEM images show that the SnNb2 O6 @C particles are covered with uniformly ultrathin amorphous carbon layer of about 1.8 nm, thus improving the electronic conductivity and diffusion coefficient of sodium ions. As anode for SIBs, the as-obtained SnNb2 O6 @C material exhibits excellent specific capacity (369 mAh g-1 at a current density of 50 mA g-1 ) and remarkable rate performance (177 mAh g-1 at 1000 mA g-1 ), which indicates its good prospect in practical application.

Emergency department disposition prediction using a deep neural network with integrated clinical narratives and structured data.

BACKGROUND: Emergency department (ED) overcrowding has been a serious issue and demands effective clinical decision-making of patient disposition. In previous studies, emergency clinical narratives provide a rich context for clinical decisions. We aimed to develop the disposition prediction model using deep learning modeling strategy with the heterogeneous data, including the physicians' narratives. METHODS: We constructed a retrospective cohort of all 104,083 ED visits of non-trauma adults during 2017-18 from an academically affiliated ED in Taiwan. 18,308 visits were excluded based on the completeness of each record and the unpredictable dispositions, such as out-of-hospital cardiac arrest, against-advice discharge, and escapes. We integrated subjective section of the first physicians' clinical narratives and structured data (e.g., demographics, triage vital signs, etc.) as available predictors at the first physician-patient encounter. To predict final patient disposition (i.e., hospitalization or discharge), a deep neural network (DNN) model was developed with word embedding, a common natural language processing method. We compared the proposed model to a reference model using the Rapid Emergency Medicine Score, a logistic regression model with structured data, and a DNN model with paragraph vectors. F1 score was used to measure the predictive performance for each model. RESULTS: The F1 score (with 95 % CI) for the proposed model, the reference model, the logistic regression model with structured data, and the DNN model with paragraph vectors were 0.674 (0.669-0.679), 0.474 (0.469-0.479), 0.547 (0.543-0.551), and 0.602 (0.596-0.607), respectively. While analyzing the relationship between context length and predictive performance under the proposed model, the F1 score at 95th percentile of the word counts was higher than that at 25th percentile of the word counts in chief complaint [0.634 (0.629-0.640) vs. 0.624 (0.620-0.628)] and in present illness [0.671 (0.667-0.674) vs. 0.654 (0.651-0.658)], but not in past medical history [0.674 (0.669-0.679) vs. 0.673 (0.666-0.679)]. CONCLUSIONS: The proposed deep learning model with the usage of the first physicians' clinical narratives and structured data based on natural language processing outperformed the commonly used ones in terms of F1 score. It also evidenced the importance of the subjective section of clinical narratives, which serve as vital predictors for ED clinical decision-making.

Early short-term prediction of emergency department length of stay using natural language processing for low-acuity outpatients.

BACKGROUND: Low-acuity outpatients constitute the majority of emergency department (ED) patients, and these patients often experience an unpredictable length of stay (LOS). Effective LOS prediction might improve the quality of ED care and reduce ED crowding. OBJECTIVE: The objective of this study was to explore the potential of natural language processing (NLP) of the first ED physicians' clinical notes and to evaluate NLP-based short-term prediction models based on mixed-type clinical data. METHODS: A retrospective study was conducted at an ED of a tertiary teaching hospital in Taiwan from January 2017 to June 2017. In total, 12,962 low-acuity outpatients were enrolled. Using structured data (e.g., demographic variables and vital signs) and different sections of the first SOAP notes as predictors, we developed six NLP-based prediction models (i.e., term frequency-inverse document frequency (TF-IDF) and truncated singular value decomposition (SVD)) to predict LOS. The metric for model evaluation is the mean squared error (MSE). RESULTS: Of the six NLP-based models, the model using structured data and all the sections of the first SOAP notes processed by the TF-IDF and truncated SVD method performed the best, with an MSE of 3.00 [95% CI: 2.94-3.06]. In addition, ten important topics extracted by the TF-IDF and truncated SVD method had significant effects on the LOS (p < 0.001). CONCLUSION: NLP-based models can be used as an early short-term prediction of LOS and have the potential for mixed-type clinical data analysis. The proposed models would likely aid ED physicians' decision-making processes and improve ED quality of care.

Continuity of Care for Older Adults with Chronic Illness in China: An Exploratory Study.

OBJECTIVE: To explore nurses' understanding of continuity of care and existing problems in implementation of continuity of care for Chinese elders with chronic illnesses. DESIGN AND SAMPLE: Cross-sectional survey and semi-structured interview were performed on 15 nurses and older patients and 1,902 older patients between July 2010 and February 2011. MEASURES: Semi-structured interview guideline and four-section scale were used. RESULTS: The interviews showed nurses lacked knowledge of continuity of care, and nurses from small towns or rural areas had less understanding of continuity of care and discharge planning than nurses from central cities. Significant differences were found among patients located in referred areas in selection of medical institutions for treatment, suggesting older adults were more likely to choose general hospitals for treatment. Self-reported surveys demonstrated more than 70% of hospitalized elders chose community hospitals for further recovery after discharge from general hospitals. CONCLUSIONS: Chinese nurses lack knowledge of continuity of care, and significant discontinuity exists between health care provided by general hospitals, community hospitals and other institutions for elders. A further model for the development of continuity of care should be established that addresses older patients' demands and current barriers in China.

The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community.

AIMS AND OBJECTIVES: To explore the effect of continuous nursing intervention guided by chronotherapeutics so as to provide the easy, noninvasive, effective and acceptable intervention for older hypertensive patients in the community. BACKGROUND: Many researchers studied the effect of administration at different times on blood pressure control and circadian rhythm. However, the individual administrative time was set ambiguously in previous studies. DESIGN: A semi-experimental study. METHODS: In the study, 90 eligible patients were recruited and separated into three groups randomly, which were the control group, intervention group A (behaviour and chronotherapy intervention) and intervention group B (behaviour intervention). At 6 and 12 months after the study, the intervention groups were measured 24-hour ambulatory blood pressure monitoring. RESULTS: There were significant differences in ambulatory blood pressure monitoring parameters of the two intervention groups at different measurement times, and there were interaction between measurement time and different groups. The number of patients with dipper increased and reverse dipper decreased in group A as the intervention applied. There were statistical differences between two groups. The number of patients with morning surge in group A decreased more, and there were statistical differences between two groups at six months after the intervention. CONCLUSIONS: The behaviour and chronotherapy intervention based on the patients' ambulatory blood pressure monitoring can control casual blood pressure much better and last longer, which can also improve patients' indexes of ambulatory blood pressure monitoring better than behaviour intervention only. The behaviour and chronotherapy intervention can increase patients' nocturnal blood pressure drop, increase the number of patients with dipper and decrease reverse dipper, and improve blood pressure surge in the morning. RELEVANCE TO CLINICAL PRACTICE: Nurses can use continuous nursing intervention guided by chronotherapeutics to help improve hypertension of older patients better in the community.

Pivotal factors interfering in 24-hour blood pressure fluctuation and arterial stiffness in a community of Chinese elderly hypertensive patients.

AIMS AND OBJECTIVES: To explore which sociodemographic and clinical factors could interfere in the parameters of ambulatory blood pressure monitoring and determine the affecting factors of Ambulatory Arterial Stiffness Index. BACKGROUND: Although the clinical relevance of ambulatory blood pressure monitoring and Ambulatory Arterial Stiffness Index have been studied, the explanation of their role and related interfering factors remains controversial in patients with different disease or age, etc. DESIGN: Cross-sectional study. METHODS: The study was carried out between October 2008-October 2009. A convenience sample of hypertensive patients over 60 years old was recruited in China. Twenty-four hour ambulatory blood pressure monitoring was carried out on the non-dominant arm using an oscillometric device. RESULTS: (1) All 95 patients completed the study and their ages ranged from 60-76 years. (2) There were statistical differences for certain parameters of ambulatory blood pressure monitoring between different characteristics of patients. Financial status was an important factor interfering in patients' BP fluctuation, especially daytime and 24 hours systolic pressure. The higher body mass index the patients had, the higher the pressure was. (3) Multiple variants logistic analysis of Ambulatory Arterial Stiffness Index showed statistical differences only in coefficient variation of 24-hour diastolic pressure and daytime systolic blood pressure. CONCLUSIONS: There are more factors that interfered with systolic pressure and diastolic pressure during the day than night. Patients who have less nocturnal dipping may have a higher night time systolic pressure and diastolic pressure. The coefficient of variation of 24 hours diastolic pressure and daytime systolic pressure contribute more to Ambulatory Arterial Stiffness Index which should arouse practitioners' attention. RELEVANCE TO CLINICAL PRACTICE: Ambulatory blood pressure monitoring should be used as a routine procedure, as well as Ambulatory Arterial Stiffness Index calculated for older hypertensive patients. The findings may be used to guide community health providers to pay more attention to the factors that may influence BP fluctuation and Ambulatory Arterial Stiffness Index according to individual's characteristics.

Direct human papillomavirus E6 whole-cell enzyme-linked immunosorbent assay for objective measurement of E6 oncoproteins in cytology samples.

A novel, whole-cell enzyme-linked immunosorbent assay (ELISA) based on a non-type-specific anti-human papillomavirus (HPV) E6 antibody was tested on 182 residual cytological specimens. For samples with a designation of more severe than cervical intraepithelial neoplasia grade 3 (CIN3+), 83% tested positive for E6; in a subset with paired testing for E6 ELISA and HPV DNA, 72% tested E6 positive and 92% tested high-risk (HR)-HPV DNA positive (P = 0.2). Among the women with a less than CIN3 diagnosis, 31% and 47% tested positive for E6 and HR-HPV DNA, respectively (P = 0.0006).

Cellular expression of INK4a gene in cells of bladder cancer associated with human papilloma virus-16.

Hyperexpression of p16(INK4a) protein is an early marker of cervical cancer. Hyperexpression of INK4a gene encoding this protein at the level of mRNA and p16(INK4a) was detected in tumor cells of some patients with bladder cancer associated with human papilloma virus-16. However, in contrast to cervical cancer, this phenomenon in urothelial carcinomas does not correlate with expression of human papilloma virus-16 oncogenes E6 and E7.

[Clinical study of feiyanqing rectum condensed liquid in treating 36 cases of children syncytial viral pneumonia].

OBJECTIVE: To evaluate the clinical efficacy and mechanism of Feiyangqin Rectum Condensed Liquid (FRCL) in treating children syncytial viral pneumonia. Methods Seventy-two patients were randomly divided into two groups, the 36 patients in the treated group were treated with FRCL, and the other 36 patients in the control group simply treated with Western medicine. Efficacy of treatment on clinical condition and some immune function (IgA, IgG, CD3, CD4) were observed. RESULTS: In the treated group, 28 patients were cured (77.8%), treatment was markedly effective in 4 patients (11.1%), effective in 2 (5.5%) and ineffective in 2 (5.6%), with the total effective rate of 94.4%. The corresponding number in the control group was 20 (55.6%), 7 (19.4%), 6 (16.7%), 3 (8.3%) and 91.7%, respectively. The cure rate in the treated group was obviously superior to that in the control group (P < 0.05). FRCL could improve serum IgA, IgG, CD3, CD4, and CD4/CD8, lower serum IgE, these indexes in the treated group were significantly different to those in the control group (P < 0.05). CONCLUSION: FRCL had the action in treating children syncytial viral pneumonia without any adverse reaction, one of its mechanisms might be related to its regulation on immune function.