Enhanced properties of a positive-charged nanofiltration membrane containing quaternarized chitosan through second interfacial polymerization for the removal of salts and pharmaceuticals.

Nanofiltration (NF) membrane technology has been widely used in the removal of salts and trace organic pollutants, such as pharmaceuticals and personal care products (PPCPs), due to its superiority. A positive-charged composite NF membrane with an active skin layer was prepared by polyethyleneimine (PEI), trimethyl benzene chloride, and quaternate chitosan (HTCC) through second interfacial polymerization on the polyethersulfone ultrafiltration membrane. The physicochemical properties of the nanocomposite membrane were investigated using surface morphology, hydrophilicity, surface charge, and molecular weight cut-off (MWCO). The influence of the concentration and reaction time of PEI and HTCC was documented. The optimized membrane had a MWCO of about 481 Da and possessed a pure water permeability of 25.37 L·m-2·h-1·MPa-1. The results also exhibited salt rejection ability as MgCl2 > CaCl2 > MgSO4 > Na2SO4 > NaCl > KCl, showing a positive charge on the fabricated membrane. In addition, the membrane had higher rejection to atenolol, carbamazepine, amlodipine, and ibuprofen at 89.46, 86.02, 90.12, and 77.21%, respectively. Moreover, the anti-fouling performance and stability of the NF membrane were also improved.

Machine learning based peri-surgical risk calculator for abdominal related emergency general surgery: a multicenter retrospective study.

BACKGROUND: Currently, there is a lack of ideal risk prediction tools in the field of emergency general surgery (EGS). The American Association for the Surgery of Trauma recommends developing risk assessment tools specifically for EGS-related diseases. In this study, we sought to utilize machine learning (ML) algorithms to explore and develop a web-based calculator for predicting five perioperative risk events of eight common operations in EGS. METHOD: This study focused on patients with EGS and utilized electronic medical record systems to obtain data retrospectively from five centers in China. Five ML algorithms, including Random Forest (RF), Support Vector Machine, Naive Bayes, XGBoost, and Logistic Regression, were employed to construct predictive models for postoperative mortality, pneumonia, surgical site infection, thrombosis, and mechanical ventilation >48 h. The optimal models for each outcome event were determined based on metrics, including the value of the Area Under the Curve, F1 score, and sensitivity. A comparative analysis was conducted between the optimal models and Emergency Surgery Score (ESS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and American Society of Anesthesiologists (ASA) classification. A web-based calculator was developed to determine corresponding risk probabilities. RESULT: Based on 10,993 patients with EGS, we determined the optimal RF model. The RF model also exhibited strong predictive performance compared with the ESS, APACHE II score, and ASA classification. Using this optimal model, we developed an online calculator with a questionnaire-guided interactive interface, catering to both the preoperative and postoperative application scenarios. CONCLUSIONS: We successfully developed an ML-based calculator for predicting the risk of postoperative adverse events in patients with EGS. This calculator accurately predicted the occurrence risk of five outcome events, providing quantified risk probabilities for clinical diagnosis and treatment.

From transients to permanent residents: the existence of obligate aerobic microorganisms in the goat rumen.

The rumen serves as a complex ecosystem, harboring diverse microbial communities that play crucial ecological roles. Because previous studies have predominantly focused on anaerobic microorganisms, limited attention has been given to aerobic microorganisms in the goat rumen. This study aims to explore the diversity of aerobic microorganisms in the rumen and understand their niche and ecological roles. Rumen fluid samples were collected from 6 goats at different time points post-morning feeding. pH, NH3-N, and volatile fatty acid (TVFA) concentrations were measured, while In vitro cultivation of aerobic microorganisms was performed using PDA medium. Internal Transcribed Spacer (ITS) and 16S sequencing unveiled microbial diversity within the rumen fluid samples. Evidence of obligate aerobic microorganisms in the goat rumen suggests their potential contribution to ecological functionalities. Significantly, certain aerobic microorganisms exhibited correlations with TVFA levels, implying their involvement in TVFA metabolism. This study provides evidence of the existence and potential ecological roles of obligate aerobic microorganisms in the goat rumen. The findings underscore the significance of comprehensively deciphering goat rumen microbial communities and their interactions, with aerobes regarded as permanent residents rather than transients. These insights form a solid foundation for advancing our understanding of the intricate interplay between goat and their aerobic microorganisms in the rumen.

Recent progress in the synthesis and applications of covalent organic framework-based composites.

Covalent organic frameworks (COFs) have historically been of interest to researchers in different areas due to their distinctive characteristics, including well-ordered pores, large specific surface area, and structural tunability. In the past few years, as COF synthesis techniques developed, COF-based composites fabricated by integrating COFs and other functional materials including various kinds of metal or metal oxide nanoparticles, ionic liquids, metal-organic frameworks, silica, polymers, enzymes and carbon nanomaterials have emerged as a novel kind of porous hybrid material. Herein, we first provide a thorough summary of advanced strategies for preparing COF-based composites; then, the emerging applications of COF-based composites in diverse fields due to their synergistic effects are systematically highlighted, including analytical chemistry (sensing, extraction, membrane separation, and chromatographic separation) and catalysis. Finally, the current challenges associated with future perspectives of COF-based composites are also briefly discussed to inspire the advancement of more COF-based composites with excellent properties.

The machine learning methods to analyze the using strategy of antiplatelet drugs in ischaemic stroke patients with gastrointestinal haemorrhage.

BACKGROUND: For ischaemic stroke patients with gastrointestinal haemorrhage, stopping antiplatelet drugs or reducing the dose of antiplatelet drugs was a conventional clinical therapy method. But not a study to prove which way was better. And the machinery learning methods could help to obtain which way more suit for some patients. METHODS: Data from consecutive ischaemic stroke patients with gastrointestinal haemorrhage were prospectively collected. The outcome was a recurrent stroke rate, haemorrhage events, mortality and favourable functional outcome (FFO). We analysed the data using conventional logistic regression methods and a supervised machine learning model. We used unsupervised machine learning to group and analyse data characters. RESULTS: The patients of stopping antiplatelet drugs had a lower rate of bleeding events (p = 0.125), mortality (p = 0.008), rate of recurrence of stroke (p = 0.161) and distribution of severe patients (mRS 3-6) (p = 0.056). For Logistic regression, stopping antiplatelet drugs (OR = 2.826, p = 0.030) was related to lower mortality. The stopping antiplatelet drugs in the supervised machine learning model related to mortality (AUC = 0.95) and FFO (AUC = 0.82). For group by unsupervised machine learning, the patients of better prognosis had more male (p < 0.001), younger (p < 0.001), had lower NIHSS score (p < 0.001); and had a higher value of serum lipid level (p < 0.001). CONCLUSIONS: For ischemic stroke patients with gastrointestinal haemorrhage, stopping antiplatelet drugs had a better prognosis. Patients who were younger, male, with lesser NIHSS scores at admission, with the fewest history of a medical, higher value of diastolic blood pressure, platelet, blood lipid and lower INR could have a better prognosis.

The unsupervised machine learning to analyze the use strategy of statins for ischaemic stroke patients with elevated transaminase.

BACKGROUND AND PURPOSE: Statins could elevate hepatic transaminase in ischemic stroke patients. There needed to be more evidence on which method stopped statins or adjusting the dose of statins was better for patients. And no evidence showed which way more suit for some patients. METHODS: We collected ischaemic stroke patients with elevated hepatic transaminase when they take statins. The outcome was a recurrent stroke rate, transaminase value after stopping or adjusted, mortality, and favorable functional outcome (FFO). We compare outcome events between the stopped group and the adjustment group. We grouped all patients by unsupervised machine learning and analyzed data characters by the different groups. RESULTS: The patients stopping statins had a higher stroke recurrence and rate of FFO (mRS 0-2), a lower mean value of transaminase, and mortality. By difference unsupervised machine learning group, the km2 group had the lowest stroke recurrence (p = 0.046), lowest mortality (p = 0.049), and highest FFO (p = 0.023). The patients of the km2 group were younger (p < 0.001), more male (p < 0.001), had lesser National Institutes of Health Stroke Scale (NIHSS) scores (p < 0.001), and had slightly higher values of blood pressure (p = 0.002). The group of unsupervised machine learning could improve models' performance. CONCLUSION: For ischemic patients with elevated hepatic transaminase, stopping statins temporarily was a better choice of treatment strategy. These patients who were younger, male, with a lesser NIHSS score at admission and a slightly higher blood lipid value at admission, could have had a better prognosis.

Case report: Surgical valvular pulmonary reconstruction for a previous unreported rheumatic right-sided valve disease with severe pulmonary regurgitation.

Rheumatic heart disease (RHD) is a widespread illness in developing countries. RHD causes 99% of mitral stenoses in adults and 25% of aortic regurgitation. However, it only causes 10% of stenoses of the tricuspid valve, and is almost always associated with left-side valvular lesions. Isolated right-side valves are rarely affected, but may result in severe rheumatic pulmonary regurgitation. Herein, we present a case of rheumatic right-sided valve disease with severe pulmonary valve contracture and regurgitation in a symptomatic patient, successfully managed by surgical valvular reconstruction with a tailored bileaflet bovine pericardial patch. The options for surgical approach are also discussed. To our knowledge, the presented rheumatic right-sided valve disease with severe pulmonary regurgitation is the first to be reported in the literature.

Successful surgical repair in an older adult with supracardiac total anomalous pulmonary venous connection: A case report.

Total anomalous pulmonary venous connection (TAPVC) is a rare, cyanotic and critical congenital heart disease where the entire left and right pulmonary veins fail to drain into the left atrium directly. Also, TAPVC-induced tissue hypoxia gradually worsens after birth. Thus, timely surgical repairs are recommended once diagnosed, particularly with pulmonary venous drainage obstruction(s). Nonetheless, in sporadic cases, patients with TAPVC survive to adulthood with no surgical treatment. Herein, we report a 46-year-old female with TAPVC, where the four pulmonary veins drain into to the innominate vein (IV) via the vertical vein. The patient developed palpitations and non-anginal chest pain following routine activities for over three months. The patient had a successful surgical correction with excellent postoperative recovery.

A charged nanocomposite membrane via co-deposition of gallic acid and polyethyleneimine-silver for improving separation and antibacterial properties.

Pharmaceuticals have been continuously detected from surface water and groundwater. In order to improve the rejection performance of pharmaceuticals by a nanofiltration membrane (NF), a positively charged membrane was prepared by co-deposition of natural gallic acid and polyethyleneimine on the polyacrylonitrile hydrolysis membrane. Effects of gallic acid concentration, polyethylene imine concentration, reaction time, and the molecular weight of polyethylene imine were documented. The physical and chemical properties of the membrane were also investigated by surface morphology, hydrophilicity, surface charge, and molecular weight cut-off. The optimized membrane had a molecular weight cut-off of about 958 Da and possessed a pure water permeability of 74.21 L·m-2·h-1·MPa-1. The results exhibited salt rejection in the following order: MgCl2 > CaCl2 > MgSO4 > Na2CO3 > NaCl > Na2SO4, while the rejection ability of pharmaceuticals is as follows: amlodipine > atenolol > carbamazepine > ibuprofen, suggesting that the positively charged membrane has enhanced retention to both divalent cations and charged pharmaceuticals. In addition, the antibacterial membrane was obtained by loading silver nanoparticles onto the positively charged membrane, which greatly improved the antibacterial ability of the membrane.

Collagen IV and Podocyte-Related Gene Variants in Patients with Concurrent IgA Nephropathy and Thin Basement Membrane Nephropathy.

INTRODUCTION: IgA nephropathy is the most common primary glomerulonephritis among adults in clinic. Thin basement membrane nephropathy is often underestimated or even omitted if it coincides with IgA nephropathy. Therefore, it is necessary to study the epidemiological, clinical, and molecular characteristics of the concurrence of this entity. METHODS: Eight patients with concurrent IgA nephropathy and thin basement membrane nephropathy (IgA-T) were retrospectively analyzed based on their clinicopathological characteristics. Genetic analysis was performed using whole-exome sequencing and Sanger's sequencing. Data of the patients with IgA nephropathy and normal basement membrane (IgA-N) and variants in the local in-house database were used as controls. All candidate variants were assessed in silico. RESULTS: The clinical manifestations of patients with IgA-T were hematuria, proteinuria, and renal insufficiency. Histopathological analysis showed mild mesangial hyperplasia, focal segmental glomerulosclerosis, podocyte activation, and foot process fusion. Crescent was rarely seen. COL4A and/or podocyte cytoskeleton and mitochondria-related gene variants were detected in seven IgA-T patients. Three patients exhibited pathogenic variants of COL4A, including a new variant. All IgA-T and one IgA-N patient possessed ITGB4 and/or PLEC variants, but there was no corresponding genotype-phenotype relationship. Six patients possessed other podocyte cytoskeleton and mitochondria-related gene variants such as NPHS2, SRGAP1, MYO1E, MYO1C, WT1, and COQ9, which were first reported in patients with IgA-T and were not in controls. Altogether, there were no significant differences in the degrees of proteinuria, serum creatinine, and eGFR during the follow-up period of 5-10 years, but there was a significant difference in the degree of proteinuria between IgA-T patients with podocyte-related gene variants and IgA-N patients. In the IgA-T group, patients with podocyte-related gene variants seemed predisposed to progress than patients without those variants, with higher proteinuria and serum creatinine and reduced eGFR. CONCLUSION: Concurrent thin basement membrane nephropathy and/or heterozygous COL4A gene pathogenic variants do not necessarily predict the short-term progress of sporadic IgA nephropathy in adults. Predisposition factors for this disease progression should be considered for detecting the variants of COL4A and podocyte cytoskeleton and mitochondria-related genes simultaneously, which also manifests the complexity and heterogeneity of IgA nephropathy with concurrent thin basement membrane nephropathy.

A review on chiral metal-organic frameworks: synthesis and asymmetric applications.

Chiral metal-organic frameworks (CMOFs) have the characteristics of framework structure diversity and functional tunability, and have important applications in the fields of chiral identification, separation of enantiomers and asymmetric catalysis. In recent years, the application of CMOFs has also been extended to other research fields, such as circularly polarized fluorescence and chiral ferroelectrics. Compared with achiral MOFs, the design of CMOFs only considers the modes of introduction of chirality, and also takes into account the crystallization and purification. Therefore, the synthesis and characterization of CMOFs face many difficult challenges. This review discusses three effective strategies for constructing CMOFs, including direct synthesis of chiral ligands, spontaneous resolution of achiral ligands or chiral template-induced synthesis, and post-synthetic chiralization of achiral MOFs. In addition, this review also discusses the recent application progress of CMOFs in chiral molecular recognition, enantiomer separation, asymmetric catalysis, circularly polarized fluorescence, and chiral ferroelectrics.

A super-hydrophilic partially reduced graphene oxide membrane with improved stability and antibacterial properties.

In order to improve stability and antibacterial property, a novel super-hydrophilic partially reduced graphene oxide membrane was prepared by interfacial polymerization of piperazine and partially reduced graphene oxide as aqueous solution and trimesoyl chloride as organic solution. Fourier transform infrared spectroscopy, scanning electron microscope, and contact angle measurement were conducted to probe the morphology and properties of the membranes. The modified membrane possessed super-hydrophilicity, improved durability and swelling resistance. The optimized membrane had a molecular weight cut off of about 674 Da and possessed a pure water permeability of 49.86 L·m-2·h-1·MPa-1. The retention order of salts was Na2SO4 > MgSO4 > MgCl2 > Na2CO3 > CaCl2 > NaCl, while the rejection for four kinds of pharmaceuticals followed the order of ibuprofen (92%) > carbamazepine (87%) > amlodipine (80%) > atenolol (76%), indicating that the negatively charged membrane could improve the retention performance by the electrostatic repulsive effect. Moreover, the enhanced antibacterial performance of membrane attributed to the dual effects of the super-hydrophilicity and the tea polyphenols antibacterial material loading, which may alter the charge distribution on and within the membrane, leading to loss of cell viability.

Virtual Simulation of the Effect of FMCW Laser Fuse Detector's Component Performance Variability on Target Echo Characteristics under Smoke Interference.

The laser transmitter and photoelectric receiver are the core modules of the detector in a laser proximity fuse, whose performance variability can affect the accuracy of target detection and identification. In particular, there is no study on the effect of detector's component performance variability on frequency-modulated continuous-wave (FMCW) laser fuse under smoke interference. Therefore, based on the principles of particle dynamic collision, ray tracing, and laser detection, this paper builds a virtual simulation model of FMCW laser transmission with the professional particle system of Unity3D, and studies the effect of performance variability of laser fuse detector components on the target characteristics under smoke interference. Simulation results show that the difference in the performance of the fuse detector components causes the amplitude variation and peak migration of the beat signal spectrum, and the change in the visibility of the smoke can also affect the results, which indicates that the factors affecting the signal-to-noise ratio (SNR) of the echo signal are related to the smoke interference and performance variability of the detector. The proposed simulation model is supported by experimental results, which reflect the reliability of the proposed findings. Therefore, this study can be used for the optimization of the parameters in the laser fuse antismoke interference to avoid false alarms.

A high stability GO nanofiltration membrane preparation by co-deposition and crosslinking polydopamine for rejecting dyes.

In order to improve the stability of nanofiltration membrane in separation and purification, a novel polyelectrolyte multilayer nanofiltration membrane was facilely prepared by co-deposition of polydopamine (PDA) and polyethyleneimine (PEI) on the polyethersulfone (PES) ultrafiltration membrane substrate, followed by immersing graphene oxide (GO) solution, and crosslinking PDA. The modified surfaces were characterized using scanning electron microscopy (SEM) and atomic force microscopy (AFM), water contact angle, their saline flux and ability to reject salt and dye were determined. The results also exhibited salt rejection ability as Na2SO4 > K2SO4 > MgSO4 > NaCl > KCl > MgCl2, suggesting the higher rejection of divalent anion. Also, the retention order of the dye by the GO modified membrane is DY86 > DB19 > AG27 > DY142 > DB56 > AR151 > VB5, indicating that the GO modified membrane has better rejection of negatively charged dyes as well as higher molecular weight dyes. Ethanol and hypochlorite resistance tests under different pH conditions showed the membranes coated GO enhanced stability in regard to salt rejection properties. Significantly, the anti-biological test confirmed the growth rate of microalgae on the GO introduced membrane was decreased greatly due to enhanced stability and lower roughness.

Migraine Is Associated With High Risk of Erectile Dysfunction: A Systematic Review and Cumulative Analysis.

BACKGROUND: Migraine, a common chronic primary headache, has been found to be associated with a high risk of erectile dysfunction (ED). AIM: The present study aims to summarize all the evidence related to this topic and demonstrate a quantified result on the association between migraine and ED, which has not been reported in the literature. METHODS: MEDLINE, Excerpta Medica Database, and Cochrane Library were systematically searched for identifying the eligible studies (2000-2021). This study was registered in the PROSPERO (ID: CRD42021248013). OUTCOMES: The combined effects were synthesized with the relative risks (RR) or standard mean differences (SMD) with 95% confidence intervals (CI). RESULTS: 6 trials with a total of 51,657 participants were included, of which 6,175 were men with migraine. The pooled analysis indicated that migraine was associated with a significantly higher risk of ED as compared to the non-migraine general population (RR = 1.63, 95%CI: 1.34 to 2.0, P < .001). Consistently, men with migraine have a significantly lower IIEF-5 score than healthy controls (SMD = -3.64, 95%CI: -6.4 to -0.89, P = .01). Stratification analysis on the mean age indicated that the association between migraine and ED was much stronger in the migraine patients with age < 40 years (RR = 32.29, 95% CI: 6.41-162.64, P < .001; I2 = 0.0 %, P = .837) than in those with age > 40 years (RR = 1.75, 95% CI: 1.11-2.78, P = .017; I2 = 89.2%, P = .002). Sensitivity analysis indicated that no single study had dominated the combined RR and the heterogeneity. CLINICAL IMPLICATIONS: ED is a common disease among migraine men, especially those patients whose age is under 40 years old. It shows a 32-fold increased risk of ED compared to the healthy controls. Migraine-induced ED may be correlated with multiple factors, that is, chronic illnesses, chronic pain, and psychosocial causes (like anxiety and depression). Since phosphodiesterase-5 inhibitors (ie, sildenafil) might induce or exacerbate migraine, thus it is not recommended to prescribe these drugs for patients with migraine-mediated ED. CONCLUSION: The present study provides evidence that migraine is associated with a significantly high risk of ED, especially in those aged < 40 years. The pathophysiological mechanisms of this action deserve further study. He W, Yang Y, Liang H, et al. Migraine Is Associated With High Risk of Erectile Dysfunction: A Systematic Review and Cumulative Analysis. J Sex Med 2022;19:430-440.

Adult-onset Still's disease with multiple lymphadenopathy: a case report and literature review.

BACKGROUND: Adult-onset Still's disease (AOSD) often presents with systemic multiple lymphadenopathy. In addition to the common paracortical and mixed patterns in AOSD lymph node histopathological features, other morphological patterns include diffuse, necrotic, and follicular patterns. However, to date, there have been few reports on the histopathological description of AOSD lymph nodes. CASE PRESENTATION: An 18-year-old woman presented 2 months earlier with pain in her large joints with painless rash formation; bilateral posterior cervical lymph node, left supraclavicular lymph node, and left posterior axillary lymph node enlargement, and no tenderness. Left cervical lymph node resection was performed for pathological examination. The lymph node structure was basically preserved, and subcapsular and medullary sinus structures were observed. Many histiocytes in the sinus were observed, the cortical area was reduced, a few lymphoid follicles of different sizes were observed, and some atrophy and hyperplasia were noted. The lymphoid tissue in the paracortical region of the lymph node was diffusely proliferative and enlarged, mainly comprising histiocytes with abundant cytoplasm, immunoblasts and numerous lymphocytes with slightly irregular, small- to medium-sized nuclei. Nuclear karyorrhexis was easily observed, showing a few nuclear debris and the "starry sky" phenomenon, accompanied by abundantly branching high endothelial small vessels with few scattered plasma cells and eosinophil infiltration. Lymphoid follicle immunophenotype with reactive proliferative changes was observed. Approximately 40% of the cells in the paracortical region were positive for Ki-67, and the histiocytes expressed CD68, CD163, and some expressed S-100, with the absence of myeloperoxidase. The immunoblasts expressed CD30 and CD20, not ALK or CD15. Background small- to medium-sized T cells expressed CD2, CD3, CD5, CD7, CD4, and CD8; the number of CD8-positive T cells was slightly predominant, and a small number of T cells expressed granzyme B and T-cell intracellular antigen 1. The patient received a comprehensive medical treatment after the operation, and her condition was stable without progression at the 11-month follow-up evaluation. CONCLUSIONS: The pathological features of AOSD lymphadenopathy raises the awareness of AOSD among pathologists and clinicians and aids in the diagnosis and differential diagnosis of AOSD lymphadenopathy from other reactive lymphadenopathies (lupus lymphadenitis, etc.) and lymphomas.

A survey on acute kidney injury in severely and critically ill COVID-19 patients without chronic kidney disease.

BACKGROUND: Research has shown that acute kidney injury (AKI) has a noticeable incidence in critically ill patients with coronavirus disease 2019 (COVID-19). Patients with prior renal insufficiency are particularly susceptible to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), due to their immune dysfunction. However, most patients with COVID-19 do not have a history of kidney dysfunction, and few studies have focused on the incidence of AKI among COVID-19 patients without chronic kidney disease (CKD). In this study, we aimed to investigate the occurrence of AKI in severely and critically ill COVID-19 patients, with a particular focus on those without a CKD history. METHODS: A single-center retrospective study of 96 patients with COVID-19 in China between February 7 and March 3, 2020 was conducted. All patients were diagnosed by nucleic acid test (NAT) for SARS-CoV-2. Enrolled patients were divided into the severely or critically ill group according to the defined criteria. Patients' epidemiological, clinical, and laboratory characteristics, along with their treatment information, were collected from the medical history system. The occurrence of AKI was compared between the severe and critical patients, and between patients with or without a history of CKD. The diagnostic criteria for AKI included an increase in the serum creatinine level to ≥1.5-fold the level at baseline within 7 days according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Renal outcomes were defined as AKI or non-AKI. RESULTS: Four patients (4.2%) developed AKI, all of whom were in the critically ill group, and 3 (75%) of whom died. Out of the 90 severely and critically ill COVID-19 patients without CKD, 3 (3.3%) patients developed AKI; out of the 6 patients with CKD, 1 (16.7%) patient developed AKI. Age, disease severity, procalcitonin, C-reactive protein, and interleukin-6 were correlated with AKI onset in severely and critically ill COVID-19 patients, while lymphocyte count and estimated glomerular filtration rate at admission were inversely related to the development of AKI. CONCLUSIONS: Only 3.3% of severely and critically ill COVID-19 patients without CKD in our research cohort developed AKI. Critically ill patients may be more susceptible to AKI than severely ill patients.

A case of HIV negative cryptococcal meningitis with antiphospholipid syndrome. / HIV阴性的隐球菌性脑膜炎合并抗磷脂综合征1例.

Cryptococcal meningitis has become the largest cause for the death of infectious diseases in the central nervous system infectious disease worldwide. Most patients with cryptococcal meningitis have AIDS, autoimmune diseases, hematologic malignancies, and some other relevant diseases. It is mainly caused by infection with Cryptococcus neoformans or Cryptococcus gattii. Although the relationship between cryptococcal meningitis and autoimmune diseases, such as systemic lupus erythematosus, has been recognized, little has been studied about it. Furthermore, with the use of glucocorticoids and immunosuppressants, the incidence of cryptococcal meningitis is increasing year by year. Cryptococcal meningitis accounts for 15% of HIV-related deaths globally, compared with little research on HIV-negative cryptococcal diseases. A 54-year-old female patient with gingival bleeding was admitted to the Department of Neurology at the Second Xiangya Hospital of Central South University. The patient subsequently developed a series of central nervous system symptoms such as headache, ischemic stroke, and epilepsy. The number of thrombocytes was at 4×109/L, antinuclear antibody was (+), antihuman globulin was (++), globulin IgG anticardiolipin antibody IgG, IgA, and IgM was positive, lupus anticoagulant was strong positive, antibody against ß2 glycoprotein 1 IgM >841 AU/mL with elevated cerebrospinal fluid (CSF) pressure. The CSF India ink staining was positive, CSF was cultured cryptococcus neoformans. Antiphospholipid syndrome (APS) and cryptococcal neoformans meningitis were diagnosed. After active antifungal therapy and control of APS, the patient still had a serial of complications including high CSF pressure, persistent positive India ink staining, refractory electrolyte disturbance, hemolytic anemia recurs, heart failure, and finally death. No cases of the combination of the two diseases have been reported, and this case of cryptococcal meningitis with APS may provide a new direction to the diagnosis and treatment for this kind of disease.

Deformation and Fracture Failure of a High-Speed Long Rod Intercepted by Linear Explosively Formed Penetrators Sequence.

The fracture failure of a high-speed long rod has historically been a challenge. Since the flying plate and flying rod have a relatively low velocity, it is challenging to achieve a multi-stage fracture of the high-speed long rod within the range of existing technology. In this paper, the linear explosively formed penetrators (LEFPs) sequence with a stable flight velocity of 850 m/s were used to cut a high-speed long rod. We investigated the deformation and fracture of Φ10 mm tungsten alloy long rods having different length-diameter ratios (20, 26, 35) and different speeds (1200, 1400, 1600 m/s) by employing the LEFPs sequence with different spacings (0-40 mm) and different interception angles (30°, 60°). In the meantime, the fractured rods movement pattern was recorded with a high-speed camera to elucidate the change law of the length, speed, linear momentum, and angular momentum of fractured rods. It was found that the length loss rate of the fractured rods is as high as 27%. The fractured rods rotated around the center of mass, and the vertical speed change could reach up to 18% of the muzzle velocity of the long rod, and the greatest reduction of horizontal speed and momentum could reach 37%. The longer the interaction time between LEFPs sequence and the long rod, the more beneficial the failure of the long rod. The application of LEFPs sequence solved the difficult problem of disabling the high-speed long rod, and the quantitative analysis of the fracture failure of the long rod had an important sense for studying the terminal penetration effect of the fractured rods.

Deep Learning Method on Target Echo Signal Recognition for Obscurant Penetrating Lidar Detection in Degraded Visual Environments.

With the rapid development of autonomous vehicles and mobile robotics, the desire to advance robust light detection and ranging (Lidar) detection methods for real world applications is increasing. However, this task still suffers in degraded visual environments (DVE), including smoke, dust, fog, and rain, as the aerosols lead to false alarm and dysfunction. Therefore, a novel Lidar target echo signal recognition method, based on a multi-distance measurement and deep learning algorithm is presented in this paper; neither the backscatter suppression nor the denoise functions are required. The 2-D spectrogram images are constructed by using the frequency-distance relation derived from the 1-D echo signals of the Lidar sensor individual cell in the course of approaching target. The characteristics of the target echo signal and noise in the spectrogram images are analyzed and determined; thus, the target recognition criterion is established accordingly. A customized deep learning algorithm is subsequently developed to perform the recognition. The simulation and experimental results demonstrate that the proposed method can significantly improve the Lidar detection performance in DVE.