Aligning the domains in cross domain model inversion attack.

Model Inversion Attack reconstructs confidential training dataset from a target deep learning model. Most of the existing methods assume the adversary has an auxiliary dataset that has similar distribution with the private dataset. However, this assumption does not always hold in real-world scenarios. Since the private dataset is unknown, the domain divergence between the auxiliary dataset and the private dataset is inevitable. In this paper, we use Cross Domain Model Inversion Attack to represent the distribution divergence scenario in MIA. With the distribution divergence between the private images and auxiliary images, the distribution between the feature vectors of the private images and those of the auxiliary images is also different. Moreover, the outputted prediction vectors of the auxiliary images are also misclassified. The inversion attack is thus hard to be performed. We perform both the feature vector inversion task and prediction vector inversion task in this cross domain setting. For feature vector inversion, Domain Alignment MIA (DA-MIA) is proposed. While performing the reconstruction task, DA-MIA aligns the feature vectors of auxiliary images with the feature vectors of private images in an adversarial manner to mitigate the domain divergence between them. Thus, semantically meaningful images can be reconstructed. For prediction vector inversion, we further introduce an auxiliary classifier and propose Domain Alignment MIA with Auxiliary Classifier (DA-MIA-AC). The auxiliary classifier is pretrained by the auxiliary dataset and fine-tuned during the adversarial training stage. Thus, the misclassification problem caused by domain divergence can be solved, and the images can be reconstructed correctly. Various experiments are performed to show the advancement of our methods, the results show that DA-MIA can improve the SSIM score of the reconstructed images for up to 191%, DA-MIA-AC can increase the classification accuracy score of the reconstructed images from 9.18% to 81.32% in Cross Domain Model Inversion Attack.

Nasogastric tube versus postpyloric tube feeding for critical illness: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: Gastric tube feeding and postpyloric tube feeding are two common forms of enteral nutrition in critically ill patients. This study aimed to compare the efficacy and safety of gastric tube feeding with that of postpyloric tube feeding in critically ill patients. METHODS AND STUDY DESIGN: PubMed, Embase, and Cochrane Library were systematically searched for eligible trials from their inception until March 2023. Relative risks (RRs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were used to estimate categorical and continuous outcomes using the random-effects model. RESULTS: Sixteen trials involving 1,329 critically ill patients were selected for the final meta-analysis. Overall, we noted that gastric tube feeding showed no significant difference from post-pyloric tube feeding in mortality (p = 0.891), whereas the risk of pneumonia was significantly increased in patients who received gastric tube feeding (RR: 1.45; p = 0.021). Furthermore, we noted that gastric tube feeding was associated with a shorter time required to start feeding (WMD: -11.05; p = 0.007). CONCLUSIONS: This research revealed that initiating feeding through the gastric tube required less time compared to postpyloric tube feeding. However, it was also associated with a heightened risk of pneumonia among critically ill patients.

Joint association of sedentary time and physical activity with abnormal heart rate recovery in young and middle-aged adults.

BACKGROUND: Abnormal heart rate recovery (HRR), representing cardiac autonomic dysfunction, is an important predictor of cardiovascular disease. Prolonged sedentary time (ST) is associated with a slower HRR. However, it is not clear how much moderate-to-vigorous physical activity (MVPA) is required to mitigate the adverse effects of sedentary behavior on HRR in young and middle-aged adults. This study aimed to examine the joint association of ST and MVPA with abnormal HRR in this population. METHODS: A cross-sectional analysis was conducted on 1253 participants (aged 20-50 years, 67.8% male) from an observational study assessing cardiopulmonary fitness in Fujian Province, China. HRR measured via cardiopulmonary exercise tests on a treadmill was calculated as the difference between heart rate at peak exercise and 2 min after exercise. When the HRR was ≤ 42 beats·minute-1 within this time, it was considered abnormal. ST and MVPA were assessed by the IPAQ-LF. Individuals were classified as having a low sedentary time (LST [< 6 h·day-1]) or high sedentary time (HST [≥ 6 h·day-1]) and according to their MVPA level (low MVPA [0-149 min·week-1], medium MVPA [150-299 min·week-1], high MVPA [≥ 300 min·week-1]). Finally, six ST-MVPA groups were derived. Associations between ST-MVPA groups with abnormal HRR incidence were examined using logistic regression models. RESULTS: 53.1% of the young and middle-aged adults had less than 300 min of MVPA per week. In model 2, adjusted for possible confounders (e.g. age, sex, current smoking status, current alcohol consumption, sleep status, body mass index), HST was associated with higher odds of an abnormal HRR compared to LST (odds ratio (OR) = 1.473, 95% confidence interval (CI) = 1.172-1.852). Compared with the reference group (HST and low MVPA), the HST and high MVPA groups have a lower chance of abnormal HRR (OR, 95% CI = 0.553, 0.385-0.795). Compared with individuals with HST and low MVPA, regardless of whether MVPA is low, medium, or high, the odds of abnormal HRR in individuals with LST is significantly reduced (OR, 95% CI = 0.515, 0.308-0.857 for LST and low MVPA; OR, 95% CI = 0.558, 0.345-0.902 for LST and medium MVPA; OR, 95% CI = 0.476, 0.326-0.668 for LST and high MVPA). CONCLUSION: Higher amounts of MVPA appears to mitigate the increased odds of an abnormal HRR associated with HST for healthy young and middle-aged adults.

Pharmacokinetics and Safety of Oliceridine Fumarate Injection in Chinese Patients with Chronic Non-Cancer Pain: A Phase I, Single-Ascending-Dose, Open-Label Clinical Trial.

Background: Oliceridine is a novel G protein-biased ligand µ-opioid receptor agonist. This study aimed to assess the pharmacokinetics and safety profile of single-ascending doses of oliceridine fumarate injection in Chinese patients with chronic non-cancer pain. Methods: Conducted as a single-center, open-label trial, this study administered single doses of 0.75, 1.5, and 3.0 mg to 32 adult participants. The trial was conducted in two parts. First, we conducted a preliminary test comprising the administration of a single dose of 0.75mg to 2 participants. Then, we conducted the main trial involving intravenous administration of escalating doses of oliceridine fumarate (0.75 to 3 mg) to 30 participants. Pharmacokinetic (PK) parameters were derived using non-compartmental analysis. Additionally, the safety evaluation encompassed the monitoring of adverse events (AEs). Results: 32 participants were included in the PK and safety analyses. Following a 2-min intravenous infusion of oliceridine fumarate injection (0.75, 1.5, or 3 mg), Cmax and Tmax ranged from 51.293 to 81.914 ng/mL and 0.034 to 0.083 h, respectively. AUC0-t and half-life (t1/2) increased more than proportionally with dosage (1.85-2.084 h). Treatment emergent adverse events (TEAEs) were found to be consistent with the commonly reported adverse effects of opioids, both post-administration and as documented in the original trials conducted in the United States. Critically, no serious adverse events were observed. Conclusion: Oliceridine demonstrated comparable PK parameters and a consistent PK profile in the Chinese population, in line with the PK results observed in the original trials conducted in the United States. Oliceridine was safe and well tolerated in Chinese patients with chronic non-cancer pain at doses ranging from 0.75 mg to 3.0 mg. Trial Registration: The trial is registered at chictr.org.cn (ChiCTR2100047180).

Chidamide represses MYC expression and might improve survival for patients with double expressor lymphoma.

Double expressor lymphoma (DEL), characterized by high expressions of both MYC and BCL-2, displays poor prognosis after current therapies. The HDAC inhibitor chidamide has been approved for treatment of T cell lymphoma, but its efficacy on B cell lymphoma is unclear. Here, by combining inhibition screening and transcriptomic analyses, we found that the sensitivity of B lymphoma cells to chidamide was positively correlated with the expression levels of MYC. Chidamide treatment reduced MYC protein levels and repressed MYC pathway in B lymphoma cells with high MYC expressions. Ectopic expression of MYC in chidamide-insensitive B lymphoma cells increased their response to chidamide. Thus, we proposed that adding chidamide into R-CHOP (CR-CHOP) might be effective for DEL, and retrospectively analyzed 185 DEL patients treated in West China Hospital. 80% of patients showed response to CR-CHOP treatment. In the median follow-up of 42 months, CR-CHOP significantly improve the survival for DEL patients with R-IPI ≤2. Totally 35 patients underwent autologous stem cell transplantation (ASCT) in remission and demonstrated a trend for better survival. Combining CR-CHOP with ASCT resulted in the most superior PFS and OS above all. For response patients, CR-CHOP reduced relapse with better PFS than R-CHOP-like regimens with or without ASCT. Taken together, our data indicated that chidamide repressed the MYC pathway in B lymphoma and is potentially efficacious to treat DEL.

The Relationship Between Maternal Problematic Mobile Phone Use and Hyperactive Behavior in Preschool Children: The Moderating Effect of Family Parenting Support on Chain Mediation.

Purpose: The issue of excessive mobile phone use among mothers currently is growing increasingly significant due to the rapid growth of smartphones and other technological items. Given that women are the primary caregivers for preschool-aged children, it is imperative to thoroughly investigate the detrimental impacts of mothers' problematic mobile phone use on the hyperactive behaviors of their children, as well as the underlying mechanisms. Methods: In this study, 924 Chinese mothers and their children are surveyed. The study looks into the moderating effects of parenting support in this context as well as the chain mediating roles of mothers' parent-child interaction disorder and work-family conflict in the effects of mothers' problematic cell phone use on preschoolers' hyperactive behaviors. Analysis is conducted on the moderating impact of parental support in this as well. Results: The results find that boys have significantly higher levels of hyperactive behavior than girls; maternal problematic cell phone use significantly positively predicts preschoolers' hyperactive behavior; maternal problematic cell phone use could indirectly affect preschoolers' hyperactive behavior through the chain-mediated effects of work-family conflict and parent-child interaction disorder, and parenting support moderates the predictive effects of parent-child interaction disorder on preschoolers' hyperactive behavior. Conclusion: This study reveals potential ways in which mothers' problematic mobile phone use affects preschoolers' hyperactivity behaviors in the Chinese context. The findings provide a multidimensional (protective and risk factors) indication of how to reduce the impact of mothers' problematic mobile phone use on preschoolers' levels of hyperactivity behaviors, which would contribute to improving children's mental health. However, this is a cross-sectional study and other factors may also play an important role in this pathway.

Laparoscopic caudate lobe resections: How I do it: tips and pitfalls (with video).

BACKGROUND: The caudate lobe (S1) of the liver, due to its deep central position, presents a formidable challenge for laparoscopic resection. Historical skepticism about laparoscopic approaches has been overshadowed by advancements in technology and technique, with recent studies showing comparable outcomes to open surgery. METHODS: This paper introduces the "Easy First" technique and the Sextet strategies for laparoscopic hepatic caudate lobectomy. The strategies include meticulous preoperative planning, optimal trocar placement, and team positioning, tailored to the anatomical complexities of the caudate lobe. RESULTS: With a 0% conversion and mortality rate, our series demonstrates the safety of the "Easy First" technique. The Sextet strategies have been instrumental in navigating the technical challenges, emphasizing the importance of patient selection and surgeon expertise. CONCLUSION: The "Easy First" technique, with its structured approach and the Sextet strategies, offers a replicable method for laparoscopic caudate lobectomy. It underscores the need for stringent patient selection, advanced technical skill, and high-volume center expertise to ensure procedural success and patient safety.

Enhancing sports image data classification in federated learning through genetic algorithm-based optimization of base architecture.

Nowadays, federated learning is one of the most prominent choices for making decisions. A significant benefit of federated learning is that, unlike deep learning, it is not necessary to share data samples with the model owner. The weight of the global model in traditional federated learning is created by averaging the weights of all clients or sites. In the proposed work, a novel method has been discussed to generate an optimized base model without hampering its performance, which is based on a genetic algorithm. Chromosome representation, crossover, and mutation-all the intermediate operations of the genetic algorithm have been illustrated with useful examples. After applying the genetic algorithm, there is a significant improvement in inference time and a huge reduction in storage space. Therefore, the model can be easily deployed on resource-constrained devices. For the experimental work, sports data has been used in balanced and unbalanced scenarios with various numbers of clients in a federated learning environment. In addition, we have used four famous deep learning architectures, such as AlexNet, VGG19, ResNet50, and EfficientNetB3, as the base model. We have achieved 92.34% accuracy with 9 clients in the balanced data set by using EfficientNetB3 as the base model using a GA-based approach. Moreover, after applying the genetic algorithm to optimize EfficientNetB3, there is an improvement in inference time and storage space by 20% and 2.35%, respectively.

The TSC22D, WNK, and NRBP gene families exhibit functional buffering and evolved with Metazoa for cell volume regulation.

The ability to sense and respond to osmotic fluctuations is critical for the maintenance of cellular integrity. We used gene co-essentiality analysis to identify an unappreciated relationship between TSC22D2, WNK1, and NRBP1 in regulating cell volume homeostasis. All of these genes have paralogs and are functionally buffered for osmo-sensing and cell volume control. Within seconds of hyperosmotic stress, TSC22D, WNK, and NRBP family members physically associate into biomolecular condensates, a process that is dependent on intrinsically disordered regions (IDRs). A close examination of these protein families across metazoans revealed that TSC22D genes evolved alongside a domain in NRBPs that specifically binds to TSC22D proteins, which we have termed NbrT (NRBP binding region with TSC22D), and this co-evolution is accompanied by rapid IDR length expansion in WNK-family kinases. Our study reveals that TSC22D, WNK, and NRBP genes evolved in metazoans to co-regulate rapid cell volume changes in response to osmolarity.

Pedobacter deserti sp. nov., a novel species isolated from desert soil.

An aerobic, Gram-stain-negative bacterium, designated as SYSU D00382T, was sourced from soil of Gurbantunggut Desert, PR China. The strain was short-rod-shaped, oxidase-positive and catalase-negative, with yellow-colored, convex, round, and smooth colonies on TSA plate. Growth and proliferation occurred at 4-37 °C (optimal: 28-30 °C), pH 5.0-8.0 (optimal: pH 6.0-7.0) and NaCl concentration of 0-2.5% (optimal: 0-0.5%). The 16S rRNA gene based phylogenetic assessment showed that SYSU D00382T belonged to the genus Pedobacter, and was most closely related to Pedobacter ginsengisoli Gsoil 104T with similarity of 97.7%. The genomic DNA G+C content of SYSU D00382T was 46.4%. The average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) values between SYSU D00382T and P. ginsengisoli Gsoil 104T were 75.7% and 17.5%, respectively. The main polar lipid was phosphatidylethanolamine. The major fatty acids (> 5%) were iso-C15:0, iso-C17:0 3-OH, summed features 3 and 9. The sole respiratory quinone identified was MK-7. The phylogeny based on 16S rRNA gene and whole-genome sequences revealed that SYSU D00382T formed a robust lineage with P. ginsengisoli Gsoil 104T. Based on phenotypic, phylogenetic and genotypic data, a novel specie named Pedobacter deserti sp. nov. is proposed. The type strain is SYSU D00382T (= CGMCC 1.18627T = MCCC 1K04972T = KCTC 82279T).

Differentiation of benign and malignant lesions in Bethesda III and IV thyroid nodules via dual-energy computed tomography quantitative parameters and morphologic features.

Background: Thyroid nodules (TNs) cytologically defined as category Bethesda III and IV pose a major diagnostic challenge before surgery, demanding new methods to reduce unnecessary diagnostic thyroid lobectomies for patients with benign TNs. This study aimed to assess whether a model combining dual-energy computed tomography (DECT) quantitative parameters with morphologic features could reliably differentiate between benign and malignant lesions in Bethesda III and IV TNs. Methods: Data from 77 patients scheduled for thyroid surgery for Bethesda III and IV TNs (malignant =48; benign =29) who underwent DECT scans were reviewed. DECT quantitative parameters including normalized iodine concentration (NIC), attenuation on the slope of spectral Hounsfield unit (HU) curve, and normalized effective atomic number (Zeff) were measured in the arterial phase (AP) and venous phase (VP). DECT quantitative parameters and morphologic features were compared between the malignant and benign cohorts. The receiver operating characteristic curve was performed to compare the performances of significant DECT quantitative parameters, morphologic features, or the models combining the DECT parameters, respectively, with morphologic features. A nomogram was constructed from the optimal performance model, and the performance was evaluated via the calibration curve and decision curve analysis. Results: The areas under the receiver operating characteristic curve with 95% confidence interval (CI) of the NIC in the AP (AP-NIC), slope of spectral HU curve in the AP, and NZeff in the AP were 0.749 (95% CI: 0.641-0.857), 0.654 (95% CI: 0.530-0.778), and 0.722 (95% CI: 0.602-0.842), respectively. The model combining AP-NIC with enhanced blurring showed the highest diagnostic performance, with an area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of 0.808, 0.854, and 0.655, respectively; it was then used to construct a nomogram. The calibration curve showed that the discrepancy between the prediction of the nomogram and actual observations was less than 5%. The decision curve analysis indicated the nomogram had a positive net benefit in threshold risk ranges of 14% to 58% or 60% to 91% for malignant Bethesda III and IV TNs. Conclusions: The model combining AP-NIC with enhanced blurring could reliably differentiate between benign and malignant lesions in Bethesda III and IV TNs.

Cross-sectional study of hepatitis B virus infection in female breast cancer patients in China for the first time diagnosed.

BACKGROUND: The correlation between breast cancer and hepatitis B virus (HBV) remains inconclusive. This study aims to explore the serological status of HBV infection and past infection in different age groups of female breast cancer patients, patients with benign breast diseases, and individuals undergoing routine physical examinations. METHODS: Serum data on HBV serological markers were collected and analyzed from 6072 female breast cancer patients first diagnosed from September 2012 to July 2020 at the First Affiliated Hospital of Chongqing Medical University, along with 4019 women with benign breast diseases and 54,740 healthy females undergoing routine physical examinations in the same period. The data were stratified by age for comparison between groups. RESULTS: The prevalence of HBV infection and past infection in the breast cancer group (7.9%, 55.1%) was higher than that in the benign breast disease group (6.5%, 39.1%) and the healthy females group(5.0%, 17.6%);the rate of only HBV surface antibody positivity (HBsAb ( +)) in the breast cancer group (10.3%) was lower than that in the benign breast disease group (26.9%) and the healthy females group (49.2%), with significant differences between the three groups (p < 0.05). Stratified by age, the prevalence of HBV infection in the breast cancer group (8%, 8.9%) and benign breast disease group (7.75%, 8.1%)was higher than that in the healthy females group (4.5%, 6.3%) in the 30-39 and 40-49 age group, respectively. The past infection rate of HBV in the breast cancer group (24.8%, 45.0%) was higher than that in the benign breast disease group (16.1%, 35.4%) in the ≤ 29 and 30-39 age group, respectively.. The past infection rate of HBV in the breast cancer group was higher than that in the healthy females group in all age groups, while the rate of only HBsAb ( +) in the breast cancer group was lower than that in the benign breast disease group and the routine physical examination group in all age groups. CONCLUSIONS: Breast cancer women and women with benign breast diseases have higher rates of hepatitis B virus infection and previous infections, with more significant differences among middle-aged women. Breast cancer women and women with benign breast diseases have lower rates of only HBsAb ( +) for HBV.

A 10-year mono-center study on patients with burns ≥70% TBSA: prediction model construction and multi-center validation: retrospective cohort.

BACKGROUND: Burn injuries with ≥70% total body surface area (TBSA) are especially acute and life-threatening, leading to severe complications and terrible prognosis, while a powerful model for prediction of overall survival (OS) is lacked. The objective of this study is to identify prognostic factors for the OS of patients with burn injury ≥70% TBSA, construct and validate a feasible predictive model. MATERIALS AND METHODS: Patients diagnosed with burns ≥70% TBSA admitted and treated between 2010 and 2020 in our hospital were included. A cohort of the patients from the Kunshan explosion were assigned as the validation set. The Chi-square test and K-M survival analysis were conducted to identify potential predictors for OS. Then, multi-variate Cox regression analysis was performed to identify the independent factors. Afterwards, we constructed a nomogram to predict OS probability. Finally, the Kunshan cohort was applied as an external validation set. RESULTS: Gender, the percentage of third- and fourth-degree burn as well as organ dysfunction were identified as significant independent factors. A nomogram only based on the factors of the individuals was built and evidenced to have promising predictive accuracy, accordance, and discrimination by both internal and external validation. CONCLUSIONS: This study recognized significant influencing factors for the OS of patients with burns ≥70% TBSA. Furthermore, our nomogram proved to be an effective tool for doctors to quickly evaluate patients' outcomes and make appropriate clinical decisions at an early stage of treatment.

Downstream Emergency Department and Hospital Utilization Comparably Low Following In-Person Versus Telemedicine Primary Care for High-Risk Conditions.

BACKGROUND: Telemedicine use expanded greatly during the COVID-19 pandemic. More data is needed to understand how this shift may impact other venues of acute care delivery. OBJECTIVE: We evaluate the association of visit modality (telephone, video, or office) and downstream emergency department (ED) and hospital visits among primary care visits for acute, time-sensitive conditions. DESIGN: Observational study of patient-scheduled primary care telemedicine and office visits for acute conditions (cardiac, gastrointestinal, neurologic, musculoskeletal, and head and neck) in a large, integrated healthcare delivery system. PARTICIPANTS: Adults with a new self-booked primary care appointment for an eligible acute condition from January 1, 2022, to December 31, 2022 (with no primary care, ED, or hospital visits in prior 30 days). INTERVENTIONS: Visit modality, including office, video, or telephone. MAIN MEASURES: Seven-day ED and hospital utilization, adjusted for patient and visit characteristics. KEY RESULTS: Among 258,958 primary care visits by 239,240 adult patients, 57.7% were telemedicine visits; of these, 72.4% were telephone and 27.6% were video. Telephone visits were the timeliest, with over 70% of visits scheduled within 1 day of booking. Rates of 7-day ED utilization were low, and varied by condition group, with cardiac visits having the highest rates (4.8%) and musculoskeletal visits having the lowest (0.8%). There was less than a 1% absolute difference in ED use by visit modality for all condition types; however, telephone visits were associated with slightly higher rates than video visits. The 7-day hospitalization rate was less than 1% and observed between visit type differences varied by clinical condition. CONCLUSIONS: Among office, telephone, and video visits in primary care for potentially high-risk, time-sensitive conditions, downstream ED and hospital use were uncommon. ED utilization was lower for video visits than telephone visits, although telephone visits were timelier and may offer a safe and accessible option for acute care.

Establishing Virtual Bioequivalence and Clinically Relevant Specifications for Omeprazole Enteric-Coated Capsules by Incorporating Dissolution Data in PBPK Modeling.

Currently, Biopharmaceutics Classification System (BCS) classes I and III are the only biological exemptions of immediate-release solid oral dosage forms eligible for regulatory approval. However, through virtual bioequivalence (VBE) studies, BCS class II drugs may qualify for biological exemptions if reliable and validated modeling is used. Here, we sought to establish physiologically based pharmacokinetic (PBPK) models, in vitro-in vivo relationship (IVIVR), and VBE models for enteric-coated omeprazole capsules, to establish a clinically-relevant dissolution specification (CRDS) for screening BE and non-BE batches, and to ultimately develop evaluation criteria for generic omeprazole enteric-coated capsules. To establish omeprazole's IVIVR based on the PBPK model, we explored its in vitro dissolution conditions and then combined in vitro dissolution profile studies with in vivo clinical trials. The predicted omeprazole pharmacokinetics (PK) profiles and parameters closely matched the observed PK data. Based on the VBE results, the bioequivalence study of omeprazole enteric-coated capsules required at least 48 healthy Chinese subjects. Based on the CRDS, the capsules' in vitro dissolution should not be < 28%-54%, < 52%, or < 80% after two, three, and six hours, respectively. Failure to meet these dissolution criteria may result in non-bioequivalence. Here, PBPK modeling and IVIVR methods were used to bridge the in vitro dissolution of the drug with in vivo PK to establish the BE safety space of omeprazole enteric-coated capsules. The strategy used in this study can be applied in BE studies of other BCS II generics to obtain biological exemptions and accelerate drug development.

Unlocking 4.9 V Quasi-Solid-State Lithium Metal Battery via Solvent Screening and Interfacial Manipulation.

Parlous structure integrity of the cathode and erratic interfacial microdynamics under high potential take responsibility for the degradation of solid-state lithium metal batteries (LMBs). Here, high-voltage LMBs have been operated by modulating the polymer electrolyte intrinsic structure through an intermediate dielectric constant solvent and further inducing the gradient solid-state electrolyte interphase. Benefiting from the chemical adsorption between trimethyl phosphate (TMP) and the cathode, the gradient interphase rich in LiPFxOy and LiF is induced, thereby ensuring the structural integrity and interface compatibility of the commercial LiNi0.8Co0.1Mn0.1O2 (NCM811) cathode even at the 4.9 V cutoff voltage. Eventually, the specific capacity of NCM811|Li full cell based on TMP-modulated polymer electrolyte increased by 27.7% from 4.5 to 4.9 V. Such a universal screening method of electrolyte solvents and its derived electrode interfacial manipulation strategy opens fresh avenues for quasi-solid-state LMBs with high specific energy.

Real-time breath gas analysis of methane using a multipass cell-based near-infrared gas sensor.

We demonstrated a near-infrared exhaled breath sensor for real-time methane measurements by using tunable diode laser absorption spectroscopy (TDLAS), which can enable the noninvasive diagnosis of intestinal tract problems. The core component of the near-infrared TDLAS sensor is a two-mirror-based multipass cell with nine-circle patterns. An optical path length of 23.4 m was achieved in a volume of 233.3 cm3, which effectively improved the detection sensitivity and shortened the gas exchange time. The minimum detection limit was 0.37 ppm by applying wavelength modulation spectroscopy, which was 12.4 times greater than that of direct absorption spectroscopy. In addition, combined with wavelength modulation spectroscopy, the two-mirror-based multipass cell enabled sub-second gas exchange time of 0.6 s. Methane breath experiments were conducted with six volunteers, and the real-time measurement results and concentrations at the end of exhalation were analyzed. This study demonstrates that the developed sensor has high sensitivity, high selectivity, and fast response for breath methane measurements and has promising potential for noninvasive, real-time, and point-of-care disease diagnosis in clinical applications.

Evaluation on LED lighting driving power supply for urban rail vehicles based on adaptive PID algorithm.

LED (Light Emitting Diode) lighting has the characteristics of efficiency, environmental protection, energy conservation, and so on. It is more and more widely used in the lighting system of urban rail vehicles. The research on the LED lighting system of rail vehicles has important practical significance. As the core of the LED lighting system of rail vehicles, the LED control system of urban rail vehicles is the key to ensure the stable operation of the entire LED lighting system. The lighting environment of urban rail vehicles needs LED lighting system with good power stability, long life of drive chip, high feedback accuracy, fast processing speed, intelligent algorithm efficiency and other characteristics to ensure continuous operation, and also should have strong anti-interference ability and excellent static performance. However, conventional lighting systems not only have low life, but also have poor stability. Therefore, this paper studied the uniqueness and functional module analysis of LED driving power supply by analyzing the causes and disadvantages of LED lighting, and finally optimized the design of LED lighting control system by using the adaptive PID (Proportional Integral Differential) algorithm. Through comparison, the brightness acquisition quality of LED lighting control system was 21.2 % higher than that of traditional lighting control system, and the lighting control effect was 18 % higher than that of traditional lighting control system. In short, the selection of LED lighting driving power affects the lighting effect of rail vehicles.

Primary Care Telemedicine and Care Continuity: Implications for Timeliness and Short-term Follow-up Healthcare.

BACKGROUND: The effectiveness of telemedicine by a patient's own primary care provider (PCP) versus another available PCP is understudied. OBJECTIVE: Examine the association between primary care visit modality with timeliness and follow-up in-person healthcare, including variation by visits with the patient's own PCP versus another PCP. DESIGN AND PARTICIPANTS: Cohort study including primary care visits in a large, integrated delivery system in 2022. MEASURES: Outcomes included timeliness (visit completed within 7 days of scheduling) and in-person follow-up (PCP visits, emergency department (ED) visits, hospitalizations) within 7 days of the index PCP visit. Logistic regression measured the association between visit modality (in-person, video, and audio-only telemedicine) with the patient's own PCP or another PCP and outcomes, adjusting for characteristics. KEY RESULTS: Among 4,817,317 primary care visits, 59% were in-person, 27% audio-only, and 14% video telemedicine. Most (71.3%) were with the patient's own PCP. Telemedicine visits were timelier, with modality having a larger association for visits with patient's own PCP versus another PCP (P < 0.001). For visits with patient's own PCPs, return office visit rates were 1.2% for in-person, 5.3% for video, and 6.1% for audio-only. For another PCP, rates were 2.2% for in-person, 7.3% for video, and 8.1% for audio. Follow-up ED visits ranged from 1.4% (in-person) to 1.6% (audio-only) with own PCP, compared to 1.9% (in-person) to 2.3% (audio-only) with another PCP. Differences in return office and ED visits between in-person and telemedicine were larger for visits with another PCP compared to their own PCP (P < 0.001). Follow-up hospitalizations were rare, ranging from 0.19% (in-person with own PCP) to 0.32% (video with another PCP). CONCLUSION: Differences in return office and ED visits between in-person and telemedicine were larger when patients saw a less familiar PCP compared to their own PCP, reinforcing the importance of care continuity.