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Background: The scarcity of sepsis epidemiologic data from most low- and middle-income countries (LMICs) hampered estimation of regional and global burden of the disease, and provided limited guidance for policy makers. We aimed to characterize and analyze the temporal trends of sepsis-related mortality in China, by population groups, underlying causes of death, geographic regions, and sociodemographic index (SDI) levels. Methods: Sepsis-related deaths were identified from the National Mortality Surveillance System (NMSS) of China from 2006 to 2020. Trends of sepsis-related mortality and years of life lost (YLLs), stratified by age, sex, underlying diseases, and regions were analyzed using the Jointpoint regression analysis. We investigated the association of SDI with trends of sepsis-related mortality. Results: In 2020, sepsis was estimated to be responsible for 986,929 deaths and 17.1 million YLLs in China. Age-standardized sepsis-related mortality significantly declined from 130.2 (95%CI, 129.4–131) per 100,000 population in 2006 to 76.6 (76.3–76.9) in 2020. Age-standardized YLLs decreased from 2172.7 (2169.4–2176) per 100,000 population in 2006 to 1271 (1269.8–1272.2) in 2020. Substantial variations of sepsis-related mortality and YLLs were observed between population groups and regions, with higher burden in males, the elderly, and western China. An inverse relation was noted between SDI and sepsis-related mortality or YLLs. Conclusions: Despite declining trends of age-standardized mortality and YLLs of sepsis in China, significant disparities between population groups and regions highlight a need for targeted policies and measures to close the gaps and improve the outcome of sepsis. [ABSTRACT FROM AUTHOR]

Novel ZrSn1−xCoxO4−δ catalysts for the direct decomposition of nitrous oxide (N2O) were synthesized using a co‐precipitation method. Metastable ZrSnO4 with an α‐PbO2‐type structure was used as the mother solid because of its interstitial open spaces derived from its lattice distortion that may be effective for N2O adsorption. The doping of Co2+/3+ into the ZrSnO4 lattice improved the N2O decomposition activity, likely owing to the enhancement of the redox properties and the increase in the number of oxygen vacancies. Among the prepared catalysts, Zr1.17Sn0.73Co0.10O4−δ exhibited the highest activity decomposing N2O completely decomposed at 550°C. In addition, the Zr1.17Sn0.73Co0.10O4−δ catalyst showed high durability in the presence of CO2, O2, and H2O vapor. [ABSTRACT FROM AUTHOR]

High entropy carbide ceramics possess high hardness but suffer from low toughness and densification challenges. A dense (ZrNbTiCrV)C composite coating was fabricated through spraying ZrO 2 -Nb 2 O 5 -TiO 2 -Cr 2 O 3 -V 2 O 5 -Al-SiC powders, which was subsequently compared to a (ZrNbTiCrV)C coating produced from binary carbides. Incorporating the V element facilitated the densification and element diffusion. The coating obtained via spraying ZrO 2 -Nb 2 O 5 -TiO 2 -Cr 2 O 3 -V 2 O 5 -Al-SiC powders exhibited superior mechanical properties and wear resistance, particularly achieving a 17.2 % increase in fracture toughness and a 73.3 % reduction in wear rate compared to the coating derived from binary carbides. These improved properties were attributed to fine-grained particles and a low porosity of 1.56 %. Wear resistance was also enhanced through rolling friction and the formation of a protective oxide film. • A dense (ZrNbTiCrV)C composite coating was synthesized successfully. • The microhardness of (ZrNbTiCrV)C composite coating reached 1321 HV 0.1. • (ZrNbTiCrV)C particles were beneficial to mechanical properties and wear resistance. • Oxide film also helped to improve the wear resistance. [ABSTRACT FROM AUTHOR]

Background: The US Centers for Disease Control and Prevention (CDC) recently released simplified eSOFA organ dysfunction criteria of Adult Sepsis Event for sepsis surveillance in the US. Our study aimed to compare the prevalence, characteristics, and outcomes of sepsis patients identified by eSOFA criteria versus Sequential Organ Failure Assessment (SOFA) Score (Sepsis-3) and assess the external validity of eSOFA criteria in China. Methods: We conducted a retrospective cohort study of adult residents of Yuetan Subdistrict, Beijing, China, who were hospitalized from July 1, 2012 to June 30, 2014. Among patients with infection, sepsis was identified if there was a concurrent rise in SOFA score by 2 or more points (Sepsis-3) or the presence of 1 or more eSOFA criteria: vasopressor initiation, mechanical ventilation initiation, doubling in creatinine, doubling in bilirubin to 2.0 mg/dL or above, 50% or greater decrease in platelet count to less than 100 cells/μL, or lactate equal to or above 2.0 mmol/L. Areas under the receiver operating characteristic curves (AUROCs) for in-hospital mortality were compared between sepsis patients detected by the two criteria, adjusting for baseline characteristics. Results: Of 1716 hospitalized patients with infection, 935 (54.5%) met Sepsis-3 criteria, 573 (33.4%) met eSOFA criteria, while 475 (27.7%) met both criteria. Demographic and clinical characteristics of sepsis patients meeting Sepsis-3 or eSOFA criteria were similar. In-hospital mortality was higher with eSOFA criteria versus Sepsis-3 (46.6% vs. 32.0%, p < 0.001). eSOFA criteria had high PPV (82.9%), but low sensitivity (50.8%) for the diagnosis of Sepsis-3. Patients meeting both criteria had the highest in-hospital mortality rate (52.8%, all p < 0.001), while patients who only met eSOFA criteria had higher mortality rate than those meeting Sepsis-3 alone (16.3% vs. 10.4%, p = 0.097). The predicted probability for in-hospital mortality was higher with eSOFA criteria versus Sepsis-3 (AUROC 0.830 vs. 0.795, p = 0.001) adjusting for baseline characteristics. Conclusions: The CDC Adult Sepsis Event's eSOFA criteria identify a smaller, more severely ill cohort of sepsis patients with similar demographic and clinical characteristics as the more complex Sepsis-3 SOFA score. These results suggest similar performance of eSOFA criteria across diverse populations, with low sensitivity and high specificity for the diagnosis of Sepsis-3. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the genetic variation of poly (ADP-ribose) polymerase-1 (PARP-1) as risk factor in development of Graves' disease (GD) and Graves' ophthalmopathy (GO) among Chinese individuals. Patients with confirmed diagnosis of GD or healthy individuals with no clinical symptoms of hyperthyroiditis were enrolled at the Department of Ophthalmology, Tianjin First Center Hospital, China. Genetic polymorphism was studied in plasma DNA samples of subjects by polymerase chain reaction of restriction fragment length polymorphism to confirm our hypothesis. Cytokine levels were measured routinely on serum samples of subjects by sandwich ELISA technique. Patients with GG genotype (odds ratio (OR) 95% CI = 2.25 (1.35-3.73), p = 0.002) and carriers of G allele (OR = 2.03 (1.23-3.36), p = 0.006) were at high risk of developing ophthalmopathy. Polymorphism of del/ins of nuclear factor-κB1 gene (NFkB1) gene (OR = 7.1 (2.88-17.52), p < 0.0001) and PARP-1 C410T polymorphism was found to be associated with GO ( p < 0.05). Cytokine level was significantly higher in patients with GD ( p < 0.05), but no significant change in cytokines level among GO patients from baseline ( p > 0.05). Our study results recommended that polymorphism of PARP-1 gene is more likely responsible for development of GD in Chinese individuals. We also observed that the polymorphism of gene-related del/ins to NFkB1 in development of GO. [ABSTRACT FROM AUTHOR]

In the field of music composition, creating polyphony is relatively one of the most difficult parts. Among them, the basis of multivoice polyphonic composition is two-part counterpoint. The main purpose of this paper is, through the computer technology, conducting a series of studies on “Two-Part Inventions” of Bach, a Baroque polyphony master. Based on digitalization, visualization and mathematical methods, data mining algorithm has been applied to identify bipartite characteristics and rules of counterpoint polyphony. We hope that the conclusions drawn from the article could be applied to the digital creation of polyphony. [ABSTRACT FROM AUTHOR]

Certain amount of primary amine (NH) groups of hyperbranched polyethylenimine (HPEI) was first protected by Boc groups. Subsequently, the residual reactive amine groups were reacted with isobutyric anhydride to introduce isobutyramide (IBAm) groups to HPEI. Finally, Boc groups were deprotected to result in HPEI-IBAm-NH with 18% of primary amine terminals on the periphery and 80% of IBAm terminal groups (abbreviated as HPEI-IBAm-NH). H-NMR characterization proved the successful preparation of the product in each step. Compared with its spatial isomer HPEIIBAm without primary amine groups, H-NMR spectra verified that more IBAm groups were located in the interior of HPEI-IBAm-NH. The further modification of HPEI-IBAm-NH and HPEI-IBAm with p-nitrobenzaldehyde demonstrated that HPEI-IBAm-NH was more reactive than HPEI-IBAm due to its possession of primary amines. Turbidimetry measurements showed that HPEI-IBAm-NH was thermoresponsive in water. In the pH range of 9.5-10 its cloud point temperature ( T) was constant, and it increased obviously upon decreasing the pH below 9.5. The thermoresponsive HPEI-IBAm exhibited the similar trend, but the pH threshold to achieve the constant T was around 8.5. Moreover, HPEI-IBAm-NH showed higher T and broader phase transition than HPEI-IBAm. The mechanism leading to the different thermoresponsive properties between HPEI-IBAm-NH and its spatial isomer HPEI-IBAm was discussed. [ABSTRACT FROM AUTHOR]

The development of potassium‐ion batteries (KIBs) relies on the exploration of stable layer‐structured oxide cathode materials and a comprehensive understanding of ion storage and diffusion behaviors. A multiphase riveting‐structured O3/P2/P3‐Na0.9[Ni0.3Mn0.55Cu0.1Ti0.05]O2 (Tri‐NMCT) is employed as cathode material for KIBs. It demonstrates an initial discharge specific capacity of 108 mA g−1 at current density of 15 mA g−1 in the voltage range of 1.5–4 V. Excellent cyclic stability is exhibited as well with a high 83% capacity retention after 600 cycles at a higher current density of 300 mA g−1. Based on the in‐situ XRD, it reveals that the P2 phase offers a more stable triangular prism site compared to the O3 phase. This stability inhibits the undesired phase transition from P3 to O3 during discharge, thereby ensuring the long‐term cyclic performance. Furthermore, Density of state (DOS) calculations and migration barrier analyses indicate a preferential migration of K+ ions to the P2 phase due to the lower Fermi level. This observation elucidates the structural preservation of the P3 phase during K+ embedding. Overall, this work sheds light on Tri‐NMCT as a promising cathode material for advanced KIBs. [ABSTRACT FROM AUTHOR]

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Atrial fibrillation (AF) is the most common arrhythmia and its incidence increases with sepsis. However, data on new-onset AF during sepsis hospitalization remain limited in China. We aimed to evaluate the incidence, risk factors, and associated mortality of new-onset AF in sepsis patients in China. We conducted a retrospective study using the National Data Center for Medical Service system, from 1923 tertiary and 2363 secondary hospitals from 31 provinces in China from 2017 to 2019.In total we included 1,425,055 sepsis patients ≥ 18 years without prior AF. The incidence of new-onset AF was 1.49%. Older age, male sex, hypertension, heart failure, coronary disease, valvular disease, and mechanical ventilation were independent risk factor. New-onset AF was associated with a slight increased risk of mortality (adjusted RR 1.03, 95% CI 1.01–1.06). Population attributable fraction suggested AF accounted for 0.2% of sepsis deaths. In this large nationwide cohort, new-onset AF occurred in 1.49% of sepsis admissions and was associated with a small mortality increase. Further research should examine whether optimized AF management can improve sepsis outcomes in China. [ABSTRACT FROM AUTHOR]

Background: Serum Krebs von den Lungen‐6 (KL‐6) has been reported to be elevated in patients with idiopathic pulmonary fibrosis (IPF). Objective: The aim of this study was to evaluate the diagnostic value of KL‐6 and whether the expression value of KL‐6 could indicate the severity of the disease in IPF patients. To address this question, it is necessary to see whether the patients' physical characteristics and other clinical conditions could affect the baseline KL‐6 level. Design We conducted a study of 100 patients who were diagnosed with IPF. Lung function, computed tomography (CT), and serological lab tests data were analyzed. Results: The tests showed that there is a significant elevation of KL‐6 in IPF patients compared with other interstitial lung disease (ILD) and healthy controls. It was noted that serum KL‐6 is a stable biomarker not affected by lung infection and smoking, though IPF patients with antinuclear antibody (ANA) showed higher KL‐6 levels. KL‐6, in conjunction with poor pulmonary function and higher radiological fibrosis scores, indicates the severity of the disease but not poor survival. Conclusions: It is identified that serum KL‐6 is a useful noninvasive biomarker to help improve the certainty of IPF diagnosis from other interstitial lung disease and assist evaluation of disease severity and prognosis. [ABSTRACT FROM AUTHOR]

Introduction: The impact of immunosuppression on prognosis of carbapenem-resistant organism (CRO) bloodstream infection (BSI) remains unclear. The aim of this study was to clarify the relationship between immunosuppression and mortality of CRO-BSI and to identify the risk factors associated with mortality in immunosuppressed patients. Methods: This retrospective study included 279 patients with CRO-BSI from January 2018 to March 2023. Clinical characteristics and outcomes were compared between the immunosuppressed and immunocompetent patients. The relationship between immunosuppression and 30-day mortality after BSI onset was assessed through logistic-regression analysis, propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Factors associated with mortality in immunosuppressed patients were analyzed using multivariable logistic regression analysis. Results: A total of 88 immunocompetent and 191 immunosuppressed patients were included, with 30-day all-cause mortality of 58.8%. Although the 30-day mortality in immunosuppressed patients was significantly higher than in immunocompetent patients (46.6% vs. 64.4%, P = 0.007), immunosuppression was not an independent risk factor for mortality in multivariate logistic regression analysis (odds ratio [OR] 3.53, 95% confidence interval [CI] 0.74–18.89; P = 0.123), PSM (OR 1.38, 95% CI 0.60–3.18; P = 0.449,) or IPTW (OR 1.40, 95% CI 0.58–3.36; P = 0.447). For patients with CRO-BSI, regardless of immune status, appropriate antibiotic therapy was associated with decreased 30-day mortality, while Charlson comorbidity index (CCI), intensive care unit (ICU)-acquired infection and thrombocytopenia at CRO-BSI onset were associated with increased mortality. Conclusion: Despite the high mortality rate of CRO-BSI, immunosuppression did not affect the mortality. Appropriate antibiotic therapy is crucial for improving the prognosis of CRO-BSI, regardless of the immune status. [ABSTRACT FROM AUTHOR]

Although the suspension gap between a maglev train and its track is narrow, it has a significant impact on the aerodynamic performance of the train. This study investigated the effect of the suspension gap on the wake flow of a superconducting maglev train traveling at a speed of 600 km/h by comparing the aerodynamics and flow field structure of a tail car (TC) with suspension gaps of 8, 10, 12, and 14 cm. The results showed that with increasing suspension gap, the vortex structures in the wake region move closer to the TC, the airflow from the suspension gap inhibits the high-pressure region of the wake, and the pressure and velocity fluctuations significantly increase near the nose tip of the TC. Moreover, the suspension gap was found to have a significant impact on lift and almost no effect on drag. Increasing the suspension gap leads to a balance in the lift between the head car (HC) and the TC; as the gap continues to increase, the lift ratio of the HC and TC rapidly decreases. [ABSTRACT FROM AUTHOR]

Background: Tissue oxygen saturation (StO2) decrease could appear earlier than lactate alteration. However, the correlation between StO2 and lactate clearance was unknown. Methods: This was a prospective observational study. All consecutive patients with circulatory shock and lactate over 3 mmol/L were included. Based on the rule of nines, a BSA (body surface area) weighted StO2 was calculated from four sites of StO2 (masseter, deltoid, thenar and knee). The formulation was as follows: masseter StO2 × 9% + (deltoid StO2 + thenar StO2) × (18% + 27%)/ 2 + knee StO2 × 46%. Vital signs, blood lactate, arterial and central venous blood gas were measured simultaneously within 48 h of ICU admission. The predictive value of BSA-weighted StO2 on 6-hour lactate clearance > 10% since StO2 initially monitored was assessed. Results: A total of 34 patients were included, of whom 19 (55.9%) had a lactate clearance higher than 10%. The mean SOFA score was lower in cLac ≥ 10% group compared with cLac < 10% group (11 ± 3 vs. 15 ± 4, p = 0.007). Other baseline characteristics were comparable between groups. Compared to non-clearance group, StO2 in deltoid, thenar and knee were significantly higher in clearance group. The area under the receiver operating curves (AUROC) of BSA-weighted StO2 for prediction of lactate clearance (0.92, 95% CI [Confidence Interval] 0.82-1.00) was significantly higher than StO2 of masseter (0.65, 95% CI 0.45–0.84; p < 0.01), deltoid (0.77, 95% CI 0.60–0.94; p = 0.04), thenar (0.72, 95% CI 0.55–0.90; p = 0.01), and similar to knee (0.87, 0.73-1.00; p = 0.40), mean StO2 (0.85, 0.73–0.98; p = 0.09). Additionally, BSA-weighted StO2 model had continuous net reclassification improvement (NRI) over the knee StO2 and mean StO2 model (continuous NRI 48.1% and 90.2%, respectively). The AUROC of BSA-weighted StO2 was 0.91(95% CI 0.75-1.0) adjusted by mean arterial pressure and norepinephrine dose. Conclusions: Our results suggested that BSA-weighted StO2 was a strong predictor of 6-hour lactate clearance in patients with shock. [ABSTRACT FROM AUTHOR]

• Coupling analysis of blockchain technology and electricity trading. • Multi-microgrid transaction model based on blockchain. • Using ant colony algorithm to solve multi-microgrid power market transaction model to obtain local optimal electricity price. • Establish a detailed solution process for multi-microgrid power transactions based on blockchain technology. As a new distributed generation system, multi-microgrid is an important part of Energy Internet. There are a series of problems in the selection of generation resources and power trading which includes obvious concentration, fairness and low credibility. Aiming at the shortcomings of microgrid in real-time electricity trade, a multi-microgrid electricity bidding trading model based on blockchain technology is proposed. A competitive spot market with distributed "multi-seller and multi-buyer" is constructed to realize the integration of "source-sale". This paper compares the traditional trading mode with the power trading mode supported by blockchain technology. In addition, this paper establishes a blockchain-based multi-microgrid power trading model, and uses ant colony algorithm random bidding matching to achieve multi-objective optimization. Through the whole process, the unification of energy flow, information flow and currency flow are realized. Finally, the reasonable allocation of power resources and the openness and transparency of power trading are ensured. [ABSTRACT FROM AUTHOR]

Coherent structures in surrounding flows around ground vehicles play an important role in characterizing their aerodynamic features. However, due to restrictions of traditional reduced-order models, extracting physically meaningful coherent structures from turbulent flows with massive separation still remains a challenging issue. The spectral proper orthogonal decomposition (SPOD), which extracts modes optimally representing the space-time flow statistics, enables the feasibility of further modeling and control of vehicle aerodynamic features. This study intends to investigate the influence of spectral estimation parameters on SPOD results, so as to serve as fundamentals for future works into this topic. The time-resolved pressure field obtained from a large-eddy simulation considering a generic high-speed train is used as the snapshot database. Spectral estimation parameters including block number, frequency resolution, and cutoff frequency are, respectively, discussed to quantify their impacts on both SPOD spectra and modes. The results reveal that, with the increasing of block number, higher reliability and accuracy of SPOD prediction can be achieved, with the block number of 20–30 that leads both requirements of efficiency and precision. The frequency axis with finer resolution reproduces more detailed spectral information, with the eigenvalue distribution and spatial distribution of mode energy under acceptable accuracy when dimensionless frequency resolution reaches 0.025. Moreover, the reducing of cutoff frequency results in increasing unresolved energy content, which will be distributed mostly near the corresponding cutoff frequency, and more minor scaled spatial structures in SPOD modes. The findings and approaches could also work as references for wider application field of SPOD approach. [ABSTRACT FROM AUTHOR]

New Findings: •What is the central question of this study?The aim was to explore the effects and underlying mechanisms of H2 on bleomycin‐induced pulmonary fibrosis.•What are the main findings and its importance?Our results indicate that, in bleomycin‐induced pulmonary fibrosis, H2 inhalation attenuated oxidative stress and reversed the pulmonary epithelial‐to‐mesenchymal transition process by reducing reactive oxygen species production and inhibiting the expression of transforming growth factor‐β1, α‐smooth muscle actin and collagen I to improve fibrotic injury and exert anti‐fibrogenic effects. Thus, H2 inhalation has promising therapeutic potential as a useful adjuvant treatment for patients with idiopathic pulmonary fibrosis, which deserves further study and evaluation. Hydrogen (H2) can protect against tissue damage. The effect of H2 inhalation therapy on the pathogenesis of pulmonary fibrosis remains unknown. This study was designed to explore the effects and underlying mechanisms of H2 inhalation on bleomycin (BLM)‐induced pulmonary fibrosis. A rat model of pulmonary fibrosis was established with BLM. Rats were randomly divided into control and H2 inhalation groups. Haematoxylin and Eosin staining and Mason's Trichrome staining were performed to evaluate pulmonary fibrosis injury, inflammatory cell infiltration, structural disorder and collagen deposition. qRT‐PCR and western blot assays were used to determine the expression of TNF‐α, TGF‐β1, α‐SMA, E‐cadherin, N‐cadherin, vimentin, VEGF and collagen type I at both mRNA and protein levels. The contents of reactive oxygen species, TGF‐β1, TNF‐α, malondialdehyde and hydroxyproline were determined with biochemical test kits or ELISA kits. Bleomycin‐stimulated rats exhibited typical symptoms of pulmonary fibrosis, which featured an increase in collagen deposition, alveolitis, fibrosis and parenchymal structural disorder in the lung. However, BLM‐induced oxidative stress was attenuated by H2 inhalation therapy, which reduced the contents of reactive oxygen species, malondialdehyde and hydroxyproline, enhanced the activity of glutathione peroxidase and decreased the expression of TGF‐β1 and TNF‐α. In addition, H2 inhalation also inhibited BLM‐induced epithelial‐to‐mesenchymal transition by inhibiting TGF‐β1, increasing the expression level of the epithelial cell marker E‐cadherin, and decreasing the expression level of the mesenchymal cell marker vimentin in a time‐dependent manner. In addition, H2 inhalation downregulated α‐SMA expression and suppressed collagen I generation, exerting anti‐fibrogenic effects. Hydrogen inhalation therapy attenuates BLM‐induced pulmonary fibrosis by inhibiting TGF‐β1, relevant oxidative stress and epithelial‐to‐mesenchymal transition. [ABSTRACT FROM AUTHOR]

The potassium dual-ion batteries (DIBs) have been attracting a great attention in recent years due to their promising environmental benignancy, high energy density, and long lifespan. The active materials based on conversion reaction mechanism are favorable and widely expected to alleviate the dendrite formation, red phosphorous was thus employed and fabricated into a three-dimensional porous carbon matrix anchored by P– O –C chemical bonding using vaporization–condensation–conversion process. Meanwhile, the elements modified carbon can not only guarantee the electronic conductivity and ions diffusion, but also alleviate the red phosphorous volumetric expansion and detachment. When coupled with graphite, the K-DIBs demonstrate excellent electrochemical performance with a high 213 Wh kg−1 energy density and a promising stability up to 650 cycles. This explored material will provide highly relevant insights for next-generation advanced energy storage systems. • New explored red phosphorous structure for potassium dual-ion batteries. • Inducing P– O –C chemical bonding to anchor red phosphorous for electronic conductivity and structure stability. • Excellent energy density of 213 Wh kg−1 and superior lifespan up to 650 cycles. [ABSTRACT FROM AUTHOR]