Sleep apnea is one of the most common sleep disorders. The consequences of undiagnosed sleep apnea can be very serious, increasing the risk of high blood pressure, heart disease, stroke, and Alzheimer’s disease over a long period of time. However, many people are often unaware of their condition. The gold standard for diagnosing sleep apnea is nighttime polysomnography monitoring in a specialized sleep laboratory. However, these diagnoses are expensive and the number of beds is limited, and there is insufficient monitoring in terms of time dimension. Existing methods for automated detection use no more than three physiological signals, but all other signals are also associated with the patient’s sleep. In addition, the limited amount of medical real annotation data, especially abnormal samples, lead to weak model generalization capability. The gap between model generalization capability and medical field needs still exists. In this paper, we propose a method for integrating medical interpretation rules into a long short-term memory neural network based on self-attention with multichannel respiratory signals as input. We obtain attention weights through a token-level attention mechanism and then extract key rules of medical interpretation to assist the weights, improving model generalization and reducing the dependence on data volume. Compared with the best prediction performance of existing methods, the average improvements of our method in accuracy, precision, and f1-score are 3.26%, 7.03%, and 1.78%, respectively. The algorithm tested the performance of our model on the Sleep Heart Health Study data set and found that the model outperformed existing methods and could help physicians make decisions in their practices.

The phase summation effect in sum-frequency mixing process is utilized to avoid a nonlinearity obstacle in the power scaling of single-frequency visible or ultraviolet lasers. Two single-frequency fundamental lasers are spectrally broadened by phase modulation to suppress stimulated Brillouin scattering in fiber amplifier and achieve higher power. After sum-frequency mixing in a nonlinear optical crystal, the upconverted laser returns to single frequency due to phase summation, when the phase modulations on two fundamental lasers have a similar amplitude but opposite sign. The method was experimentally proved in a Raman fiber amplifier-based laser system, which generated a power-scalable sideband-free single-frequency 590 nm laser. The proposal manifests the importance of phase operation in wave-mixing processes for precision laser technology.

We present a high-energy, hundred-picosecond (ps) pulsed mid-ultraviolet solid-state laser at 266 nm by a direct second harmonic generation (SHG) in a barium borate (BaB2O4, BBO) nonlinear crystal. The green pump source is a 710 mJ, 330 ps pulsed laser at a wavelength of 532 nm with a repetition rate of 1 Hz. Under a green pump energy of 710 mJ, a maximum output energy of 253.3 mJ at 266 nm is achieved with 250 ps pulse duration resulting in a peak power of more than 1 GW, corresponding to an SHG conversion efficiency of 35.7% from 532 to 266 nm. The experimental data were well consistent with the theoretical prediction. To the best of our knowledge, this laser exhibits both the highest output energy and highest peak power ever achieved in a hundred-ps/ps regime at 266 nm for BBO-SHG.

Coastal eutrophication and hypoxia remain a persistent environmental crisis despite the great efforts to reduce nutrient loading and mitigate associated environmental damages. Symptoms of this crisis have appeared to spread rapidly, reaching developing countries in Asia with emergences in Southern America and Africa. The pace of changes and the underlying drivers remain not so clear. To address the gap, we review the up-to-date status and mechanisms of eutrophication and hypoxia in global coastal oceans, upon which we examine the trajectories of changes over the 40 years or longer in six model coastal systems with varying socio-economic development statuses and different levels and histories of eutrophication. Although these coastal systems share common features of eutrophication, site-specific characteristics are also substantial, depending on the regional environmental setting and level of social-economic development along with policy implementation and management. Nevertheless, ecosystem recovery generally needs greater reduction in pressures compared to that initiated degradation and becomes less feasible to achieve past norms with a longer time anthropogenic pressures on the ecosystems. While the qualitative causality between drivers and consequences is well established, quantitative attribution of these drivers to eutrophication and hypoxia remains difficult especially when we consider the social economic drivers because the changes in coastal ecosystems are subject to multiple influences and the cause–effect relationship is often non-linear. Such relationships are further complicated by climate changes that have been accelerating over the past few decades. The knowledge gaps that limit our quantitative and mechanistic understanding of the human-coastal ocean nexus are identified, which is essential for science-based policy making. Recognizing lessons from past management practices, we advocate for a better, more efficient indexing system of coastal eutrophication and an advanced regional earth system modeling framework with optimal modules of human dimensions to facilitate the development and evaluation of effective policy and restoration actions.

The association between time to positivity (TTP) of blood culture and the clinical prognosis of patients with Klebsiella pneumoniae bloodstream infection (BSI) remains unclear. A retrospective study of 148 inpatients with BSI caused by K. pneumoniae was performed at Shanghai Tongji Hospital, China, from October 2016–2020. The total in-hospital fatality rate was 32%. The median TTP was 11.0 (7.7–16.1) h and the optimal cutoff for prediction of in-hospital mortality was 9.4 h according to the ROC curve. Early TTP (<9.4 h) was a risk factor for in-hospital mortality by univariate analysis (OR = 2.5, 95% CI 1.2–5.0, P = 0.01), but not by multivariate analysis (OR = 2.7, 95% CI 1.0–7.4, P = 0.06). Old age, serum creatinine, white blood cells, and C-reactive protein values were risk factors for in-hospital mortality by multivariate analysis. Early TTP was not a risk factor for septic shock (OR = 1.8, 95% CI 0.6–5.1, P = 0.27) or ICU admission (OR = 1.0, 95% CI 1.0–1.0, P = 0.32). In conclusion, the in-hospital fatality rate of patients with K. pneumoniae BSI was relatively high and associated with an early TTP of blood cultures. However, no increased risk of mortality, septic shock or ICU admission was evident in early TTP patients.

High-power continuous-wave single-frequency Er-doped fiber amplifiers at 1560 nm by in-band and core pumping of a 1480 nm Raman fiber laser are investigated in detail. Both co- and counter-pumping configurations are studied experimentally. Up to 59.1 W output and 90% efficiency were obtained in the fundamental mode and linear polarization in the co-pumped case, while less power and efficiency were achieved in the counter-pumped setup for additional loss. The amplifier performs indistinguishably in terms of laser linewidth and relative intensity noise in the frequency range up to 10 MHz for both configurations. However, the spectral pedestal is raised in co-pumping, caused by cross-phase modulation between the pump and signal laser, which is observed and analyzed for the first time. Nevertheless, the spectral pedestal is 34.9 dB below the peak, which has a negligible effect for most applications.

Visitors to zoos are a source of potential stress to certain captive-housed animals. Much research has focused on Europe and America, whereas the effect of human audiences on the behaviour of captive animals in Chinese parks has so far not been investigated. Sika deer (Cervus nippon) housed in Zhu-Yu-Wan Park, Yangzhou City, Jiangsu Province, China, were studied to determine the effect of different visitor density levels on the animals’ activity. From June 21 to December 10, 2006, and again from February 21 to July 10, 2007, 21 subjects were observed for 10 h per week for a total of 44 weeks. Continuous focal animal sampling was used to quantify behaviours, and visitor density was recorded every minute. Friedman's tests were used to examine the effects of visitor density on the behaviour of sika deer. Results showed that high visitor density was significantly related to foraging, resting, watching and ‘non-visible’ behaviours. The findings demonstrate that high numbers of visitors have an effect on the welfare of sika deer.

Correlations for the interfacial terms in the fluid dissipation rate equation and Reynolds stress equations are established for particle-laden flows, based on data from the interfaced-resolved direct numerical simulations of particle sedimentation in a periodic domain at a density ratio ranging from 0.01 to 1000, a particle concentration ranging from 2.3 % to 30.2 % and a particle Reynolds number below 250. The correlations for the mean drag and the pseudo-turbulent kinetic energy are also reported, which are used for the modelling of the interfacial term in the fluid dissipation rate equation. The interfacial term correlations obtained are then incorporated in the Reynolds stress model (RSM) (i.e. second-moment closure) for the simulation of vertical turbulent channel flows laden with the finite-size particles at relatively low particle volume fractions. The results show that the RSM with new interfacial term correlations can quantitatively predict particle-induced turbulence enhancement or suppression in vertical channel flows.

Hyperhomocysteinaemia (HHcy) is associated with all-cause mortality in some disease states. However, the correlation between HHcy and the risk of mortality in the general population has rarely been researched. We aimed to evaluate the association between HHcy and all-cause and cause-specific mortality among adults in the USA. This study analysed data from the National Health and Nutrition Examination Survey database (1999–2002 survey cycle). A multivariable Cox regression model was built to evaluate the correlation between HHcy and all-cause and cause-specific mortality. Smooth curve fitting was used to analyse their dose-dependent relationship. A total of 8442 adults aged 18–70 years were included in this study. After a median follow-up period of 14·7 years, 1007 (11·9 %) deaths occurred including 197 CVD-related deaths, 255 cancer-related deaths and fifty-eight respiratory disease deaths. The participants with HHcy had a 93 % increased risk of all-cause mortality (hazard ratio (HR) 1·93; 95 % CI (1·48, 2·51)), 160 % increased risk of CVD mortality (HR 2·60; 95 % CI (1·52, 4·45)) and 82 % increased risk of cancer mortality (HR 1·82; 95 % CI (1·03, 3·21)) compared with those without HHcy. For unmeasured confounding, E-value analysis proved to be robust. In conclusion, HHcy was associated with high risk of all-cause and cause-specific (CVD, cancer) mortality among adults aged below 70 years.

A drag correlation is established for laminar particle-laden flows, based on data from the interfaced-resolved direct numerical simulations (IR-DNS) of particle sedimentation in a periodic domain at density ratio ranging from 2 to 1000, particle concentration ranging from 0.59 % to 14.16 %, and particle Reynolds number below 132. Our drag decreases slightly with increasing density ratio when the other parameters are fixed. The drag correlation is then corrected to account for the turbulence effect by introducing the relative turbulent kinetic energy, from the IR-DNS data of the upward turbulent channel flows laden with the particles larger than the Kolmogorov length scale at relatively low particle volume fractions. A drift velocity model is developed to obtain the effective slip velocity from the interphase mean velocity difference for the vertical turbulent channel flow by considering the effects of particle inertia, particle concentration distribution and large-scale streamwise vortices.

Severe fever with thrombocytopenia syndrome (SFTS) virus has caused a large number of human infections since discovered in 2009. This study elucidated epidemiological features and fatal risk factors of SFTS cases accumulated up to ten years in Taizhou, a coastal prefecture of Zhejiang Province in Eastern China. A total of 188 hospitalised SFTS cases (including 40 deaths) reported to Taizhou Center for Disease Control and Prevention (CDC) during 2011–2020 were enrolled in the study. In the past decade, the annual incidence of SFTS increased over the years (P < 0.001) along with an expanding epidemic area, and the case fatality of hospitalised cases has remained high (21.3%). Although most cases occurred in hilly areas, a coastal island had the highest incidence and case fatality. The majority of cases were over the age of 60 years (72.3%), and both incidence and case fatality of SFTS increased with age. Multivariate logistic regression analysis showed that age (OR 7.47, 95% CI 1.32–42.33; P = 0.023), and haemorrhagic manifestations including petechiae (OR 7.76, 95% CI 1.17–51.50; P = 0.034), gingival haemorrhage (OR 5.38, 95% CI 1.25–23.15; P = 0.024) and melena (OR 5.75, 95% CI 1.18–28.07; P = 0.031) were significantly associated with the death of SFTS cases. Five family clusters identified were farmers, among four of which the index patients were female with a history of hypertension. Based on the study, age is a critical risk factor for incidence and case fatality of SFTS. With an increased annual incidence over the last ten years, SFTS remains a public health threat that should not be ignored. Further study is needed to look at the natural foci in the coastal islands.

Low molecular weight glutenin subunits (LWM-GSs) play a crucial role in determining wheat flour processing quality. In this work, 35 novel LMW-GS genes (32 active and three pseudogenes) from three Aegilops umbellulata (2n = 2x = 14, UU) accessions were amplified by allelic-specific PCR. We found that all LMW-GS genes had the same primary structure shared by other known LMW-GSs. Thirty-two active genes encode 31 typical LMW-m-type subunits. The MZ424050 possessed nine cysteine residues with an extra cysteine residue located in the last amino acid residue of the conserved C-terminal III, which could benefit the formation of larger glutenin polymers, and therefore may have positive effects on dough properties. We have found extensive variations which were mainly resulted from single-nucleotide polymorphisms (SNPs) and insertions and deletions (InDels) among the LMW-GS genes in Ae. umbellulata. Our results demonstrated that Ae. umbellulata is an important source of LMW-GS variants and the potential value of the novel LMW-GS alleles for wheat quality improvement.

Lower-crust-derived adakitic rocks in the Gangdese belt provide important constraints on the timing of Tibetan crustal thickening and on the relative contributions of magmatic and tectonic processes. Here we present geochronological and geochemical data for the Wangdui porphyritic monzogranites in the western Gangdese belt. Zircon U–Pb dating yields emplacement ages of 46–44 Ma. All samples have high Sr (321–599 ppm), low Yb (0.76–1.33 ppm) and Y (10.6–18.3 ppm) contents, with high La/Yb (51.1–72.3) and Sr/Y (21.0–51.4) ratios, indicating adakitic affinities. The low MgO (0.97–1.76 wt %), Cr (7.49–53.6 ppm) and Ni (4.75–29.1 ppm) contents, as well as high 87Sr/86Sr(i) (0.7143–0.7145), low ϵNd(t) (−10.4 to −9.8) and zircon ϵHf(t) (−17.7 to 0.4) values, suggest that the Wangdui pluton most likely originated from partial melting of the thickened ancient lower crust. In combination with previously published data, despite the east–west-trending heterogeneity of crustal composition in the Gangdese belt, the La/Yb ratios of magmatic rocks reveal that both western and eastern segments experienced remarkable crustal thickening in the Eocene. However, in contrast to the thickened juvenile lower crust in the eastern segment formed by the underplating of mantle-derived magmas, tectonic shortening plays a more crucial role in thickening of the ancient basement in western Gangdese. In fact, such Eocene-thickened ancient lower-crust-derived adakitic rocks are widely distributed in the central Himalayan–Tibetan orogen. This, together with the extensive development of fold–thrust belts, suggests that tectonic shortening might be the main mechanism accounting for the crustal thickening associated with the India–Asia collision.

Sporadic clusters of healthcare-associated coronavirus disease 2019 (COVID-19) occurred despite intense rostered routine surveillance and a highly vaccinated healthcare worker (HCW) population, during a community surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) B.1.617.2 δ (delta) variant. Genomic analysis facilitated timely cluster detection and uncovered additional linkages via HCWs moving between clinical areas and among HCWs sharing a common lunch area, enabling early intervention.