Background: The off-target effects linezolid have the potential to cause serotonin syndrome when given in conjunction with serotonergic agents. Despite package insert labeling as a contraindication, several postmarketing studies have demonstrated a low incidence of serotonin syndrome with the concomitant use of linezolid and other serotonergic agents. Linezolid provides a convenient oral option for gram-positive infections. However, due to concerns for serotonin syndrome, the use of linezolid is sometimes avoided. Methods: We performed a single-center, retrospective, medical record review of all adult inpatients from September 2021 to September 2022. Patients included had 1 administration of linezolid and 1 inpatient administration of a selective serotonin reuptake inhibitor (SSRI) or serotonin and norepinephrine reuptake inhibitor (SNRI) within 14 days. The primary outcome was the incidence of serotonin syndrome as defined by the Hunter serotonin toxicity criteria, which were retrospectively applied to each patient based on medical-record documentation. We compared patients receiving 1 versus multiple serotonergic agents. Secondary outcomes included duration of hospitalization and adverse outcomes based on concerns for serotonin syndrome such as need for rescue, ICU admission, or change in medication. Results: Of the 50 included patients from a convenience sample, 27 (54%) were on linezolid and >1 serotonergic agent. Patients had similar baseline characteristics (Table 1). The most common concomitant agent used was an SSRI. Other agents that predispose patients to serotonin syndrome included opioid analgesics and other classes of antidepressants (Fig. 1). Serotonin syndrome occurred within 48 hours in 1 patient on an SNRI and a continuous fentanyl drip. There was no need for rescue or ICU admission due to serotonin syndrome. No patients were readmitted due to serotonin syndrome, and no differences were observed in hospital lengths of stay. Conclusions: Exposure to a single serotonergic agent combined with receipt of linezolid was not associated with any cases of serotonin syndrome. Exposure to multiple serotonergic agents was not associated with a high incidence of serotonin syndrome. This small series supports previous reports demonstrating relative safety of linezolid given with serotonergic agents and encourages review of interruptive drug–drug interaction alerts for linezolid within the electronic ordering system.

Disclosures: None

An increased number of rogue waves, relative to standard distributions, can be induced by unidirectional waves passing over abrupt decreases in water depth. We investigate this phenomenon in a more general setting of multidirectional waves. We examine the influence of the directionality on the occurrence probability of rogue waves using laboratory experiments and fully nonlinear potential flow simulations. Based on the analysis of the statistics of random waves, we find that directional spreading reduces the formation probability of rogue waves relative to unidirectional seas. Nevertheless, for typical values of directional spreading in the ocean ($15^{\circ }\unicode{x2013}30^{\circ }$), our numerical results suggest that there is still a significant enhancement to the number of rogue waves just beyond the top of a depth discontinuity.

Research on policy experimentation has mainly focused on central–local relations; scholars have paid little attention to the interaction between policy experimentation and the public. We argue that policy experimentation can be used by decision makers as an instrument to communicate with the public, facilitating the building of a social consensus regarding controversial policies. We evaluate the effects of the Chinese government's policy experimentation efforts to promote shared responsibility between the state and individuals for the urban pension system on the public's regime support. Evidence from two rounds of a nationwide survey conducted before and after the policy experiment indicates that the policy experimentation has significantly contributed to citizens’ acceptance of their individual welfare responsibility. Moreover, the image-building of governmental responsibility via official news, with varied intensity across regions, consolidates the political trust of residents while posing a challenge to local government credibility in the long run.

For decreasing sequences $\{t_{n}\}_{n=1}^{\infty }$ converging to zero and initial data $f\in H^s(\mathbb {R}^N)$, $N\geq 2$, we consider the almost everywhere convergence problem for sequences of Schrödinger means ${\rm e}^{it_{n}\Delta }f$, which was proposed by Sjölin, and was open until recently. In this paper, we prove that if $\{t_n\}_{n=1}^{\infty }$ belongs to Lorentz space ${\ell }^{r,\infty }(\mathbb {N})$, then the a.e. convergence results hold for $s>\min \{\frac {r}{\frac {N+1}{N}r+1},\,\frac {N}{2(N+1)}\}$. Inspired by the work of Lucà-Rogers, we construct a counterexample to show that our a.e. convergence results are sharp (up to endpoints). Our results imply that when $0< r<\frac {N}{N+1}$, there is a gain over the a.e. convergence result from Du-Guth-Li and Du-Zhang, but not when $r\geq \frac {N}{N+1}$, even though we are in the discrete case. Our approach can also be applied to get the a.e. convergence results for the fractional Schrödinger means and nonelliptic Schrödinger means.

We make some remarks on the Euler–Lagrange equation of energy functional $I(u)=\int _\Omega f(\det Du)\,{\rm d}x,$ where $f\in C^1(\mathbb {R}).$ For certain weak solutions $u$ we show that the function $f'(\det Du)$ must be a constant over the domain $\Omega$ and thus, when $f$ is convex, all such solutions are an energy minimizer of $I(u).$ However, other weak solutions exist such that $f'(\det Du)$ is not constant on $\Omega.$ We also prove some results concerning the homeomorphism solutions, non-quasimonotonicity and radial solutions, and finally we prove some stability results and discuss some related questions concerning certain approximate solutions in the 2-Dimensional cases.

In order to solve the problems of low loading capacity and low driving efficiency for the powered exoskeleton, this paper presents a bionic multi-chamber pneumatic actuator based on muscle scale mechanism. Firstly, the bionic muscle scale mechanism and multi-chamber structure design for the novel pneumatic actuator are introduced. Afterward, the driving characteristics of the multi-chamber actuator are analyzed theoretically, including analysis of output force and analysis of energy efficiency. Then, the load matching control strategy for the novel actuator is optimized, and the load matching performance, displacement tracking accuracy, and energy efficiency are studied by simulation. Finally, the prototype of the multi-chamber actuator is developed, and the exoskeleton testing platform is built, experiment and discussion are conducted for the driving characteristics, which realized the high energy efficiency and the feasibility of load matching.

The COVID-19 pandemic has had a profound impact on the mental health of healthcare workers (HCWs). We aimed to identify the factors associated with depression among HCWs during the pandemic. We conducted literature search using eight electronic databases up to July 27 2022. Observational studies with more than 200 participants investigating correlates of depression in HCWs after COVID-19 outbreak were included. We used fixed- and random-effects models to pool odds ratios (ORs) across studies, and Cochran's chi-squared test and I2 statistics to assess study heterogeneity. Publication bias was evaluated by funnel plots. Thirty-five studies involving 44,362 HCWs met the inclusion criteria. Female (OR=1.50, 95% CI [1.23,1.84]), single (OR=1.36, 95% CI [1.21,1.54]), nurse (OR=1.69, 95% CI [1.28,2.25]), history of mental diseases (OR=2.53, 95% CI [1.78,3.58]), frontline (OR=1.79, 95% CI [1.38,2.32]), health anxiety due to COVID-19 (OR=1.88, 95% CI [1.29,2.76]), working in isolation wards (OR=1.98, 95% CI [1.38,2.84]), and insufficient personal protective equipment (OR=1.49, 95% CI [1.33,1.67]) were associated with increased risk of depression. Instead, HCWs with a positive professional prospect (OR=0.34, 95% CI [0.24,0.49]) were less likely to be depressed. This meta-analysis provides up-to-date evidence on the factors linked to depression among HCWs during the COVID-19 pandemic. Given the persistent threats posed by COVID-19, early screening is crucial for the intervention and prevention of depression in HCWs.

Before the Omicron variant ran amok inside China in November 2022, the Chinese central government’s dynamic zero-COVID policy effectively contained the spread of the coronavirus and its variants during multiple waves of outbreaks. However, it was not without cost. This study examines the impacts of stringent lockdown interventions on urban residents’ mental health during the initial outbreak of the Omicron variant in the spring of 2022. Using survey data from 522 respondents within the same neighbourhood and a spatial quasi-experimental design, the results show that strict lockdown interventions are significantly related to higher levels of psychological distress after controlling for observed confounders and that lockdown interventions have further spillover effects on mental health for residents in adjacent residential compounds who are otherwise free. Moreover, the results show that the lack of material supplies and medical care plays a more salient role in explaining lockdown effects on psychological distress than residents’ social interaction and trust levels of COVID-19 policy. Policy and intervention implications are also discussed.

For a perturbed generalized Korteweg–de Vries equation with a distributed delay, we prove the existence of both periodic and solitary waves by using the geometric singular perturbation theory and the Melnikov method. We further obtain monotonicity and boundedness of the speed of the periodic wave with respect to the total energy of the unperturbed system. Finally, we establish a relation between the wave speed and the wavelength.

This article presents a system architecture and a set of interfaces that can build scalable information systems capable of large city modeling based on dynamic geospatial knowledge graphs to avoid pitfalls of Web 2.0 applications while blending artificial and human intelligence during the knowledge enhancement processes. We designed and developed a GeoSpatial Processor, an SQL2SPARQL Transformer, and a geospatial tiles ordering tasks and integrated them into a City Export Agent to visualize and interact with city models on an augmented 3D web client. We designed a Thematic Surface Discovery Agent to automatically upgrade the model’s level of detail to interact with thematic parts of city objects by other agents. We developed a City Information Agent to help retrieve contextual information, provide data concerning city regulations, and work with a City Energy Analyst Agent that automatically estimates the energy demands for city model members. We designed a Distance Agent to track the interactions with the model members on the web, calculate distances between objects of interest, and add new knowledge to the Cities Knowledge Graph. The logical foundations and CityGML-based conceptual schema used to describe cities in terms of the OntoCityGML ontology, together with the system of intelligent autonomous agents based on the J-Park Simulator Agent Framework, make such systems capable of assessing and maintaining ground truths with certainty. This new era of GeoWeb 2.5 systems lowers the risk of deliberate misinformation within geography web systems used for modeling critical infrastructures.

The association between the consumption of dairy products and risk of CVD has been inconsistent. There is a lack of studies in populations with high intakes of dairy products. We aimed to examine the association between intake of dairy products and risk of incident major adverse coronary events and stroke in the Swedish Malmö Diet and Cancer cohort study. We included 26 190 participants without prevalent CVD or diabetes. Dietary habits were obtained from a modified diet history, and endpoint data were extracted from registers. Over an average of 19 years of follow-up, 3633 major adverse coronary events cases and 2643 stroke cases were reported. After adjusting for potential confounders, very high intakes of non-fermented milk (>1000 g/d) compared with low intakes (<200 g/d) were associated with 35 % (95 % CI (8, 69)) higher risk of major adverse coronary events. In contrast, moderate intakes of fermented milk (100–300 g/d) were associated with a lower risk of major adverse coronary events compared with no consumption. Intakes of cheese (only in women) and butter were inversely associated with the risk of major adverse coronary events. We observed no clear associations between any of the dairy products and stroke risk. These results highlight the importance of studying different dairy foods separately. Further studies in populations with high dairy consumption are warranted.

The benefits of branched-chain amino acid (BCAA) administration after hepatic intervention in patients with liver diseases remain unclear. We conducted a systematic review and meta-analysis to evaluate the effects of BCAA on patients undergoing hepatectomy, trans-arterial embolisation and radiofrequency ablation. Relevant randomised controlled trials (RCT) were obtained from PubMed, EMBASE and Cochrane Library databases. A meta-analysis was performed to calculate the pooled effect size by using random-effects models. The primary outcomes were survival and tumour recurrence. The secondary outcomes were hospital stay, nutrition status, biochemistry profile, complication rate of liver treatment and adverse effect of BCAA supplementation. In total, eleven RCT involving 750 patients were included. Our meta-analysis showed no significant difference in the rates of tumour recurrence and overall survival between the BCAA and control groups. However, the pooled estimate showed that BCAA supplementation in patients undergoing hepatic intervention significantly increased serum albumin (mean difference (MD): 0·11 g/dl, 95 % CI: 0·02, 0·20; 5 RCT) at 6 months and cholinesterase level (MD: 50·00 U/L, 95 % CI: 21·08, 78·92; 1 RCT) at 12 months and reduced ascites incidence (risk ratio: 0·39, 95 % CI: 0·21, 0·71; 4 RCT) at 12 months compared with the control group. Additionally, BCAA administration significantly increased body weight at 6 months and 12 months and increased arm circumference at 12 months. In conclusion, BCAA supplementation significantly improved the liver function, reduced the incidence of ascites and increased body weight and arm circumference. Thus, BCAA supplementation may beneficial for selected patients undergoing liver intervention.

GPT-3 is a large-scale natural language model developed by OpenAI that can perform many different tasks, including topic classification. Although researchers claim that it requires only a small number of in-context examples to learn a task, in practice GPT-3 requires these training examples to be either of exceptional quality or a higher quantity than easily created by hand. To address this issue, this study teaches GPT-3 to classify whether a question is related to data science by augmenting a small training set with additional examples generated by GPT-3 itself. This study compares two augmented classifiers: the Classification Endpoint with an increased training set size and the Completion Endpoint with an augmented prompt optimized using a genetic algorithm. We find that data augmentation significantly increases the accuracy of both classifiers, and that the embedding-based Classification Endpoint achieves the best accuracy of about 76%, compared to human accuracy of 85%. In this way, giving large language models like GPT-3 the ability to propose their own training examples can improve short text classification performance.

To be successfully used in daily life situations, exoskeletons should be effective across multimodal scenarios, including walking on various terrains, and transitions between locomotion modes such as walking-to-stop. Correct continuous gait phase estimation is essential for high-level walking assistance control. Despite the impressive advances in gait phase estimation for a variety of locomotion modes, transition gait phase estimation is rarely researched, leading to the jittering of exoskeletons during walking-to-stop transitions. We propose an optimized phase oscillator (PO-opt) that estimates the gait phase correctly during transition gaits in multimodal locomotion, which is beneficial to eliminating the jittering. In the phase plane, a lateral axis extreme difference (LAED) is adopted to classify transition gaits. The threshold of LAED for transition gaits in multimodal locomotion was preliminarily determined by simulation, which was then applied and validated in experiments. Simulation results indicated that a threshold of 15.0 was suitable for transition gaits classification during treadmill walking, free walking, and ramp ascent/descent, while results of the experiment showed that a threshold between 6.5 and 10.5 was applicable for treadmill walking, free walking, and stair ascent/descent. In particular, the jittering elimination rates for 3, 4, and 5 km/h treadmill walking were improved from 29%, 21%, and 4% (PO model) to 100%, respectively, when the threshold of LAED was set at 15.0 in PO-opt model. The results indicated a significant increase in the rate of jittering elimination when the PO-opt model was applied. The model holds great promise in real-world applications for prostheses and other types of exoskeletons.