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The novel coronavirus disease 2019 (COVID-19) pandemic has spread to over 213 countries and territories. We sought to describe the clinical features of fatalities in patients with severe COVID-19.
We conducted an Internet-based retrospective cohort study through retrieving the clinical information of 100 COVID-19 deaths from nonduplicating incidental reports in Chinese provincial and other governmental websites between January 23 and March 10, 2020.
Approximately 6 of 10 COVID-19 deaths were males (64.0%). The average age was 70.7 ± 13.5 y, and 84% of patients were elderly (over age 60 y). The mean duration from admission to diagnosis was 2.2 ± 3.8 d (median: 1 d). The mean duration from diagnosis to death was 9.9 ± 7.0 d (median: 9 d). Approximately 3 of 4 cases (76.0%) were complicated by 1 or more chronic diseases, including hypertension (41.0%), diabetes (29.0%) and coronary heart disease (27.0%), respiratory disorders (23.0%), and cerebrovascular disease (12.0%). Fever (46.0%), cough (33.0%), and shortness of breath (9.0%) were the most common first symptoms. Multiple organ failure (67.9%), circulatory failure (20.2%), and respiratory failure (11.9%) are the top 3 direct causes of death.
COVID-19 deaths are mainly elderly and patients with chronic diseases especially cardiovascular disorders and diabetes. Multiple organ failure is the most common direct cause of death.
Preoperative nutritional status plays an important role in predicting postoperative outcomes. Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) are good tools to assess patients’ nutritional status. They have been used in predicting outcomes in various malignancies, but few studies have focused on pancreatic adenocarcinoma (PDAC) patients. Totally, 306 PDAC patients were enrolled. The propensity score matching (PSM) method was introduced to eliminate the baseline inequivalence. Patients with different PNI (or CONUT) scores showed inequivalence baseline characteristics, and patients with compromised nutritional status were related with a more advanced tumour stage. After PSM, the baseline characteristics were well balanced. Both low PNI (≤45) and high CONUT (≥3) were independent risk factors for poor overall survival (P < 0·05), and the result remained the same after PSM. Survival analysis demonstrated both patients with low PNI and high CONUT score were associated with poorer survival, and the result remained the same after PSM. The results of AUC indicated that CONUT might have a higher sensitivity and specificity in predicting complications and survival. Preoperative low PNI (≤45) and high CONUT (≥3) scores might be reliable predictors of prognosis and surgical complications in PDAC patients. Compared with PNI, CONUT might be more effective.
The nitrogen-decorated CeO2/reduced graphene oxide nanocomposite (CeO2/N-rGO) was one-step synthesized by a facile hydrothermal technique and applied as counter electrode materials for dye-sensitized solar cells (DSSCs). For comparison, CeO2/rGO and rGO were also synthesized by adjusting corresponding reactants. It was found that the as-synthesized CeO2/N-rGO shows better electrocatalytic activity for triiodide/iodide reduction than that of pure rGO and CeO2/rGO, and a synergistic effect of nitrogen and CeO2 on the rGO sheets was observed. The photoelectric conversion efficiency of DSSCs based on CeO2/N-rGO counter electrode was 3.20%, which is higher than that of CeO2/rGO (2.45%) and rGO counter electrode (1.37%). Furthermore, the synergistic effect of nitrogen and CeO2 on the rGO sheets was also discussed in detail with different CeO2 amount levels. It is believed that this one-step synthetic method is a potential way to synthesize low-cost and efficient rGO-based multiple composited counter electrode materials to replace more expensive Pt.
Real-time and accurate fault detection and isolation is very important to ensure the reliability and precision of integrated inertial navigation and global navigation satellite systems. In this paper, the detection performance of a residual chi-square method is analysed, and on this basis an improved method of fault detection is proposed. The local test based on a standardised residual is introduced to detect and identify faulty measurements directly. Differing from the traditional method, two appropriate thresholds are selected to calculate the weight factor of each measurement, and the gain matrix is adjusted adaptively to reduce the influence of the undetected faulty measurement. The sliding window test, which uses past measurements, is also added to further improve the fault detection performance for small faults when the local test based on current measurements cannot judge whether a fault has occurred or not. Several simulations are conducted to evaluate the proposed method. The results show that the improved method has better fault detection performance than the traditional detection method, especially for small faults, and can improve the reliability and precision of the navigation system effectively.
Synaptotagmin 1 (Syt1) is an abundant and important presynaptic vesicle protein that binds Ca2+ for the regulation of synaptic vesicle exocytosis. Our previous study reported its localization and function on spindle assembly in mouse oocyte meiotic maturation. The present study was designed to investigate the function of Syt1 during mouse oocyte activation and subsequent cortical granule exocytosis (CGE) using confocal microscopy, morpholinol-based knockdown and time-lapse live cell imaging. By employing live cell imaging, we first studied the dynamic process of CGE and calculated the time interval between [Ca2+]i rise and CGE after oocyte activation. We further showed that Syt1 was co-localized to cortical granules (CGs) at the oocyte cortex. After oocyte activation with SrCl2, the Syt1 distribution pattern was altered significantly, similar to the changes seen for the CGs. Knockdown of Syt1 inhibited [Ca2+]i oscillations, disrupted the F-actin distribution pattern and delayed the time of cortical reaction. In summary, as a synaptic vesicle protein and calcium sensor for exocytosis, Syt1 acts as an essential regulator in mouse oocyte activation events including the generation of Ca2+ signals and CGE.
In traditional Simultaneous Localisation and Mapping (SLAM) algorithms based on Extended Kalman Filtering (EKF-SLAM), the uncertainty of state estimation will increase rapidly with the development of the exploration process and the increase of map area. Likewise, the computational complexity of the EKF-SLAM is proportional to the square of the number of feature points contained in the state variables in a single filtering process. A new SLAM algorithm combining the local submaps and the body-fixed coordinates of the rover is presented in this paper. The algorithm can reduce the computational complexity and enhance computational speed in consideration of the processing capability of the onboard computer. Due to the introduction of local submaps, the algorithm represented in this paper is able to reduce the number of feature points contained in the state variables in each single filtering process. Therefore, the algorithm could reduce the computational complexity and improve the computational speed. In addition, rover body-fixed SLAM could improve the navigation accuracy of a rover and decrease the cumulative linearization error by coordinates transformation during the update process, which is shown in the simulation results.
Repetitive motion planning and control (RMPC) is a significant issue in the research of redundant robot manipulators. Moreover, noise from rounding error, truncation error, and robot uncertainty is an important factor that greatly affects RMPC schemes. In this study, the RMPC of redundant robot manipulators in a noisy environment is investigated. By incorporating the proportional and integral information of the desired path, a new RMPC scheme with pseudoinverse-type (P-type) formulation is proposed. Such a P-type RMPC scheme possesses the suppression of constant and bounded time-varying noises. Comparative simulation results based on a five-link robot manipulator and a PUMA560 robot manipulator are presented to further validate the effectiveness and superiority of the proposed P-type RMPC scheme over the previous one.
A priori attitude information can improve the success rate and reliability of Global Navigation Satellite System (GNSS) multi-antennae attitude determination. However, a priori attitude information is nonlinear, and integrating a priori information into the objective function rigorously will increase the complexity of an ambiguity domain search, such as the Multivariate Constrained-Least-squares Ambiguity Decorrelation Adjustment (MC-LAMBDA) method. In this paper, a new method based on attitude domain search is presented to make use of the a priori attitude angle information with high efficiency. First, the a priori information of pitch and roll is integrated into the search process to derive the analytic search step for attitude angle, and the integer candidates are determined by traversal search in the three-dimensional attitude domain. Then, the objective function is parameterised with Euler angles, and a non-iterative approximate method is utilised to simplify the iterative computation in calculating objective function values. Experimental results reveal that compared to the MC-LAMBDA method, our new method has the same success rate and reliability, but higher efficiency in making use of a priori attitude information.
In inertial confinement fusion experiments that involve short-laser pulses such as fast ignition (FI), diagnosis of neutrons is usually very challenging because high-intensity γ rays generated by short-laser pulses would mask the much weaker neutron signal. In this paper, fast-response scintillators with low afterglow and gated microchannel plate photomultiplier tubes are combined to build neutron time-of-flight (nTOF) spectrometers for such experiments. Direct-drive implosion experiments of deuterium-gas-filled capsules were performed at the Shenguang-II Upgrade (SG-II-UP) laser facility to study the compressed fuel areal density (〈ρR〉) and evaluate the performance of such nTOF diagnostics. Two newly developed quenched liquid scintillator detectors and a gated ultrafast plastic scintillator detector were used to measure the secondary DT neutrons and primary DD neutrons, respectively. The secondary neutron signals were clearly discriminated from the γ rays from (n, γ) reactions, and the compressed fuel areal density obtained with the yield-ratio method agrees well with the simulations. Additionally, a small scintillator decay tail and a clear DD neutron signal were observed in an integrated FI experiment as a result of the low afterglow of the oxygen-quenched liquid scintillator.
We study numerically the dynamics of an insoluble surfactant-laden droplet in a simple shear flow taking surface viscosity into account. The rheology of drop surface is modelled via a Boussinesq–Scriven constitutive law with both surface tension and surface viscosity depending strongly on the surface concentration of the surfactant. Our results show that the surface viscosity exhibits non-trivial effects on the surfactant transport on the deforming drop surface. Specifically, both dilatational and shear surface viscosity tend to eliminate the non-uniformity of surfactant concentration over the drop surface. However, their underlying mechanisms are entirely different; that is, the shear surface viscosity inhibits local convection due to its suppression on drop surface motion, while the dilatational surface viscosity inhibits local dilution due to its suppression on local surface dilatation. By comparing with previous studies of droplets with surface viscosity but with no surfactant transport, we find that the coupling between surface viscosity and surfactant transport induces non-negligible deviations in the dynamics of the whole droplet. More particularly, we demonstrate that the dependence of surface viscosity on local surfactant concentration has remarkable influences on the drop deformation. Besides, we analyse the full three-dimensional shape of surfactant-laden droplets in simple shear flow and observe that the drop shape can be approximated as an ellipsoid. More importantly, this ellipsoidal shape can be described by a standard ellipsoidal equation with only one unknown owing to the finding of an unexpected relationship among the drop’s three principal axes. Moreover, this relationship remains the same for both clean and surfactant-laden droplets with or without surface viscosity.
Previous studies on capsule dynamics in shear flow have dealt with Newtonian fluids, while the effect of fluid viscoelasticity remains an unresolved fundamental question. In this paper, we report a numerical investigation of the dynamics of capsules enclosing a viscoelastic fluid and which are freely suspended in a Newtonian fluid under simple shear. Systematic simulations are performed at small but non-zero Reynolds numbers (i.e.
) using a three-dimensional front-tracking finite-difference model, in which the fluid viscoelasticity is introduced via the Oldroyd-B constitutive equation. We demonstrate that the internal fluid viscoelasticity presents significant effects on the deformation behaviour of initially spherical capsules, including transient evolution and equilibrium values of their deformation and orientation. Particularly, the capsule deformation decreases slightly with the Deborah number De increasing from 0 to
. In contrast, with De increasing within high levels, i.e.
, the capsule deformation increases continuously and eventually approaches the Newtonian limit having a viscosity the same as the Newtonian part of the viscoelastic capsule. By analysing the viscous stress, pressure and viscoelastic stress acting on the capsule membrane, we reveal that the mechanism underlying the effects of the internal fluid viscoelasticity on the capsule deformation is the alterations in the distribution of the viscoelastic stress at low De and its magnitude at high De, respectively. Furthermore, we find some new features in the dynamics of initially non-spherical capsules induced by the internal fluid viscoelasticity. Particularly, the transition from tumbling to swinging of oblate capsules can be triggered at very high viscosity ratios by increasing De alone. Besides, the critical viscosity ratio for the tumbling-to-swinging transition is remarkably enlarged with De increasing at relatively high levels, i.e.
, while it shows little change at low De, i.e. below
A new minimally invasive surgical (MIS) robot consisting of a spherical remote center motion (RCM) mechanism with modular design is proposed. A multi-objective dimensional synthesis model is presented to obtain the excellent performance indices. There are four objectives: a global kinematic index, a compactness index, a global comprehensive stiffness index, and a global dynamic index. Other indices characterizing the design requirement, such as workspace, mechanical parameter, and mass, are chosen as constraints. A new decoupled mechanism is raised to solve the coupled motion between the linear platform and the four degrees of freedom (DoF) of surgical instrument as a result of post-driving motors. Another new mechanical decoupled method is proposed to eliminate the coupled motion between the wrist and the forceps, enhance the dexterity of surgical instrument, and improve the independence of each motor. Then, a 7-DoF MIS robotic prototype based on optimization results has been built up. Experiment results validate the effectiveness of the two mechanical decoupled methods. The position change of the RCM point, accuracy, and repeatability of the MIS robot meet the requirements of MIS. Successful animal experiments validate the effectiveness of the novel MIS robot.
Evidence regarding the association between BMI and mortality in tuberculosis (TB) patients is limited and inconsistent. We investigated the impact of BMI on TB-specific and non-TB-specific mortality with respect to different timing of death. All Taiwanese adults with TB in Taipei were included in a retrospective cohort study in 2012–2014. Multinomial Cox proportional hazards regression was used to evaluate the associations between BMI, cause-specific mortality and timing of death. Of 2410 eligible patients, 86·0 % (2061) were successfully treated, and TB-specific and non-TB-specific mortality occurred for 2·2 % (54) and 13·9 % (335), respectively. After controlling for potential confounders, underweight was significantly associated with a higher risk of all-cause mortality (adjusted hazard ratio (AHR) 1·57; 95 % CI 1·26, 1·95), whereas overweight was not. When cause-specific death was considered, underweight was associated with an increased risk of either TB-specific (AHR 1·85; 95 % CI 1·03, 3·33) or non-TB-specific death (AHR 1·52; 95 % CI 1·19, 1·95) during treatment. With joint consideration of cause-specific and timing of death, underweight only significantly increased the risk of TB-specific (AHR 2·23; 95 % CI 1·09, 4·59) and non-TB-specific mortality (AHR 1·81; 95 % CI 1·29, 2·55) within the first 8 weeks of treatment. This study suggests that underweight increases the risk of early death in TB patients during treatment.
This study aimed to investigate the effects of dietary live yeast (LY) supplementation on growth, intestinal permeability and immunological parameters of piglets challenged with enterotoxigenic Escherichia coli K88 (ETEC). Piglets weaned at 21 d were allocated into three treatments with six pens and six piglets per pen, receiving the control diet (CON), diets supplemented with antibiotics plus zinc oxide (ANT–ZnO) and LY (Saccharomyces cerevisiae strain CNCM I-4407), respectively, for a period of 2 weeks. On day 8, thirty-six piglets were selected as control without ETEC (CON), CON–ETEC, ANT–ZnO–ETEC and LY–ETEC groups challenged with ETEC until day 10 for sample collections. Piglets fed ANT–ZnO diet had the highest average daily gain and average daily feed intake (P<0·05) during the 1st week, but ADG of piglets fed the ANT–ZnO diet was similar as piglets fed LY diet during the second week. Piglets with LY–ETEC or ANT–ZnO–ETEC had markedly lower diarrhoea score (P<0·05) than piglets with CON–ETEC during the 24 h after ETEC challenge. Relative to piglets with CON, the counts of E. coli, urinary ratio of lactulose to mannitol, plasma IL-6 concentration, mRNA abundances of innate immunity-related genes in ileum and mesenteric lymph node tissues were increased (P<0·05), whereas the villous height of jejunum and relative protein expression of ileum claudin-1 were decreased (P<0·05) in piglets with CON–ETEC; however, these parameters did not markedly change in piglets with LY–ETEC or ANT–ZnO–ETEC. In summary, dietary LY supplementation could alleviate the severity of diarrhoea in piglets with ETEC, which may be associated with the improved permeability, innate immunity and bacterial profile.
Although previous studies have considered the antecedents and outcomes of absorptive capacity, much remains to be learned on this subject. Firms need to absorb breadth and depth of knowledge and form absorptive capacities that are contingent on various social capitals to improve innovation and performance. The purpose of this study is to explore the antecedents and outcomes of the breadth and depth of absorptive capacity from the perspective of social capital theory. Based on a sample of 218 Chinese firms, empirical results suggest that weak tie sources and knowledge breadth can enhance the breadth of absorptive capacity, and that strong tie sources and knowledge depth can strengthen the depth of absorptive capacity. The results also suggest that the breadth of absorptive capacity positively impacts the depth of absorptive capacity, and that both breadth and depth of absorptive capacity are positively related to innovation performance.
Excavation of the Han Dynasty chambered tomb at Laoguanshan in Chengdu, south-west China, has provided the earliest known evidence of pattern loom technology. Four model looms, along with accompanying artefacts and figurines relating to the weaving process, give insight into the technique of jin silk production. The discovery is hugely significant as it provides the first direct evidence of pattern-weave textile production in ancient China. Jin silk, made using this method, was both valuable and widely distributed, and the design of the machine influenced the invention of later looms and the spread of technology throughout Eurasia and Europe, representing great technological accomplishment for the second century BC.
Muons produced by a short pulse laser can serve as a new type of muon source having potential advantages of high intensity, small source emittance, short pulse duration and low cost. To validate it in experiments, a suitable muon diagnostics system is needed since high muon flux generated by a short pulse laser shot is always accompanied by high radiation background, which is quite different from cases in general muon researches. A detection system is proposed to distinguish muon signals from radiation background by measuring the muon lifetime. It is based on the scintillator detector with water and lead shields, in which water is used to adjust energies of muons stopped in the scintillator and lead to against radiation background. A Geant4 simulation on the performance of the detection system shows that efficiency up to 52% could be arrived for low-energy muons around 200 MeV and this efficiency decreases to 14% for high-energy muons above 1000 MeV. The simulation also shows that the muon lifetime can be derived properly by measuring attenuation of the scintilla light of electrons from muon decays inside the scintillator detector.
Choline and betaine are essential nutrients involved in one-carbon metabolism and have been hypothesised to affect breast cancer risk. Functional polymorphisms in genes encoding choline-related one-carbon metabolism enzymes, including phosphatidylethanolamine N-methyltransferase (PEMT), choline dehydrogenase (CHDH) and betaine-homocysteine methyltransferase (BHMT), have important roles in choline metabolism and may thus interact with dietary choline and betaine intake to modify breast cancer risk. This study aimed to investigate the interactive effect of polymorphisms in PEMT, BHMT and CHDH genes with choline/betaine intake on breast cancer risk among Chinese women. This hospital-based case–control study consecutively recruited 570 cases with histologically confirmed breast cancer and 576 age-matched (5-year interval) controls. Choline and betaine intakes were assessed by a validated FFQ, and genotyping was conducted for PEMT rs7946, CHDH rs9001 and BHMT rs3733890. OR and 95 % CI were estimated using unconditional logistic regression. Compared with the highest quartile of choline intake, the lowest intake quartile showed a significant increased risk of breast cancer. The SNP PEMT rs7946, CHDH rs9001 and BHMT rs3733890 had no overall association with breast cancer, but a significant risk reduction was observed among postmenopausal women with AA genotype of BHMT rs3733890 (OR 0·49; 95 % CI 0·25, 0·98). Significant interactions were observed between choline intake and SNP PEMT rs7946 (Pinteraction=0·029) and BHMT rs3733890 (Pinteraction=0·006) in relation to breast cancer risk. Our results suggest that SNP PEMT rs7946 and BHMT rs3733890 may interact with choline intake on breast cancer risk.
Psychiatric disorders such as schizophrenia and major depressive disorder
(MDD) are likely to be caused by multiple susceptibility genes, each with
small effects in increasing the risk of illness. Identifying DNA variants
associated with schizophrenia and MDD is a crucial step in understanding
the pathophysiology of these disorders.
To investigate whether the SP4 gene plays a significant
role in schizophrenia or MDD in the Han Chinese population.
We focused on nine single nucleotide polymorphisms (SNPs) harbouring the
SP4 gene and carried out case–control studies in 1235
patients with schizophrenia, 1045 patients with MDD and 1235 healthy
controls recruited from the Han Chinese population.
We found that rs40245 was significantly associated with schizophrenia in
both allele and genotype distributions (Pallele = 0.0005, Pallele = 0.004 after Bonferroni correction; Pgenotype = 0.0023, Pgenotype = 0.0184 after Bonferroni correction). The rs6461563
SNP was significantly associated with schizophrenia in the allele
distributions (Pallele = 0.0033, Pallele = 0.0264 after Bonferroni correction).
Our results suggest that common risk factors in the SP4
gene are associated with schizophrenia, although not with MDD, in the Han