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A recently developed pneumonia caused by SARS-CoV-2 has quickly spread across the world. Unfortunately, a simplified risk score that could easily be used in primary care or general practice settings has not been developed. The objective of this study is to identify a simplified risk score that could easily be used to quickly triage severe COVID-19 patients. All severe and critical adult patients with laboratory-confirmed COVID-19 on the West campus of Union Hospital, Wuhan, China, from 28 January 2020 to 29 February 2020 were included in this study. Clinical data and laboratory results were obtained. CURB-65 pneumonia score was calculated. Univariate logistic regressions were applied to explore risk factors associated with in-hospital death. We used the receiver operating characteristic curve and multivariate COX-PH model to analyse risk factors for in-hospital death. A total of 74 patients (31 died, 43 survived) were finally included in the study. We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (area under curve 0.81, 95% confidence interval (CI) 0.71–0.91). CURB-65 ⩾ 2 may serve as a cut-off value for prediction of in-hospital death in severe patients with COVID-19 (sensitivity 68%, specificity 81%, F1 score 0.7). CURB-65 (hazard ratio (HR) 1.61; 95% CI 1.05–2.46), LDH (HR 1.003; 95% CI 1.001–1.004) and albumin (HR 0.9; 95% CI 0.81–1) were risk factors for in-hospital death in severe patients with COVID-19. Our study indicates CURB-65 may serve as a useful prognostic marker in COVID-19 patients, which could be used to quickly triage severe patients in primary care or general practice settings.
The efficiency of halide perovskite solar cells has progressed rapidly through a series of major breakthroughs. Currently, a certified efficiency of 25.2% has been achieved for a solar cell using a polycrystalline thin film. This is the result of having reached 75% of the Shockley–Queisser limit for single-junction solar cells. However, for further improvements, new breakthrough technologies are required. This article reviews the impact of previous breakthrough technologies on the efficiency of halide perovskite solar cells, based on certified efficiencies. We clarify the current status of halide perovskite solar cells and introduce photon recycling as the next technological innovation for higher efficiencies. Photon recycling keeps the photon concentration inside the light-harvesting layer high, and consequently, leads to open-circuit voltages close to the theoretical value. Although photon recycling has not yet been implemented in real halide perovskite solar cells, three key technologies for implementing it are examined.
During recent stratigraphical and micropaleontological investigations of the Gulupu section in Tüna, Yadong, of the Eocene Zhepure Formation, numerous holoplanktonic mollusks (pteropods) were recovered. Four species, assignable to two genera of pteropods (including Limacina yadongensis new species) were systematically described and illustrated, and a gastropod-bivalve biofacies was identified. This is the first report of Eocene (Ypresian) pteropods in southern Tibet; the same stratum also yields many other neritic faunas. The data presented in this study suggest that a semi-closed restricted gulf in the Tüna area existed and the occurrence of pteropods in Tüna may indicate transport from more open, deep water by oceanic currents during early Eocene. Based on the analysis of paleogeographical distribution of pteropods, it indicates that a Tethys seaway existed during the early Eocene (Ypresian).
This paper presents a novel dual-band (DB) dual-polarized (DP) shared aperture antenna with high isolation by using a combination of microstrip dipoles and dielectric resonator antennas (DRAs) for S and C bands, respectively. In the S band, two sets of proximity coupled stacked microstrip dipoles which crossed at the center are employed to achieve dual-linear polarization (DLP) and obtain desired bandwidth (BW), isolation, and pure polarization. The rectangle DRA with hybrid feed is selected as the C band element for its advantages of small base area and high isolation, and a 2 × 2 array is presented with the “pair-wise” anti-phase feed technique to achieve a low cross-polarized level. Moreover, benefited from the back feed scheme, the proposed antenna has a symmetrical structure and has the potential of expanding into a larger aperture. The proposed antenna has been manufactured and measured, and the results agree well with simulations, which prove the validity of the proposed design.
Schizophrenia is a serious health problem worldwide. This systematic analysis aims to quantify the burden of schizophrenia at the global, regional and national levels using the Global Burden of Disease Study 2017 (GBD 2017).
We collected detailed information on the number of incidence cases, disability-adjusted life years (DALYs) and age-standardised incidence rate (ASIR) and age-standardised rate of DALYs (ASDR) during 1990–2017 from GBD 2017. The estimated annual percentage changes (EAPCs) in the ASIR and in the ASDR were calculated to quantify the temporal trends in the ASIR and ASDR of schizophrenia.
Globally there were 1.13 million (95% uncertainty interval [UI] = 1.00 to 1.28) incident schizophrenia cases and 12.66 million (95% UI = 9.48 to 15.56) DALYs due to schizophrenia in 2017. The global ASIR decreased slightly from 1990 to 2017 (EAPC = −0.124, 95% UI = −0.114 to −0.135), while the ASDR was stable. The number of incident cases, DALYs, ASIR and ASDR were higher for males than for females. The incident rate and DALYs rate were highest among those aged 20–29 and 30–54 years, respectively. ASIR and ASDR were highest in East Asia in 2017, at 19.66 (95% UI = 17.72 to 22.00) and 205.23 (95% UI = 153.13 to 253.34), respectively. In 2017, the ASIR was highest in countries with a high-moderate sociodemographic index (SDI) and the ASDR was highest in high-SDI countries. We also found that the EAPC in ASDR was negatively correlated with the ASDR in 1990 (P = 0.001, ρ = −0.23).
The global burden of schizophrenia remains large and continues to increase, thereby increasing the burden on health-care systems. The reported findings should be useful for resource allocation and health services planning for the increasing numbers of patients with schizophrenia in ageing societies.
This study develops a Yb:KGW dual-crystal based regenerative amplifier. The thermal lensing and gain-narrowing effects are compensated by the dual-crystal configuration. Sub-nanojoule pulses are amplified to 1.5 mJ with 9 nm spectral bandwidth and 1 kHz repetition rate using chirped pulse amplification technology. Consequently, 1.2 mJ pulses with a pulse duration of 227 fs are obtained after compression. Thanks to the cavity design, the output laser was a near diffraction limited beam with M2 around 1.1. The amplifier has the potential to boost energy above 2 mJ after compression and act as a front end for a future kilohertz terawatt-class diode-pumped Yb:KGW laser system.
Iodine intake and excretion vary widely; however, these variations remain a large source of geometric uncertainty. The present study aims to analyse variations in iodine intake and excretion and provide implications for sampling in studies of individuals or populations. Twenty-four healthy women volunteers were recruited for a 12-d sampling period during the 4-week experiment. The duplicate-portion technique was used to measure iodine intake, while 24-h urine was collected to estimate iodine excretion. The mean intra-individual variations in iodine intake, 24-h UIE (24-h urinary iodine excretion) and 24-h UIC (24-h urinary iodine concentration) were 63, 48 and 55 %, respectively, while the inter-individual variations for these parameters were 14, 24 and 32 %, respectively. For 95 % confidence, approximately 500 diet samples or 24-h urine samples should be taken from an individual to estimate their iodine intake or iodine status at a precision range of ±5%. Obtaining a precision range of ±5% in a population would require twenty-five diet samples or 150 24-h urine samples. The intra-individual variations in iodine intake and excretion were higher than the inter-individual variations, which indicates the need for more samples in a study on individual participants.
A nanoparticle-based drug delivery system is first established by mesoporous silica encapsulating amino acid–intercalated layered double hydroxide (LDH) to construct nanocomposites AA-LDH@MS. The amino acids including phenylalanine (Phe) and histidine (His) with aromatic groups are intercalated into LDH as the cores Phe-LDH and His-LDH. These nanocomposites AA-LDH@MS display multispaces of the interlayer spaces of LDH and porous channels of mesoporous silica to load drugs. Moreover, amino acid molecules provide the interaction sites to improve effectively loading amounts of drugs. 5-Fluorouracil (5-FU) is used as the cargo molecules to observe the delivery in vitro. The results indicate that the maximum loading amounts of drugs are up to 392 mg/g at 60 °C for 12 h in the nanocomposite Phe-LDH@MS. All the nanocomposites exhibit the sustained release of 5-FU at pH 4 and pH 7.4. The Korsmeyer–Peppas model is used to fit the kinetic plot of the drug release in vitro, which concludes that 5-FU release from AA-LDH@MS belongs to Fickian diffusion.
The dipeptide dl-methionyl-dl-methionine (Met-Met) has extremely low water solubility and better absorption than other methionine sources (such as dl-methionine and l-methionine) available in the market. Therefore, six diets (D1, D2, D3, D4, D5 and D6) containing 0, 0·07, 0·15, 0·21, 0·28 and 0·38 % Met-Met were formulated to investigate the effects of Met-Met in juvenile Nile tilapia, Oreochromis niloticus (17 g initial body weight). The results indicated that percentage weight gain and specific growth rate of fish fed with D2 and D3 diets were higher than those fed with D1, D4–D6 diets. The levels of total essential amino acid in whole body of fish fed with D3 and D4 diets were significantly higher than those fed the D1 diet. Superoxide dismutase activity and malondialdehyde content have no significant difference in fish fed the diet with or without Met-Met supplementation. Majority of reads derived from the fish intestine belonged to members of Fusobacteria, followed by Bacteroidetes and Proteobacteria. Diversity of intestinal microbiota and total antioxidant capacity in fish fed with D3 diet was significantly higher than that of other groups. Based on the growth results, the authors conclude that the optimal level of Met is 0·61 % Met with the addition of 0·15 % Met-Met for grower-phase O. niloticus.
Biochar conversion from corn stover was evaluated under various process conditions, and the absorption capacity of biochar was investigated for the removal of oxytetracycline in wastewater. Biochar was prepared at lower carbonization temperatures (200–500 °C) and was used in three different concentrations of chemical oxygen wastewater. The results showed that the biochar prepared at the temperature range of 200–500 °C had a faster sorption rate and shorter sorption equilibrium time compared to biochar produced at higher temperatures. The longest time to reach sorption equilibrium was 9 h for biochar obtained at 200 °C. However, the biochar prepared at 500 °C required only 0.5 h to reach the sorption equilibrium. The corn stover-biochar had the highest sorption capacity of 246.3 mg/g for oxytetracycline at 30 °C. The adsorption kinetics was consistent with pseudo–second-order kinetics. This study provides a theoretical basis for the conversion of corn stover into biochar as efficient sorbents.
Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
Schizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.
To investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.
Genomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.
The imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.
These findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
A varactor-based fully reconfigurable microstrip bandpass-to-bandpass-with-embedded-stopband filter is presented in this paper. This filter offers wide center frequency and bandwidth tuning flexibility under both bandpass mode and bandpass-with-embedded-stopband mode. The entire tuning ability is based on multiple mode resonator theory and external quality factor tuning structure for bandpass mode and the introduction of transmission zeros (TZs) for bandpass-with-embedded-stopband mode. Under the bandpass mode, the center frequency tuning range is 0.96–1.45 GHz and the bandwidth can be tuned from 0.09 to 1.41 GHz with a fixed center frequency at 1.22 GHz. Under bandpass-with-embedded-stopband mode, the center frequency and bandwidth can be tuned from 0.94 to 1.61 GHz and 0.2–0.33 GHz, respectively. Good agreements are shown between simulated and measured results.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
Underground Nuclear Astrophysics in China (JUNA) will take the advantage of the ultra-low background in Jinping underground lab. High current accelerator with an ECR source and detectors were commissioned. JUNA plans to study directly a number of nuclear reactions important to hydrostatic stellar evolution at their relevant stellar energies. At the first period, JUNA aims at the direct measurements of 25Mg(p,γ)26 Al, 19F(p,α) 16 O, 13C(α, n) 16O and 12C(α,γ) 16O near the Gamow window. The current progress of JUNA will be given.
This paper proposes a new radar cross section (RCS) reduced microstrip antenna incorporating 475 square slots on the patch. The proposed antenna achieves wideband RCS reduction with radiation performance sustained. The modified and reference antenna are simulated and analyzed in radiating and scattering mode, respectively. Prototypes of two antennas are fabricated and measured. Compared with the reference antenna, the simulated result shows the modified antenna RCS reduced in the frequency range 1.1–2.6 GHz, which contains the in-band and out-of-band frequency band simultaneously. And the maximum RCS reduction is 7.6dB at the frequency of 1.19GHz. Besides, the modified antenna can achieve the antenna RCS reduction in the case of oblique incidence. The prototypes of two antennas are fabricated and measured, and the accuracy of the simulation is proved by the measured result. Due to its advantages of simplicity, wideband RCS reduced, broad-angle RCS reduced, the method in this paper is suitable for wideband antenna RCS reduction in space-limited environment.
Nutrition therapy is considered an important treatment of burn patients. The aim of the study was to delineate the nutritional support in severe burn patients and to investigate association between nutritional practice and clinical outcomes. Severe burn patients were enrolled (n 100). In 90 % of the cases, the burn injury covered above 70 % of the total body surface area. Mean interval from injury to nutrition start was 2·4 (sd 1·1) d. Sixty-seven patients were initiated with enteral nutrition (EN) with a median time of 1 d from injury to first feed. Twenty-two patients began with parenteral nutrition (PN). During the study, thirty-two patients developed EN intolerance. Patients received an average of about 70 % of prescribed energy and protein. Patients with EN providing <30 % energy had significantly higher 28- d and in-hospital mortality than patients with EN providing more than 30 % of energy. Mortality at 28 d was 11 % and in-hospital mortality was 45 %. Multiple regression analysis demonstrated that EN providing <30 % energy and septic shock were independent risk factors for 28- d prognosis. EN could be initiated early in severe burn patients. Majority patients needed PN supplementation for energy requirement and EN feeding intolerance. Post-pyloric feeding is more efficient than gastric feeding in EN tolerance and energy supplement. It is difficult for severe burn patients to obtain enough feeding, especially in the early stage of the disease. More than 2 weeks of underfeeding is harmful to recovery.
As important epigenetic regulators, microRNA regulate protein expression by triggering the degradation of target mRNA and/or by inhibiting their translation. Dysregulation of microRNA expression has been reported in several cancers, including colorectal cancer. In this study, microRNA-array differential analysis revealed strongly enhanced expression of miR-24-1-5p in the colon tissue of azoxymethane/dextran sulphate sodium-induced mice that were fed with black raspberry anthocyanins for 9 weeks. Overexpression of miR-24-1-5p in human colorectal cancer cells significantly repressed β-catenin expression, and simultaneously decreased cell proliferation, migration and survival. Furthermore, miR-24-1-5p could target β-catenin and trigger a negative regulatory loop for β-catenin and its downstream target genes. β-Catenin signalling is vital to the formation and progression of human colorectal cancer. The current findings therefore identified miR-24-1-5p as a potent regulator of β-catenin, and this may provide a novel chemopreventive and therapeutic strategy for β-catenin signalling-driven colorectal cancer.