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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.
Data on average iodine requirements for the Chinese population are limited following implementation of long-term universal salt iodisation. We explored the minimum iodine requirements of young adults in China using a balance experiment and the ‘iodine overflow’ hypothesis proposed by our team. Sixty healthy young adults were enrolled to consume a sequential experimental diet containing low, medium and high levels of iodine (about 20, 40 and 60 μg/d, respectively). Each dose was consumed for 4 d, and daily iodine intake, excretion and retention were assessed. All participants were in negative iodine balance throughout the study. Iodine intake, excretion and retention differed among the three iodine levels (P < 0·01 for all groups). The zero-iodine balance derived from a random effect model indicated a mean iodine intake of 102 μg/d, but poor correlation coefficients between observed and predicted iodine excretion (r 0·538 for μg/d data) and retention (r 0·304 for μg/d data). As iodine intake increased from medium to high, all of the increased iodine was excreted (‘overflow’) through urine and faeces by males, and 89·5 % was excreted by females. Although the high iodine level (63·4 μg/d) might be adequate in males, the corresponding level of 61·6 μg/d in females did not meet optimal requirements. Our findings indicate that a daily iodine intake of approximately half the current recommended nutrient intake (120 μg/d) may satisfy the minimum iodine requirements of young male adults in China, while a similar level is insufficient for females based on the ‘iodine overflow’ hypothesis.
To identify the association of the glucokinase gene (GCK) rs4607517 polymorphism with gestational diabetes mellitus (GDM) and determine whether sweets consumption could interact with the polymorphism on GDM in Chinese women.
We conducted a case–control study at a hospital including 1015 participants (562 GDM cases and 453 controls). We collected the data of pre-pregnancy BMI, sweets consumption and performed genotyping of the GCK rs4607517 polymorphism. Logistic regression was performed to test the association between the rs4607517 polymorphism and GDM, and the stratified analyses by sweets consumption were conducted, using an additive genetic model.
A case–control study of women at a hospital in Beijing, China.
One thousand and fifteen Chinese women.
The GCK rs4607517 A allele was significantly associated with GDM (OR 1·35, 95 % CI 1·03, 1·77; P = 0·028). Furthermore, stratified analyses showed that the A allele increased the risk of GDM only in women who had a habitual consumption of sweet foods (sweets consumption ≥ once per week) (OR 1·61, 95 % CI 1·17, 2·21; P = 0·003). Significant interaction on GDM was found between the rs4607517 A allele and sweets consumption (P = 0·004).
This study for the first time reported the interaction between the GCK rs4607517 polymorphism and sweets consumption on GDM. The results provided novel evidence for risk assessment and personalised prevention of GDM.
West Junggar in the southwestern Central Asian Orogenic Belt is a critical area for the study of the Junggar oceanic basin and may also reveal tectonic evolutionary events before the final closure of the Palaeo-Asian Ocean. The sedimentary formations and paragenetic associations of the Upper Carboniferous Chengjisihanshan Formation in southern West Junggar jointly reveal a back-arc basin setting with zircon U–Pb ages of 313–310 Ma for the basaltic rocks. Geochemically, the basaltic rocks are tholeiitic with low SiO2 (47.76–52.06 wt %) and K2O (0.05–0.74 wt %) but high MgO (6.55–7.68 wt %) contents and Mg no. (52.9–58.9) values. They display slightly flat rare earth element patterns with weak positive Eu anomalies, and show enrichments in large ion lithophile elements relative to high field strength elements with negative Nb and Ta anomalies, exhibiting both N-MORB-like and arc-like signatures, similar to the back-arc basin basalt from the Mariana Trough. The high positive zircon εHf(t) and bulk εNd(t) values as well as high initial Pb isotopes, together with relatively high Sm/Yb and slightly low Th/Ta ratios imply a depleted spinel lherzolitic mantle source metasomatized by slab-derived fluids. The field and geochemical data jointly suggest that the volcanic rocks within the Chengjisihanshan Formation were formed in an intra-oceanic back-arc basin above the northwestward subduction of the Junggar oceanic lithosphere in southern West Junggar. The confirmation of the Late Carboniferous back-arc basin basalts, together with other geological observations, indicate that an arc-basin evolutionary system still existed in southern West Junggar at c. 310 Ma, and the Junggar Ocean closed after Late Carboniferous time.
The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.
The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.
Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.
Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.
Transmission of varicella occurs frequently in schools and households. We investigated the characteristics of varicella cases derived from within-household transmission and the modes of varicella transmission between school and household settings in Shanghai, China, from 2009 to 2018. Within-household transmission occurred in 278 households, of which 134 transmission events were between children. Sixty-one household varicella transmission events may be attributed to isolation procedures for infected students during school outbreaks, and 7.6% of school outbreaks were caused by schoolchildren cases derived from within-household transmission. The frequency of ‘school-household-school’ transmission adds an additional layer of complexity to the control of school varicella outbreaks. Administration of varicella vaccine as post-exposure prophylaxis after exposure is considered to be an effective measure to control varicella spread within households and schools.
To explore the relationship between dietary patterns and risk of chronic kidney disease (CKD) in Chinese adults aged 45–59 years.
Dietary data were collected using a semi-quantitative FFQ. Factor analysis was used to identify the major dietary patterns. Logistic regression models were applied to clarify the association between dietary patterns and the risk of CKD.
The present study population was a part of the population-based Nutrition and Health Study performed in the city of Hangzhou, Zhejiang Province, eastern China.
A total of 2437 eligible participants (45–59 years) were enrolled in the present cross-sectional study from June 2015 to December 2016.
Three major dietary patterns were identified: ‘traditional southern Chinese’, ‘Western’ and ‘grains–vegetables’ patterns, collectively accounting for 25·6 % of variance in the diet. After adjustment for potential confounders, participants in the highest quartile of the Western pattern had greater odds for CKD (OR = 1·83, 95 % CI 1·21, 2·81; P < 0·05) than those in the lowest quartile. Compared with the lowest quartile of the grains–vegetables pattern, the highest quartile had lower odds for CKD (OR = 0·84, 95 % CI 0·77, 0·93; P < 0·05). In addition, there was no significant association between the traditional southern Chinese pattern and risk of CKD (P > 0·05).
Our results suggest that the Western pattern is associated with an increased risk, whereas the grains–vegetables pattern is associated with a reduced risk for CKD. These findings can guide dietary interventions for the prevention of CKD in a middle-aged Chinese population.
The aim of this study is to characterize the injury profiles and outcomes of victims of a tornado in Jiangsu Province, China.
This study retrospectively investigated the clinical records of 144 patients treated at a teaching hospital due to a tornado. Each patient’s demographic data, diagnosis, injury types, causes of injury, infection status, and outcomes were all reviewed.
Of the 144 patients, 64 (44.4%) were male, and 80 (55.6%) were female. The patients’ ages ranged from 2 months to 94 years; 91 (63.19%) were admitted within the first 12 h after the disaster. The most frequently injured sites were the body surfaces (24.48%), followed by the limbs and pelvis (21.79%) and chest (20.3%). Soft-tissue injuries and fractures were the most frequent injuries. Traumatic brain injuries were the main causes of death. Tornado-related injuries were primarily caused by flying/falling bricks, wood, and glass. Twenty-three (15.9%) patients suffered from infections, which consisted mainly of skin/soft tissue infections and pneumonia.
Destructive tornadoes often cause heavy casualties with little warning. Medical aid agencies must be prepared to accommodate the massive numbers of injured patients after a catastrophe. Proper triage and prompt treatment of injured victims may decrease mortality. (Disaster Med Public Health Preparedness. 2019;xx:xxx-xxx).
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.
Palladium (Pd) and gold (Au) nanoparticles (NPs) hybridized on two types of carbon supports, graphene and granular activated carbon (GAC), were shown to be promising catalysts for the sustainable hydrodehalogenation of aqueous trichloroethylene (TCE). These catalysts are capable of degrading TCE more rapidly than commercial Pd-on-GAC catalysts. The catalysts were synthesized at room temperature without the use of any environmentally unfriendly chemicals. Pd was chosen for its catalytic potency to break down TCE, while Au acts as a strong promoter of the catalytic activity of Pd. The results indicate that both graphene and GAC are favorable supports for the NPs due to high surface-to-volume ratios, unique surface properties, and the prevention of NP aggregation. The properties of NP catalysts were characterized using electron microscopy and spectroscopy techniques. The TCE degradation results indicate that the GAC-supported catalysts have a higher rate of TCE removal than the commercial Pd-on-GAC catalyst, and the degradation rate is greatly increased when using graphene-supported samples.
Monosized spherical Cu–20% Sn (wt%) alloy particles with diameter ranging from 70.6 to 334.0 μm were prepared by the pulsated orifice ejection method (termed “POEM”). Fully dense without pores and bulk inclusions, the cross-sectional micrographs of the spherical alloy particles indicate an even distribution of Cu and Sn. These spherical Cu–Sn alloy particles exhibit a good spherical shape and a narrow size distribution, suggesting that the liquid Cu–Sn alloy can completely break the balance between the surface tension and the liquid static pressure in the crucible micropores and accurately control the volume of the droplets. Furthermore, the cooling rate of spherical Cu–20% Sn alloy particles is estimated by a Newton’s cooling model. The cooling rate of the Cu–20% Sn alloy particle decreases gradually with the particle diameter increasing. Smaller particles have higher cooling rates and when the particle diameter is less than 70 μm, the cooling rate of particles can reach more than 3.3 × 104 K/s. The secondary dendrite arm spacing has strong dependence on particle diameter which increases gradually with the increase of particle diameter. The results demonstrate that POEM is an effective route for fabrication of high-quality monosized Cu–20% Sn alloy particles.
Elastocaloric materials exhibit extraordinary cooling potential, but the repetition of cyclic mechanical loadings during long-term operation of cooling systems requires the refrigerant material to have long fatigue life. This article reviews the fundamental cause of fatigue from aspects of initiation and propagation of fatigue cracks in shape-memory alloys (SMAs) that are used as elastocaloric materials, and highlights recent advances in using compression to overcome fatigue by curtailing the generation of surfaces associated with crack propagation. Compression is identified as a key means to extend fatigue lifetime in engineering design of elastocaloric cooling drive mechanisms. We summarize the state-of-the-art performance of different SMAs as elastocaloric materials and discuss the influence of low cyclic strains and high resistance to transformation. We present integration of compression-based material assemblies into a cooling system prototype and optimization of the system efficiency using work recovery and related measures.
Disclosing the diagnosis of Alzheimer's disease (AD) to a patient is controversial. There is significant stigma associated with a diagnosis of AD or dementia in China, but the attitude of the society toward disclosure of such a diagnosis had not been formally evaluated prior to our study. Therefore, we aimed to evaluate the attitude toward disclosing an AD diagnosis to patients in China with cognitive impairment from their caregivers, and the factors that may affect their attitude.
We designed a 17-item questionnaire and administered this questionnaire to caregivers, who accompanied patients with cognitive impairment or dementia in three major hospitals in Shanghai, China. The caregiver's attitude toward disclosing the diagnosis of AD as evaluated by the questionnaire was compared to that of disclosing the diagnosis of terminal cancer.
A majority (95.7%) of the 175 interviewed participants (mean 14.2 years of education received) wished to know their own diagnosis if they were diagnosed with AD, and 97.6% preferred the doctor to tell their family members if they were diagnosed with AD. If a family member of the participants suffered from AD, 82.9% preferred to have the diagnosis disclosed to the patient. “Cognitive impairment” was the most accepted term by caregivers to disclose AD diagnosis in Chinese.
This study suggests most of the well-educated individuals in a Chinese urban area favored disclosing the diagnosis when they or their family members were diagnosed with AD.
Obesity is associated with blood pressure (BP), but the associations between different obesity indicators and BP have not reached agreement. Besides, both obesity and BP are influenced by genetic and environmental factors. Whether they share the same genetic or environmental etiology has not been fully understood. We therefore analyzed the relationship between different obesity indicators and BP components as well as the genetic and environmental contributions to these relationships in a Chinese adult twin sample. Twins aged 18–79 years (n = 941) were included in this study. Body mass index (BMI) was used as the index of general obesity, whereas waist circumference (WC), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) were used as the indicators of central obesity. BP components included systolic blood pressure (SBP) and diastolic blood pressure (DBP). Linear regression models and bivariate structural equation models were used to examine the relation of various obesity indicators with BP components, and genetic or environmental influences on these associations, respectively. A strong association of BP components with BMI—and a somewhat weaker association with WC, WHtR, and WHR—was found in both sexes, independent of familial factors. Of these phenotypic correlations between obesity indicators and BP components, 60–76% were attributed to genetic factors, whereas 24–40% were attributed to unique environmental factors. General obesity was most strongly associated with high BP in Chinese adult twins. There were common genetic backgrounds for obesity and BP, and unique environmental factors also played a role.
The acquisition and tracking strategies of the BeiDou navigation satellite signals are affected by the modulation of Neumann-Hoffman code (NH code), which increases the complexity of receiver baseband signal processing. Based on the analysis of probability statistics of the NH code, a special sequence of incoming signals is proposed to evade the bit transitions caused by the NH code, and an NH Code Evasion and Stripping method (NCES) based on the NH-pre-modulated code is proposed. The NCES can be applied in both 20-bit NH code and 10-bit NH code. The fine acquisition eliminates the impact of NH code on the traditional tracking loop. These methods were verified with a BeiDou PC-based software-defined receiver using the actual sampled signals. Compared with other acquisition schemes which try to determine or ignore the NH code phase, the NCES needs fewer incoming signals and the actual runtime is greatly reduced without sacrificing much time to search in the secondary code dimension, and the success rate of acquisition is effectively improved. An extension of Fast Fourier Transform (FFT)-based parallel code-phase search acquisition gives the NCES an advantage in engineering applications.
A fundamental problem of biology is to construct gene regulatory networks that characterize the operational interaction among genes. The term “gene” is used generically because such networks could involve gene products. Numerous inference algorithms have been proposed. The validity, or accuracy, of such algorithms is of central concern. Given data generated by a ground-truth network, how well does a model network inferred from the data match the data-generating network? This chapter discusses a general paradigm for inference validation based on defining a distance between networks and judging validity according to the distance between the original network and the inferred network. Such a distance will typically be based on some network characteristics, such as connectivity, rule structure, or steady-state distribution. It can also be based on some objective for which the model network is being employed, such as deriving an intervention strategy to apply to the original network with the aim of correcting aberrant behavior. Rather than assuming that a single network is inferred, one can take the perspective that the inference procedure leads to an “uncertainty class” of networks, to which belongs the ground-truth network. In this case, we define a measure of uncertainty in terms of the cost that uncertainty imposes on the objective, for which the model network is to be employed, the example discussed in the current chapter involving intervention in the yeast cell cycle network.
From a translational perspective, we are interested in gene regulatory networks (GRNs) as a vehicle to derive optimal intervention strategies for regulatory pathologies, cancer being the salient example (see [1–3] for reviews and  for extensive coverage). Two basic intervention approaches have been considered for gene regulatory networks in the context of probabilistic Boolean networks (PBNs), external control and structural intervention , a key to intervention being that the dynamic behavior of a PBN can be modeled by a Markov chain, thereby making intervention in PBNs amenable to the theory of Markov decision processes. Perhaps we should note that the ability of Markov chains to model GRNs has a long history in translational genomics . External control is based on externally manipulating the value of a control gene to beneficially alter the steady-state distribution, either indirectly via a one-step cost function  or directly via an objective function based on the steady-state distribution [7, 8].
Detailed analysis of the polarization tracking modules for Ku band active phased array antennas is presented. The proposed transmitter (14.0–14.5 GHz) and receiver (12.25–12.75 GHz) modules are based on the low temperature co-fired ceramic (LTCC) technique, containing orthogonal dual channels with different phases controlled by phase shifters. The effect of amplitude and phase inconsistency between two channels on polarization tracking performance is analyzed. The validity of the analysis is verified by the measurements of the manufactured prototypes. The measured patterns of the active phased array antenna are given to illustrate the effects of the modules on polarization agility, which may be used for Ku band satellite antennas on mobile terminals.
To ascertain whether the Kunming (KM) mouse is an available model for age-related decline in female fertility in human or not, oocytes from young (6–8 weeks), middle-aged (9 months) and aged (12 months) female mice were compared with respect to number of oocytes, frequency of in-vitro maturation (IVM) and in-vitro fertilization (IVF), and meiotic chromosome segregation and alignment. The mean number of pups born per mouse decreased significantly from the young to the middle-aged and the aged mice. The mean number of ovarian follicles, ovarian germinal vesicle oocytes and ovulated MII oocytes decreased significantly with maternal age. The rate of IVM in oocytes from young mice (73.9%) was less significantly than that in oocytes from middle-aged and aged mice (86.1% and 84.4%, respectively). Immunocytochemical analysis showed that ageing caused a significantly higher rate (49.3%) of chromosome misalignment than that (15.7%) of the young mice. The presence of premature chromatids was also significantly higher in MII oocytes of aged mice as compared with young mice (37.8 versus 8.3%). Pronuclear formation was delayed in oocytes of middle-aged and aged females (35.5 and 42.3% respectively in 5 h of IVF) as compared with young mice (88.1%). The study suggests that KM mouse exhibits an age-related decline in female fertility. Significant reduction of germinal vesicle (GV) and MII oocytes and significant increase of metaphase chromosome misalignment and premature chromatid segregation after meiotic maturation of oocytes, similar to human, presumably contribute to the decline in aged KM mice.