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The outbreak of pneumonia known as coronavirus disease (COVID-19) occurred in China since December 2019 and spread rapidly across the world. Paediatric medical workers have a serious imbalance doctor-patient ratio in China, they have accumulated experience during the anti-COVID-19 period, however, some flaws were revealed in the current medical system. Meanwhile, these problems were also reported in other countries. Thus far, the outbreak of COVID-19 is still going all over the world. The experience from anti-COVID-19 could be useful and teach us to provide better medical service for Chinese children in case of similar public emergencies in the future. Furthermore, it also provides guidance for paediatric medical staff in other developing countries against COVID-19.
Understanding the patterns of treatment response is critical for the treatment of patients with schizophrenia; one way to achieve this is through using a longitudinal dynamic process study design.
This study aims to explore the response trajectory of antipsychotics and compare the treatment responses of seven different antipsychotics over 6 weeks in patients with schizoprenia (trial registration: Chinese Clinical Trials Registry Identifier: ChiCTR-TRC-10000934).
Data were collected from a multicentre, randomised open-label clinical trial. Patients were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up at weeks 2, 4 and 6. Trajectory groups were classified by the method of k-means cluster modelling for longitudinal data. Trajectory analyses were also employed for the seven antipsychotic groups.
The early treatment response trajectories were classified into a high-trajectory group of better responders and a low-trajectory group of worse responders. The results of trajectory analysis showed differences compared with the classification method characterised by a 50% reduction in PANSS scores at week 6. A total of 349 patients were inconsistently grouped by the two methods, with a significant difference in the composition ratio of treatment response groups using these two methods (χ2 = 43.37, P < 0.001). There was no differential contribution of high- and low trajectories to different drugs (χ2 = 12.52, P = 0.051); olanzapine and risperidone, which had a larger proportion in the >50% reduction at week 6, performed better than aripiprazole, quetiapine, ziprasidone and perphenazine.
The trajectory analysis of treatment response to schizophrenia revealed two distinct trajectories. Comparing the treatment responses to different antipsychotics through longitudinal analysis may offer a new perspective for evaluating antipsychotics.
The risk of environmental contamination by SARS-CoV-2 in the intensive care unit (ICU) is unclear. We aimed to evaluate the extent of environmental contamination in the ICU and correlate this with patient and disease factors, including the impact of different ventilatory modalities.
Observational study where surface environmental samples collected from ICU patient rooms and common areas were tested by SARS-CoV-2 PCR, with select samples from the common area tested on cell culture. Clinical data were collected and correlated to presence of environmental contamination. Results were compared to historical data from a previous study in general wards (GW).
200 samples from 20 patient rooms, and 75 samples from common areas and the staff pantry, were tested. 14 rooms had at least one site contaminated, with an overall contamination rate of 14% (28 of 200 samples). Environmental contamination was not associated with day of illness, ventilatory mode, aerosol generating procedures, or viral load. There was lower frequency of environmental contamination in ICU compared to GW rooms. Eight samples from the common area were positive, though all were negative on cell culture.
Environmental contamination in the ICU is lower compared to the GW. Use of mechanical ventilation or high-flow nasal oxygen was not associated with greater surface contamination, supporting their use and safety from an infection control perspective. Transmission risk via environmental surfaces in the ICUs is likely to be low. Nonetheless, infection control practices should be strictly reinforced, and transmission risk via droplet or airborne spread remains.
Few studies have suggested that long-term adherence to low-carbohydrate diets (LCD) may affect maternal glucose metabolism in western countries. We aimed to investigate the association between LCD during pregnancy and glucose metabolism in Chinese population. A total of 1,018 women in mid-pregnancy were recruited in 2017-2018. Participants underwent a 75g oral glucose tolerance test (OGTT). Daily dietary intakes over the past month were accessed using a validated food frequency questionnaire. The overall, animal, and vegetable LCD scores which represent adherence to different low-carbohydrate dietary patterns were calculated. Mixed linear regression and generalized linear mixed regression were conducted to evaluate the associations between LCD scores and maternal glucose metabolism. Of the 1,018 subjects, 194 (19.1%) was diagnosed with gestational diabetes mellitus (GDM). The overall LCD score (β: 0.024, standard error (SE): 0.008, PFDR=0.02) and animal LCD score (β: 0.023, SE: 0.008, PFDR=0.02) was positively associated with OGTT 1-h glucose. No significant associations were found between the three different LCD scores with fasting plasma glucose (FPG), OGTT 2-h glucose, or insulin resistance, respectively. Compared with the lowest quartile, the crude odds ratios of GDM for the highest quartile were 1.84 (95% CI: 1.14, 2.95) for overall LCD score (P for trend = 0.02) and 1.56 (1.00, 2.45) for animal LCD score (P for trend = 0.02). However, these associations became nonsignificant after adjustment for covariates. In conclusion, a low-carbohydrate dietary pattern with high animal protein and fat is associated with higher postprandial 1-h glucose levels in Chinese pregnant women.
Monitoring the tension in cables is significant in some ice drill and deepwater applications. Take our RECoverable Autonomous Sonde (RECAS) for example. It is able to melt a hole to the bottom of ice sheet and is able to move upwards. A winch is installed inside RECAS to release and recover the cable, whose tension needs to be monitored in real time in order to control the behavior of the winch. The high pressure of deep water and limited installation space pose great challenges in sensor development. In this paper, two editions of newly designed deepwater tension sensors are proposed. The first edition is based on a fresh hydraulic load module that operates in high pressure environment and the second edition tension, which aims to improve the accuracy, applies a newly designed watertight load module. Detailed force transmission and characteristic analysis of the sensors are carried out. The sensors have got through a series of experiments, including calibration experiments, pressure experiments and field experiments. The resultant accuracy of the second edition sensor, which has a better performance, is over 2% under the measuring range of 1000 kg and the dimension of the final sensor is as compact as 150 mm × 137 mm × 86 mm.
Mutation in CFAP43 leads to severe asthenozoospermia and multiple morphological abnormalities of the sperm flagellum (MMAF) in both human and mouse. Previous studies have shown that disruption of intra-manchette transport (IMT) caused failure of flagellum assembly and sperm head shaping. In a previous study, therefore, we postulated that disruption of IMT may contribute to the failure of sperm flagellum formation and result in MMAF, however the mechanisms underlying these defects are still poorly understood. Cfap43-deficient mice were studied here to reveal the cellular mechanisms of abnormal sperm head morphology and MMAF. Depletion of Cfap43 led to abnormal spermiogenesis and caused MMAF, sperm head abnormality and oligozoospermia. Furthermore, both abnormal manchette and disorganized ectoplasmic specialization (ES) could be observed at the elongated spermatids in Cfap43-deficient mice. Therefore, our findings demonstrated that, in mice, CFAP43-mediated IMT is essential for sperm head shaping and sperm flagellum formation.
High carbohydrate diet could achieve protein sparing effect, but it may cause negative impacts on the growth condition of fish due to their poor utilization ability of carbohydrate. How to reduce the adverse effects caused by high carbohydrate diet is important for the development of aquaculture. In the present study, we aimed to identify whether inulin could attenuate metabolic syndrome caused by high-carbohydrate diet in fish. Nile tilapia (Oreochromis niloticus) (1.19 ± 0.01 g) were supplied with 35% carbohydrate (CON), 45% carbohydrate (HC) and 45% carbohydrate + 5g/kg inulin (HCI) diets for ten weeks. The results showed that addition of inulin improved the survival rate when fish were challenged with Aeromonas hydrophila, indicating inulin had an immunostimulatory effect. Compared with HC group, HCI group had lower lipid accumulation in liver and the gene expression analyses indicated that addition of inulin downregulated genes related to lipogenesis and upregulated genes relevant to β-oxidation significantly (P < 0.05). Higher liver glycogen and glucose tolerance were found in HCI group compared with HC group (P < 0.05). These results indicated that inulin could alleviate the metabolic syndrome induced by high-carbohydrate diet. Furthermore, addition of inulin in high-carbohydrate diet changed the intestinal bacterial composition and significantly increased the concentration of acetic acid and propionic acid in fish gut which have the potential to increase pathogen resistance and regulate metabolic characteristics in fish. Collectively, our results demonstrated a possible causal role for the gut microbiome in metabolic improvements induced by inulin in fish.
The construction of halloysite spherical capsules (halloysite aerogels) was reported for the first time in our previous work. The excellent performance of the microcapsule in functional carrying was also found in our further research. In this work, the anti-icing surface was fabricated by using halloysite nanotubes and halloysite spherical microcapsules. The fabrication of the anti-icing coating was investigated, and the ice nucleation behavior of droplet on the coating surface was studied. The modified halloysite nanotubes (F-HNTs) and the modified halloysite microcapsules (F-HAs) were characterized by Fourier-transform infrared spectroscopy, thermal gravimetric, and pore size distribution. The results show that the introduction of F-HNTs and F-HAs have successfully formed a micro-nano structure on the coating surface with superhydrophobicity performance. The icing temperature of the coating has decreased 2.3 °C compared with bare glass, and the ice adhesion strength has decreased 82%. According to the ice dynamic mechanics, the ice nucleation rate on the coating is significantly reduced, thus the halloysite microcapsule coating has good icephobic performance.
Eurasian steppes experienced frequent cultural transfers, human migration, and diffusion of techniques during the Bronze Age. The Hami Oasis is one of the most dynamic areas and has attracted multiple cultural flows. It is an important area that connects various routes of the Tianshan Corridor with the Hexi Corridor in western China. The Tianshanbeilu cemetery is the largest Bronze Age cemetery in Hami. Thirty-seven new radiocarbon dates allowed us to establish a new and more accurate chronology for Tianshanbeilu. Our results showed that the Tianshanbeilu cemetery was used from approximately 2022–1802 cal BC and remained in use from 1093–707 cal BC. This indicates that Tianshanbeilu is the earliest and longest-used known cemetery in eastern Xinjiang. By incorporating the typology of artifacts and stratigraphic relationships, the development of the Tianshanbeilu cemetery was divided into four phases. The first phase was from 2011–1672 cal BC, the second phase was from 1660–1408 cal BC, the third phase was from 1385–1256 cal BC, and the fourth phase was from 1214–1029 cal BC.
The association between egg consumption and diabetes is inconclusive. We aimed to examine the association between long-term egg consumption and its trajectory with diabetes in Chinese adults. A total of 8 545 adults aged ≥ 18 years old who attended the China Health and Nutrition Survey from 1991 to 2009 were included in this analysis. Egg consumption at each survey was assessed by a three-day 24-hour recall and weighed food record methods. The consumption trajectories of egg were modelled with the latent class group approach. Diabetes was diagnosed based on fasting blood glucose in 2009. Logistic regression was used to examine the association. The mean age of the study population was 50.9 (SD 15.1) years. 11.1% had diabetes in 2009. Egg consumption nearly doubled in 2009 from 16 g/day in 1991. Compared with the first quartile of egg consumption (0-9.0 g/day), the adjusted OR (95% CI) of diabetes for the second (9.1-20.6 g/day), third (20.7-37.5 g/day), and fourth (≥ 37.6 g/day) quartiles were 1.29 (95% CI 1.03, 1.62), 1.37 (95% CI 1.09, 1.72), and 1.25 (95% CI 1.04, 1.64), respectively (P for trend = 0.029). Three trajectory groups of egg consumption were identified. Compared with Group 1 (30.7%, low baseline intake and slight increase), both Group 2 (62.2%, medium baseline intake and increase) and Group 3 (7.1%, high baseline intake and decrease) were associated with an increased odds ratio (OR) for diabetes. The results suggested that higher egg consumption was positively associated with the risk of diabetes in Chinese adults.
Microwaves are a form of electromagnetic radiation commonly used for telecommunications, navigation and food processing. More recently microwave technologies have found applications in fibre-reinforced polymer composites, which are increasingly used in aircraft structures. Microwave energy can be applied with low power (up to milliwatts) for non-destructive testing and high power (up to kilowatts) for heating/curing purposes. The state-of-the-art applications at high power include curing, three-dimensional (3D) printing, joining and recycling, whereas low-power microwave techniques can provide quality checks, strain sensing and damage inspection. Low-power microwave testing has the advantage of being non-contact, there is no need for surface transducers or couplants, it is operator friendly and relatively inexpensive; high-power microwave energy can offer volumetric heating, reduced processing time and energy saving with no ionising hazards. In this paper the recent research progress is reviewed, identifying achievements and challenges. First, the critical electromagnetic properties of composites that are closely related to the heating and sensing performance are discussed. Then, representative case studies are presented. Finally, the trends are outlined, including intelligent/automated inspection and solid-state heating.
Vibration-based methods can be used effectively to characterize the physical properties of biological materials, with an increasing interest focused on the mechanics of individual, living cells. Real-time measurements of cell properties, such as mass and Young's modulus, can yield important insights into many aspects of cell growth and metabolism as well as the interaction of cells with external stimuli (e.g., drugs). Vibrational test structures designed for the study of such cell properties often use fixed configurations and operational modes, with associated limitations in determining multiple characteristics of the cell, simultaneously. Recent development of mechanics-guided techniques for deterministic assembly of three-dimensional (3D) microstructures provides a route to vibrational frameworks that offer tunable configurations, vibration modes, and resonant frequencies. Here we propose a method that exploits such tunable vibrational structures to simultaneously determine the mass and modulus of a single adherent cell, or of other biological materials or small-scale living systems (e.g., organoids), through theoretical modeling and finite element analysis. The idea involves a 3D architecture that supports two different vibrational structures and can be converted from one to the other through application of strain to an elastomeric substrate. Specifically, tailored designs for serpentine ribbons in these systems enable a decoupling of the dependence of the resonant frequencies of the two structures to the cell mass and modulus, with an associated ability to measure these two properties accurately and independently. These same concepts can be scaled to apply to various types of cells, as well as to organoids (3D clusters of cells) and other biological materials with small geometries, across a range of values of mass and modulus. This method could serve as the foundation for microelectromechanical systems capable of monitoring mass and modulus in real time for use in research in biomechanics and dynamic biological processes.
Potassium and cerium co-doped Bi4Ti2.86W0.14O12 ceramics with a formula of (K0.5Ce0.5)xBi4−xTi2.86W0.14O12 (abbreviated as KC100x-BITW, x = 0, 0.02, 0.04, 0.06, 0.08, 0.1) were prepared by a conventional solid-state reaction method. The effect of (K0.5Ce0.5) complex doping amount on the structure, dielectric, and piezoelectric properties of the KC100x-BITW ceramics was investigated. X-ray diffraction results indicated that the KC100x-BITW ceramics are Aurivillius-type phase with the bismuth layer structure. (K0.5Ce0.5) complex addition first increases and then decreases the grain size which can be observed by scanning electron microscopy. With the increase of (K0.5Ce0.5) complex doping amount, the Curie temperature (TC) was slightly decreased from 632 to 608 oC. The dielectric and piezoelectric properties were optimized in KC100x-BITW ceramics with x = 0.08 as follows: d33 = 24 pC/N, kp = 8.2%, Qm = 6766, εr = 135 (@100 kHz), tanδ = 0.28% (@100 kHz), Tc = 611 oC, and resistivity ρ = 2.9 × 106 Ω cm at 500 oC, indicating that the KC100x-BITW ceramics are suitable for high-temperature piezoelectric sensing applications.
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.
Severe fever with thrombocytopenia syndrome (SFTS) is a disease with a high case-fatality rate that is caused by infection with the SFTS virus (SFTSV). Five electronic databases were systematically searched to identify relevant articles published from 1 January 2011 to 1 December 2019. The pooled rates with 95% confidence interval (CI) were calculated by a fixed-effect or random-effect model analysis. The results showed that 92 articles were included in this meta-analysis. For the confirmed SFTS cases, the case-fatality rate was 0.15 (95% CI 0.11, 0.18). Two hundred and ninety-six of 1384 SFTS patients indicated that they had been bitten by ticks and the biting rate was 0.21 (95% CI 0.16, 0.26). The overall pooled seroprevalence of SFTSV antibodies among the healthy population was 0.04 (95% CI 0.03, 0.05). For the overall seroprevalence of SFTSV in animals, the seroprevalence of SFTSV was 0.25 (95% CI 0.20, 0.29). The infection rate of SFTSV in ticks was 0.08 (95% CI 0.05, 0.11). In conclusion, ticks can serve as transmitting vectors of SFTSVs and reservoir hosts. Animals can be infected by tick bites, and as a reservoir host, SFTSV circulates continuously between animals and ticks in nature. Humans are infected by tick bites and direct contact with patient secretions.
To reveal the thermal shock resistance of double-layer thermal barrier coatings (TBCs), two types of TBCs were prepared via atmospheric plasma spraying, i.e., Gd2Zr2O7/yttria-stabilized zirconia (GZ/YSZ) TBCs and La2Zr2O7 (LZ)/YSZ TBCs, respectively. Subsequently, thermal cycling tests of the two TBCs were conducted at 1100 °C and their thermal shock resistance and failure mechanism were comparatively investigated through experiments and the finite element method. The results showed that the thermal shock failure of the two TBCs occurred inside the top ceramic coating. However, the GZ/YSZ TBCs had longer thermal cycling life. It was the mechanical properties of the top ceramic coating, and the thermal stresses arising from the thermal mismatch between the top ceramic coating and the substrate that determined the thermal cycling life of the two TBCs together. Compared with the LZ layer in the LZ/YSZ TBCs, the GZ layer in the GZ/YSZ TBCs had smaller elastic modulus, larger fracture toughness, and smaller thermal stresses, which led to the higher crack propagation resistance and less spallation tendency of the GZ/YSZ TBCs. Therefore, the GZ/YSZ TBCs exhibited superior thermal shock resistance to the LZ/YSZ TBCs.
The mortality of coronavirus disease 2019 (COVID-19) differs between countries and regions. This study aimed to clarify the clinical characteristics of imported and second-generation cases in Shaanxi. This study included 134 COVID-19 cases in Shaanxi outside Wuhan. Clinical data were compared between severe and non-severe cases. We further profiled the dynamic laboratory findings of some patients. In total, 34.3% of the 134 patients were severe cases, 11.2% had complications. As of 7 March 2020, 91.8% patients were discharged and one patient (0.7%) died. Age, lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, direct bilirubin, lactate dehydrogenase and hydroxybutyrate dehydrogenase showed difference between severe and no-severe cases (all P < 0.05). Baseline lymphocyte count was higher in survived patients than in non-survivor case, and it increased as the condition improved, but declined sharply when death occurred. The interleukin-6 (IL-6) level displayed a downtrend in survivors, but rose very high in the death case. Pulmonary fibrosis was found on later chest computed tomography images in 51.5% of the pneumonia cases. Imported and second-generation cases outside Wuhan had a better prognosis than initial cases in Wuhan. Lymphocyte count and IL-6 level could be used for evaluating prognosis. Pulmonary fibrosis as the sequelae of COVID-19 should be taken into account.
In this paper, dual-band and tri-band bandpass filters (BPFs) with fully independent and controllable passbands based on multipath-embedded resonators are presented. The dual-band BPF consists of two double open-ended stub-loaded terminal-shorted resonators (DOESL-TSRs) with a common via-hole connected along the symmetric plane of the filter. Based on DOESL-TSRs, a triple open-ended stub-loaded terminal-shorted resonator (TOESL-TSR) is proposed in the design of tri-band BPFs. The resonant characteristics of DOESL-TSR/TOESL-TSR are analyzed by the numerical calculation method. The measured results of the dual-band BPF show that the center frequencies (CFs) are located at 2.595 and 5.75 GHz, respectively, with 3 dB fraction bandwidth (FBWs) of 15 and 12.8%. The measured CFs of the tri-band BPF are located at 2.545, 3.775, and 5.95 GHz, respectively, with 3 dB FBWs of 9.8, 9.3, and 5.5%. Both of the filters exhibit the merits of fully independent and controllable passbands, high selectivity, and compact size.