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Since December 2019, a number of new infectious diseases, mainly lung diseases caused by novel coronavirus infections, have been discovered in Wuhan, Hubei province. With the spread of the epidemic, cases in other regions of China and abroad have been confirmed. This sudden outbreak of a new type of infectious disease has seriously threatened people’s health and safety, and China has adopted strong prevention and control measures in response. To provide a reference for international health emergency management workers, this article summarizes, from an academic perspective, the main prevention and control measures taken in China.
Although prenatal exposure to high ambient temperatures were reported to be associated with preterm birth, limited research assessed the impact of weather-related extreme heat events (EHE) on birthweight, particularly by trimester. We, therefore, investigated the impact of prenatal EHE on birthweight among term babies (tLBW) by trimester and birthweight percentile. We conducted a population-based case–control study on singleton live births at 38–42 gestational weeks in New York State (NYS) by linking weather data with NYS birth certificates. A total of 22,615 cases were identified as birthweight <2500 gram, and a random sample of 139,168 normal birthweight controls was included. EHE was defined as three consecutive days with the maximum temperatures of ≥32.2 °C/90 °F (EHE90) and two consecutive days of temperatures ≥97th percentile (EHE97) based on the distribution of the maximum temperature for the season and region. We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) with multivariable unconditional logistic regression, controlling for confounders. Overall exposure to EHE97 for 2 d was associated with tLBW (OR 1.05; 95% CI 1.02, 1.09); however, the strongest associations were only observed in the first trimester for both heat indicators, especially when exposure was ≥3 d (ORs ranged: 1.06–1.13). EHE in the first trimester was associated with significant reduction in mean birthweight from 26.78 gram (EHE90) to 36.25 gram (EHE97), which mainly affected the 40th and 60th birthweight percentiles. Findings revealed associations between multiple heat indicators and tLBW, where the impact was consistently strongest in the first trimester.
Because of their structural versatility, fast redox reactivity, high storage capacity, sustainability, and environmental friendliness, soluble organic redox molecules have emerged as materials that have potential for use in energy-storage systems. Considering these advantages, this paper reviews recent progress in implementing such materials in aqueous soluble organic redox flow batteries and organic alkali metal/air batteries. We identify and discuss major challenges associated with molecular structures, cell configurations, and electrochemical parameters. Hopefully, we provide a general guidance for the future development of soluble organic redox materials for emerging energy-storage devices used in the electricity grid.
The physics associated with various cavitation regimes about a hydrofoil is investigated in a variable-pressure water tunnel using high-speed photography and synchronised force measurements. Experiments were conducted on a relatively stiff stainless steel hydrofoil at a chord-based Reynolds number,
for cavitation numbers,
, ranging from 0.2 to 1.2, with the hydrofoil experiencing sheet, cloud and supercavitation regimes. The NACA0009 model of tapered planform was vertically mounted in a cantilevered configuration to a six-component force balance at an incidence,
to the oncoming flow. Tip deformations and cavitation behaviour were recorded with synchronised force measurements utilising two high-speed cameras mounted underneath and to the side of the test section. Break-up and shedding of an attached cavity was found to be due to either interfacial instabilities, re-entrant jet formation, shockwave propagation or a complex coupled mechanism, depending on
. Three primary shedding modes are identified. The Type IIa and IIb re-entrant jet-driven oscillations exhibit a non-linear dependence on
, decreasing in frequency with decreasing
due to growth in the cavity length, and occur at higher
values (Type IIa: 0.4–1.0; Type IIb: 0.7–0.9). Shockwave-driven Type I shedding occurs for lower
values (0.3–0.6) with the oscillation frequency being practically independent of
. The Type IIa oscillations locked in to the first sub-harmonic of the hydrofoil’s first bending mode in water which has been modulated due to the reduced added mass of the vapour cavity. Supplementary movies are available with the online version of the paper.
A gravity-driven water film falling down an ice sheet is considered within the framework of a long-wave approximation. The integral-boundary-layer method, modified with the account of the phase transition, is adopted to describe the evolution of both the free surface of a water film and the interface between the ice and water. A set of governing equations consisting of five coupled nonlinear partial differential equations is established. The linear instability analysis of the uniform base flow is performed, and the result is in good agreement with the Orr–Sommerfeld analysis of the linearized Navier–Stokes equations. The phase transition at the interface between the ice and water plays a role in stabilizing the system linearly with long-wavelength perturbations. The nonlinear solutions of the steady travelling waves are constructed numerically. The phase transition tends to suppress the dispersion of the interfacial wave. Comparisons to direct numerical simulation of the Navier–Stokes equations, which are performed with an extended marker and cell method, show a remarkable agreement. The integral-boundary-layer method captures the water film thickness and the topography of the ice sheet satisfactorily. The phase transition is observed to enhance the backflow phenomenon in the capillary region of the solitary-like interfacial wave.
Population ageing in China calls for evidence-based solutions, especially in terms of fulfilling long-term care needs among frail older adults. Respite services are identified as effective resources for alleviating care-giver burden and promoting the wellbeing of both older adults and their family care-givers. However, respite care is often under-used in China. This research aimed to examine factors associated with intention to use respite services among informal care-givers in Shanghai, mainland China. This study was part of the Longitudinal Study on Family Caregivers for Frail Older Adults in Shanghai. Pairs of older adults and their care-givers (N = 583) who successfully completed the 2013 and 2016 waves were included in the data analysis. Two logistic regression models were conducted, one with time-invariant and one with time-variant factors. The model with time-variant factors had greater explanatory power than the original Andersen model with time-invariant factors influencing intention to use respite services among care-givers. Care-givers had higher odds of intending to use respite services if they had higher care-giving burden, were caring elderly people who experienced care-giver transitions, or were caring for elderly people with increased function of ambulation or decreased function of feeding. The findings imply that change in functional health was a significant determinant of intention to use respite care. Relevant policy and service implications will be discussed.
The lane-level map, which contains the lane-level information severely lacking in widely used commercial navigation maps, has become an essential data source for autonomous driving systems. The linking relations between lane-level map and commercial navigation map can facilitate an autonomous driving system mapping information between different applications using different maps. In this paper, an approach is proposed to build the linking relations automatically. The different topology networks are first reconstructed into similar structures. Then, to build the linking relations automatically, the adaptive multi-filter algorithm and forward path exploring algorithm are proposed to detect corresponding junctions and paths, respectively. The approach is validated by two real data sets of more than 150 km of roads, mainly highway. The linking relations for nearly 94% of the total road length have been built successfully.
Since December 2019, China has experienced a widespread outbreak of COVID-19. However, at the early stage of outbreak, investigations revealed a variety of patterns resulting in the transmission of COVID-19. Thus, it is essential to understand the transmission types and the potential for sustained human-to-human transmission. Moreover, the information regarding the characteristics of transmission helps in coordinating the current screening programme, and controlling and containing measures, and also, helps in deciding the appropriate quarantine duration. Thus, this investigation reports an outbreak of COVID-19 in a family residing in Wenzhou, Zhejiang, China during the month of January−February 2020.
In late December 2019, patients of atypical pneumonia due to an unidentified microbial agent were reported in Wuhan, Hubei Province, China. Subsequently, a novel coronavirus was identified as the causative pathogen which was named SARS-CoV-2. As of 12 February 2020, more than 44 000 cases of SARS-CoV-2 infection have been confirmed in China and continue to expand. Provinces, municipalities and autonomous regions of China have launched first-level response to major public health emergencies one after another from 23 January 2020, which means restricting movement of people among provinces, municipalities and autonomous regions. The aim of this study was to explore the correlation between the migration scale index and the number of confirmed coronavirus disease 2019 (COVID-19) cases and to depict the effect of restricting population movement. In this study, Excel 2010 was used to demonstrate the temporal distribution at the day level and SPSS 23.0 was used to analyse the correlation between the migration scale index and the number of confirmed COVID-19 cases. We found that since 23 January 2020, Wuhan migration scale index has dropped significantly and since 26 January 2020, Hubei province migration scale index has dropped significantly. New confirmed COVID-19 cases per day in China except for Wuhan gradually increased since 24 January 2020, and showed a downward trend from 6 February 2020. New confirmed COVID-19 cases per day in China except for Hubei province gradually increased since 24 January 2020, and maintained at a high level from 24 January 2020 to 4 February 2020, then showed a downward trend. Wuhan migration scale index from 9 January to 22 January, 10 January to 23 January and 11 January to 24 January was correlated with the number of new confirmed COVID-19 cases per day in China except for Wuhan from 22 January to 4 February. Hubei province migration scale index from 10 January to 23 January and 11 January to 24 January was correlated with the number of new confirmed COVID-19 cases per day in China except for Hubei province from 22 January to 4 February. Our findings suggested that people who left Wuhan from 9 January to 22 January, and those who left Hubei province from 10 January to 24 January, led to the outbreak in the rest of China. The ‘Wuhan lockdown’ and the launching of the first-level response to this major public health emergency may have had a good effect on controlling the COVID-19 epidemic. Although new COVID-19 cases continued to be confirmed in China outside Wuhan and Hubei provinces, in our opinion, these are second-generation cases.
Due to the drastic surge of COVID-19 patients, many countries are considering or already graduating health professional students early to aid professional resources. We aimed to assess outbreak-related psychological distress and symptoms of acute stress reaction (ASR) in health professional students and to characterize individuals with potential need for interventions.
We conducted a prospective cohort study of 1442 health professional students at Sichuan University, China. At baseline (October 2019), participants were assessed for childhood adversity, stressful life events, internet addiction, and family functioning. Using multivariable logistic regression, we examined associations of the above exposures with subsequent psychological distress and ASR in response to the outbreak.
Three hundred and eighty-four (26.63%) participants demonstrated clinically significant psychological distress, while 160 (11.10%) met the criterion for a probable ASR. Individuals who scored high on both childhood adversity and stressful life event experiences during the past year were at increased risks of both distress (ORs 2.00–2.66) and probable ASR (ORs 2.23–3.10), respectively. Moreover, internet addiction was associated with elevated risks of distress (OR 2.05, 95% CI 1.60–2.64) and probable ASR (OR 2.15, 95% CI 1.50–3.10). By contrast, good family functioning was associated with decreased risks of distress (OR 0.43, 95% CI 0.33–0.55) and probable ASR (OR 0.48, 95% CI 0.33–0.69). All associations were independent of baseline psychological distress.
Our findings suggest that COVID-19 related psychological distress and high symptoms burden of ASR are common among health professional students. Extended family and professional support should be considered for vulnerable individuals during these unprecedented times.
Outbreaks of norovirus-associated gastroenteritis have been reported in schools in recent decades in China. For early warning and response to infectious disease outbreaks, the Shanghai Infectious Diseases Bud Event Surveillance System (IDBESS) was established in 2016. Bud event is a term used for the early sign of a potential infectious disease outbreak in public settings when the first few cases appear. This study aimed to describe the epidemiological characteristics of Norovirus-associated gastroenteritis bud events from June 2016 to December 2017 and to understand factors influencing the severity of events. Data were extracted from the IDBESS, supplemented by field investigations and school absence surveillance. In total, 189 bud events of Norovirus-associated gastroenteritis were reported in schools and kindergartens, affecting 3827 individuals and 52.38% happened in primary schools. The attack rate of Norovirus-associated gastroenteritis was 3.82% on average in students in the affected schools. In each event, case numbers varied between 5 and 148, with a median of 16. The duration of bud events lasted for 2 days on average. School absence happened in 47.93% (1797/3749) of affected students and the average duration of absence was 3.07 days. It was found that a longer delay before reporting was associated with a longer-lasting duration of bud event (OR = 2.25, 95% CI: 1.65, 3.07). In conclusion, ascribed to the sensitive threshold for alerting and the timely field investigation, the surveillance of bud events of Norovirus-associated gastroenteritis is effective in the control of Norovirus infection among preschool children and students in Shanghai.
The aim of this paper is twofold. The first aim is to describe the entire solutions of the partial differential equation (PDE)
, where B is a constant and g is a polynomial or an entire function in
. The second aim is to consider the entire solutions of another PDE, which is a generalization of the well-known PDE of tubular surfaces.
This paper presents a soft robot which can imitate the crawling locomotion of an earthworm. Locomotion of the robot can be achieved by expanding and contracting the body that is made of flexible material. A link of the earthworm-like robot is combined with three modules, and a multi-cavity earthworm-like soft robot is combined with multiple links. The multiple links of the earthworm-like soft robot are fabricated by silicone in the three-dimensional printed customized molds. Experiments on a single module, two-links, and three-links show that the soft robot can move and bend on condition of modules extension and contraction in a specified gait. The development of the earthworm-like soft robot shows a great prospect in many complicated environments such as pipeline detection.
Coronavirus disease 2019 (COVID-19) patients were classified into four clinical stages (uncomplicated illness, mild, severe and critical pneumonia) depending on disease severity. We aim to investigate the corresponding clinical, radiological and laboratory characteristics between different clinical stages. A retrospective, single-centre study of 101 confirmed patients with COVID-19 at Renmin Hospital of Wuhan University from 2 January to 28 January 2020 was enrolled; follow-up endpoint was on 8 February 2020. Clinical data were collected and compared during the course of illness. The median age of the 101 patients was 51.0 years and 33.6% were medical staff. Fever (68%), cough (50%) and fatigue (23%) are the most common symptoms. About 26% patients underwent the mechanical ventilation and 98% patients were treated with antibiotics. Thirty-seven per cent patients were cured and 11 died. On admission, the number of patients with uncomplicated illness, mild, severe and critical pneumonia were 2 [2%], 86 [85%], 11 [11%] and 2 [2%]. Forty-four of the 86 mild pneumonia progressed to severe illness within 4 days, with nine patients worsened due to critical pneumonia within 4 days. Two of the 11 severe patients improved to mild condition while three others deteriorated. Significant differences were observed among groups of different clinical stages in numbers of influenced pulmonary segments (6 vs. 12 vs. 17, P < 0.001). A significantly upward trend was witnessed in ground-glass opacities overlapped with striped shadows (33% vs. 42% vs. 55% vs. 80%, P < 0.001), while pure ground-glass opacities gradually decreased as disease progressed (45% vs. 35% vs. 24% vs. 13%, P < 0.001) within 12 days. Lymphocytes, prealbumin and albumin showed a downtrend as disease progressed from mild to severe or critical condition, an uptrend was found in white blood cells, C-reactive protein, neutrophils and lactate dehydrogenase. The proportions of serum amyloid A > 300 mg/l in mild, severe and critical conditions were 18%, 46% and 71%, respectively.
The cotton-wheat double-cropping system is widely used in the Yellow River Valley of China, but whether and how different planting patterns within cotton-wheat double-cropping systems impact heat and light use efficiency have not been well documented. A field experiment investigated the effects of the cropping system on crop productivity and the capture and use efficiency of heat and light in two fields differing in soil fertility. Three planting patterns, namely cotton intercropped with wheat (CIW), cotton directly seeded after wheat (CDW), and cotton transplanted after wheat (CTW), as well as one cotton monoculture (CM) system were used. Cotton-wheat double cropping significantly increased crop productivity and land equivalent ratios relative to the CM system in both fields. As a result of increased growing degree days (GDD), intercepted photosynthetically active radiation (IPAR), and photothermal product (PTP), the capture of light and heat in the double-cropping systems was compared with that in the CM system in both fields. With improved resource capture, the double-cropping systems exhibited a higher light and heat use efficiency according to thermal product efficiency, solar energy use efficiency (Eu), radiation use efficiency (RUE), and PTP use efficiency (PTPU). The cotton lint yield and biomass were not significantly correlated with RUE across cropping patterns, indicating that RUE does not limit cotton production. Among the double-cropping treatments, CDW had the lowest GDD, IPAR, and PTP values but the highest heat and light resource use efficiency and highest overall resource use efficiency. This good performance was even more obvious in the high-fertility field. Therefore, we encourage the expanded use of CDW in the Yellow River Valley, especially in fields with high fertility, given the high productivity and resource use efficiency of this system. Moreover, the use of agronomic practices involving a reasonably close planting density, optimized irrigation and nutrient supply, and the application of new short-season varieties of cotton or wheat can potentially enhance CDW crop yields and productivity.
The aim of present study was to investigate the effects of dietary Zn level on growth performance, Zn bioaccumulation, antioxidant capacity and innate immunity in juvenile mud crab (Scylla paramamosain). Six semi-purified diets were formulated to contain dietary Zn levels of 44.5, 56.9, 68.5, 97.3, 155.6 or 254.7 mg·kg-1, respectively. Dietary Zn level significantly influenced percent weight gain (PWG), with highest observed in crab fed the diet containing 97.3 mg·kg-1 Zn. Tissue Zn concentrations significantly increased as dietary Zn levels increased from 44.5 to 254.7 mg·kg-1. Retention of Zn in hepatopancreas increased with dietary Zn levels up to 68.5 mg·kg-1 and then significantly decreased. Moreover, inadequate dietary Zn (44.5 and 56.9 mg·kg-1) reduced anti-oxidation markers including total superoxide dismutase and copper/zinc superoxide dismutase activities and total anti-oxidant level. Crabs fed the diet with 44.5 mg·kg-1 Zn also showed significantly lower expression of genes involved in antioxidant status, such as Cu/Zn sod, glutathione peroxidase, catalase and thioredoxin than those fed diets containing 68.5 and 97.3 mg·kg-1 Zn. Highest activities of phenoloxidase and alkaline phosphatase were recorded in crab fed the diets containing 68.5 and 97.3 mg·kg-1 Zn. Expression levels of prophenoloxidase and toll-like receptor 2 were higher in crab fed the 97.3 mg·kg-1 Zn diet compared to crab fed the other diets. Based on PWG alone, the optimal dietary Zn level was estimated to be 82.9 mg·kg-1, with 68.5 to 97.3 mg·kg-1 recommended for maintaining optimal Zn bioaccumulation, oxidation resistance and innate immune response of juvenile mud crab.
Introduction: Physician metrics extracted from an electronic medical records (EMR) system can be utilized for practice improvement. One key metric analyzed at many emergency departments (EDs) is ‘patients per hour’ (pts/hr), a proxy for physician productivity. It is often believed that early-career physicians experience rapid growth in efficiency as they acclimatize to a hospital system and develop clinical confidence. This is the first study to evaluate the following question: Do early-career ED physicians increase their productivity when beginning practice? Methods: We performed a retrospective review of EMR data of early-career ED physicians working at one or more urban, academic centers. Early-career physicians must have started practice within three months of residency completion, and were identified by privileging records and provincial medical college registration. Physicians were excluded if they did not have at least 36 months of continuous data. Monthly productivity data (pts/hr) was extracted for each physician for their first 36-months of practice. A ‘performance curve’ or graph with a trendline of productivity as a moving average was created for each physician. Each performance curve was visually evaluated by two independent reviewers to qualitatively identify the general trend as upward, downward, or stable, with disagreements resolved by conference. Each physician's first and third year average productivity was compared quantitatively as well, with a significant upward or downward trend defined as a difference of at least 0.2 pts/hr. Results: A total of 41 physicians met the inclusion and exclusion criteria. Overall monthly pts/hr averages ranged from 1.08 to 7.65. Upon visual inspection, six (14.6%) physicians had upward trends, five (12.2%) had downward trends, and 30 (73.2%) had no discernable pattern. The quantitative analysis comparing first year to third year productivity matched the qualitative inspection exactly, with the same six physicians showing increased productivity, five with decreased, and 30 without significant change. Notably, the majority (30/41) of physicians demonstrated radical productivity variations over short periods with no discernable long-term trends. Conclusion: The majority of early career physicians do not demonstrate sustained early-career productivity changes. Of those that do, an approximately equal number will become faster and slower.
The remarkable progress in additive manufacturing has promoted the design of architected materials with mechanical properties that go beyond those of conventional solids. Their realization, however, leads to architectures with process-induced defects that can jeopardize mechanical and functional performance. In this work, we investigate experimentally and numerically as-manufactured defects in Ti–6Al–4V octet truss lattice materials fabricated with selective laser melting. Four sets of as-manufactured defects, including surface, microstructural, morphological, and material property imperfections, are characterized experimentally at given locations and orientations. Within the characterized defects, material property and morphological defects are quantified statistically using a combination of atomic force microscopy and micro–computed tomography to generate representative models that incorporate individual defects and their combination. The models are used to assess the sensitivity to as-manufactured defects. Then, the study is expanded by tuning defects amplitude to elucidate the role of the magnitude of as-designed defects on the mechanical properties of the lattice material.