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Coronavirus disease-2019 (COVID-19) elicits a range of different responses in patients and can manifest into mild to very severe cases in different individuals, depending on many factors. We aimed to establish a prediction model of severe risk in COVID-19 patients, to help clinicians achieve early prevention, intervention and aid them in choosing effective therapeutic strategy. We selected confirmed COVID-19 patients who were admitted to First Hospital of Changsha city between 29 January and 15 February 2020 and collected their clinical data. Multivariate logical regression was used to identify the factors associated with severe risk. These factors were incorporated into the nomogram to establish the model. The ROC curve, calibration plot and decision curve were used to assess the performance of the model. A total of 228 patients were enrolled and 33 (14.47%) patients developed severe pneumonia. Univariate and multivariate analysis showed that shortness of breath, fatigue, creatine kinase, lymphocytes and h CRP were independent factors for severe risk in COVID-19 patients. Incorporating age, chronic obstructive pulmonary disease (COPD) and these factors, the nomogram achieved good concordance indexes of 0.89 [95% confidence interval (CI) 0.832–0.949] and well-fitted calibration plot curves (Hosmer–Lemeshow test: P = 0.97). The model provided superior net benefit when clinical decision thresholds were between 15% and 85% predicted risk. Using the model, clinicians can intervene early, improve therapeutic effects and reduce the severity of COVID-19, thus ensuring more targeted and efficient use of medical resources.
We study how pension participation and expected pension benefits affect working-age adults’ consumption based on a nationally representative dataset from the China Health and Retirement Longitudinal Study (CHARLS) during the period 2011–2018. We find that the consumption of working-age adults who participate in China's Residents' Basic Pension is 15.4% higher than that of non-participants. Furthermore, we find that if working-age adults' expected pension benefits increase by RMB 1, their consumption will increase by RMB 0.34. Overall, our findings suggest that pension expectations are critical to the consumption decisions of working-age adults and can, therefore, positively affect total domestic consumption.
As a neuroprogressive illness, depression is accompanied by brain structural abnormality that extends to many brain regions. However, the progressive structural alteration pattern remains unknown.
To elaborate the progressive structural alteration of depression according to illness duration, we recruited 195 never-treated first-episode patients with depression and 130 healthy controls (HCs) undergoing T1-weighted MRI scans. Voxel-based morphometry method was adopted to measure gray matter volume (GMV) for each participant. Patients were first divided into three stages according to the length of illness duration, then we explored stage-specific GMV alterations and the causal effect relationship between them using causal structural covariance network (CaSCN) analysis.
Overall, patients with depression presented stage-specific GMV alterations compared with HCs. Regions including the hippocampus, the thalamus and the ventral medial prefrontal cortex (vmPFC) presented GMV alteration at onset of illness. Then as the illness advanced, others regions began to present GMV alterations. These results suggested that GMV alteration originated from the hippocampus, the thalamus and vmPFC then expanded to other brain regions. The results of CaSCN analysis revealed that the hippocampus and the vmPFC corporately exerted causal effect on regions such as nucleus accumbens, the precuneus and the cerebellum. In addition, GMV alteration in the hippocampus was also potentially causally related to that in the dorsolateral frontal gyrus.
Consistent with the neuroprogressive hypothesis, our results reveal progressive morphological alteration originating from the vmPFC and the hippocampus and further elucidate possible details about disease progression of depression.
The provenance and tectonic setting of the Lower–Middle Triassic clastic sediments from the Napo basin, South China, have been examined here using detrital modes, whole-rock geochemistry and detrital zircon U–Pb ages. Field investigations indicate that these sediments consist of fan delta, slope and turbidity fan facies with dominantly southward palaeocurrent directions. Detrital modes and geochemical characteristics of the clastic rocks indicate that they were derived from mixed magmatic arc and Palaeozoic successions in a continental island arc setting, with no significant sediment recycling. The U–Pb age spectra of sandstone detrital zircons from different stratigraphic positions are similar, with one major group (300–230 Ma), two subordinate groups (400–320 Ma and 480–420 Ma, respectively) and two scattered groups (1200–800 Ma and 2000–1700 Ma, respectively). Thus, we consider that the north late Permian – Middle Triassic volcanic rocks and the uplifted Palaeozoic sedimentary/volcanic sequences constituted the predominant sources. The detritus derived from the late Permian Emeishan mafic rocks is subordinate and limited. The pre-Devonian zircons are likely sedimentary-recycled or magmatic-captured instead of directly derived from the early Palaeozoic orogen (e.g. Yunkai massif) and Neoproterozoic Jiangnan orogen because of the topographic barrier of a magmatic arc and carbonate platform. Considering the spatial and temporal distribution characteristics of the volcanic arc and ophiolite, we suggest that the Triassic Napo basin was a fore-arc basin within a continental island arc setting, which developed in response to the northward subduction of the Babu–Cao Bang branch ocean beneath the South China Block.
ITGB1 (Integrin β1, CD29) is a member of the integrin family and has a role as a major adhesion receptor. Gastric cancer (GC) is an important cause of mortality worldwide, especially in China. As a potential cancer enhancer, the role ITGB1 plays in GC progression remains unclear. In the current study, our assay on the databases of tumoassociated gene expression and interaction found that the high expression of ITGB1 was closely correlated with the poor prognosis of GC patients. To explore the roles, ITGB1 plays in GC progression, and an ITGB1-deleted cell line (ITGB1−/−SGC7901) was generated using the CRISPR/Cas9 method. The tumor malignancy-associated cell behaviors and microstructures were detected, imaged, and analyzed using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT), wound healing, transwell, scanning electron microscopy, laser scanning confocal microscopy, and others. The results indicated that ITGB1 deletion decreased the GC cell proliferation and motility, and inhibited motility-relevant microstructures, such as pseudopodia and filopodia, markedly in ITGB1-deleted SGC7901 cells. The analysis of STRING database and western blots indicated that ITGB1 contributes to the malignancy of GC mediated by Src-mediated FAK/PI3K/Akt signaling pathways. Taken together, the results showed that ITGB1 may be a potential targeting marker for GC diagnosis and therapy in the future.
The tropical areas of eastern Asia contain a high diversity of foliicolous lichens, including various species of the genus Badimia. Badimia xanthocampylidia W. C. Wang & J. C. Wei is described from tropical rainforests in southern China and Thailand based on morphology, chemistry, and combined mtSSU, ITS and nrLSU sequences. It is characterized by a pale green thallus with yellow verrucae and bright yellow campylidia and the presence of isousnic acid. Three other species, B. multiseptata Papong & Lücking, B. pallidula (Kremp.) Vězda and B. polillensis (Vain.) Vězda, are discussed and the genus Badimia is newly reported from China. A worldwide key to currently known species in the genus is presented.
The interaction between heavy particles with high Stokes number ($St$) and the wall, known as the particle–wall (P–W) process, widely exists in natural and engineering two-phase flows, whereas its effects on particle-laden flows and the large-scale/very large-scale turbulent motions (VLSM) remain unclear. In this paper, two types of wind-blown sand-laden flows were experimentally designed and investigated by keeping the same free stream velocity, flow Reynolds number and particle $St$ number. In the first type, sand particles were directly blown from a sand bed at the bottom wall of the wind tunnel, and the P–W process occurred in the whole wall-normal region of the sand-laden flow. In the second type, sand particles were released from a feeder at the top wall of wind tunnel, and the P–W process was only present in a lower wall-normal region. Simultaneous two-phase particle image/tracking velocimetry measurements were conducted for uncovering the characteristics of turbulent structures in the particle-laden turbulent boundary layers. The results confirmed that the VLSM with streamwise scales exceeding $3\delta$ ($\delta$ is boundary layer thickness) above a certain height exist in both types of the sand-laden flows and could be significantly affected by the P–W process. That is, in the region without the P–W process, the presence of sand particles can enlarge the VLSM, while in the region with the P–W process, the VLSM are substantially reduced in size or even destroyed. The reduction degree is found to be closely related to the strength of the P–W process.
We evaluate the association between the Dietary Inflammatory Index (DII) and kidney stones.
We performed a cross-sectional analysis using data from National Health and Nutrition Examination Survey (NHANES). Dietary intake information was assessed using first 24-h dietary recall interviews, and the Kidney Conditions were presented by a questionnaire. The primary outcome was to investigate the association between DII and incidence of kidney stones, and the secondary outcome was to assess the association between DII and nephrolithiasis recurrence.
The NHANES, 2007–2016.
The study included 25 984 NHANES participants, whose data on DII and kidney stones were available, of whom 2439 reported a history of kidney stones.
For the primary outcome, after fully multivariate adjustment, DII score is positively associated with the risk of kidney stones (OR = 1·07; 95 % CI 1·04, 1·10). Then, compared Q4 with Q1, a significant 38 % increased likelihood of nephrolithiasis was observed. (OR = 1·38; 95 % CI 1·19, 1·60). For the secondary outcome, the multivariate regression analysis showed that DII score is positively correlated with nephrolithiasis recurrence (OR = 1·07; 95 % CI 1·00, 1·15). The results noted that higher DII scores (Q3 and Q4) are positively associated with a significant 48 % and 61 % increased risk of nephrolithiasis recurrence compared with the reference after fully multivariate adjustment (OR = 1·48; 95 % CI 1·07, 2·05; OR = 1·61; 95 % CI 1·12, 2·31).
Our findings revealed that increased intake of pro-inflammatory diet, as a higher DII score, is correlated with increased odds of kidney stones incidence and recurrence.
A 1178 J near diffraction limited 527 nm laser is realized in a complete closed-loop adaptive optics (AO) controlled off-axis multi-pass amplification laser system. Generated from a fiber laser and amplified by the pre-amplifier and the main amplifier, a 1053 nm laser beam with the energy of 1900 J is obtained and converted into a 527 nm laser beam by a KDP crystal with 62% conversion efficiency, 1178 J and beam quality of 7.93 times the diffraction limit (DL). By using a complete closed-loop AO configuration, the static and dynamic wavefront distortions of the laser system are measured and compensated. After correction, the diameter of the circle enclosing 80% energy is improved remarkably from 7.93DL to 1.29DL. The focal spot is highly concentrated and the 1178 J, 527 nm near diffraction limited laser is achieved.
In this paper, we report the study of degradation for a kind of ideal mandrel material called poly-α-methylstyrene based on theoretical and experimental methods. First-principles calculations reveal two types of process: depolymerization and hydrogen-transfer-induced chain scission. The energy barrier for the former (0.68–0.82 eV) is smaller than that for most of the latter (1.39–4.23 eV). More importantly, reaction rates suggest that the former is fast whereas the latter is mostly slow, which can result in a difference of 5–31 orders of magnitude at 550 K. Furthermore, a thermogravimetric experiment shows that the activation energy of 2.53 eV for degradation is between those of fast and slow processes, corresponding to the theoretical average value of multiple reaction paths. Thus, a mandrel degradation model combining fast and slow processes is established at the atomic level. Our work provides a direction for research into the key technology of target fabrication in inertial confinement fusion.
We report a case of a 25-year-old man diagnosed with an unusual case of cor triatriatum sinister with a mobile left atrial thrombus. He was hospitalised with aggravating dyspnoea. Transthoracic echocardiography revealed a membrane-like structure traversing the left atrial and a small orifice of about 7.1 mm. The mean pressure gradient was 12.94 mmHg across the orifice of the membrane-like structure and there was a mobile mass in the post-erosuperior chamber. The anomaly was rectified by a surgical resection. Timely diagnosis and surgical repair may prevent stroke in patients with unusual cor triatriatum sinister.
To determine if specific dietary patterns are associated with breast cancer (BC) risk in Chinese women.
Latent class analysis (LCA) was performed to identify generic dietary patterns based on daily food-frequency data.
The Chinese Wuxi Exposure and Breast Cancer Study (2013–2014).
A population-based case–control study (695 cases, 804 controls).
Four dietary patterns were identified, Prudent, Chinese traditional, Western and Picky; the proportion in the controls and cases was 0·30/0·32/0·16/0·23 and 0·29/0·26/0·11/0·33, respectively. Women in Picky class were characterised by higher extreme probabilities of non-consumption of specific foods, the highest probabilities of consumption of pickled foods and the lowest probabilities of consumption of cereals, soya foods and nuts. Compared with Prudent class, Picky class was associated with a higher risk (OR = 1·42, 95 % CI 1·06, 1·90), while the relevant association was only in post- (OR = 1·44, 95 % CI 1·01, 2·05) but not in premenopausal women. The Western class characterised by high-protein, high-fat and high-sugar foods, and the Chinese traditional class characterised by typical consumption of soya foods and white meat over red meat, both of them showed no difference in BC risk compared with Prudent class did.
LCA captures the heterogeneity of individuals embedded in the population and could be a useful approach in the study of dietary pattern and disease. Our results indicated that the Picky class might have a positive association with the risk of BC.
Drug-induced liver injury (DILI) is a common adverse drug reaction leading to the interruption of tuberculosis (TB) therapy. We aimed to identify whether the hepatitis B virus (HBV) infection would increase the risk of DILI during first-line TB treatment. A meta-analysis of cohort studies searched in PubMed, Web of Science and China National Knowledge Infrastructure was conducted. Effect sizes were reported as risk ratios (RRs) and 95% confidence intervals (CIs) and calculated by R software. Sixteen studies with 3960 TB patients were eligible for analysis. The risk of DILI appeared to be higher in TB patients co-infected with HBV (RR 2.66; 95% CI 2.13–3.32) than those without HBV infection. Moreover, patients with positive hepatitis B e antigen (HBeAg) were more likely to develop DILI (RR 3.42; 95% CI 1.95–5.98) compared to those with negative HBeAg (RR 2.30; 95% CI 1.66–3.18). Co-infection with HBV was not associated with a higher rate of anti-TB DILI in latent TB patients (RR 4.48; 95% CI 0.80–24.99). The effect of HBV infection on aggravating anti-TB DILI was independent of study participants, whether they were newly diagnosed with TB or not. Besides, TB and HBV co-infection patients had a longer duration of recovery from DILI compared to non-co-infected patients (SMD 2.26; 95% CI 1.87–2.66). To conclude, the results demonstrate that HBV infection would increase the risk of DILI during TB therapy, especially in patients with positive HBeAg, and close liver function monitoring is needed for TB and HBV co-infection patients.
Lead-free ferroelectric electrocaloric ceramics that could convert electrical energy into heat are the promising candidate for environment-friendly cooling devices. For refrigeration devices, a large temperature change (ΔT) and good temperature stability are required, which are highly related to the phase structure and the applied electric field. In this work, a diffused ferroelectric–paraelectric (FP) phase transition is formed in (K, Na)NbO3 (KNN) by using appropriate composition engineering. The relaxor ferroelectrics in this work present both a large ΔT of 1.24 K and a high ΔT/ΔE of 0.19 K mm/kV. In addition, a wide temperature span exceeds 55 °C at the high electrocaloric effect (ECE) criterion (ΔT ≥ 0.5 K) could also be observed. This work not only opens a new strategy for obtaining high-performance ceramics for refrigeration devices but also extends the application area of the KNN-based lead-free ferroelectrics from sensors, actuators and energy harvesting to solid-state cooling applications.
The phylogeny of foliicolous taxa in Pilocarpaceae was reconstructed using Bayesian and maximum likelihood analyses of concatenated ITS and mtSSU sequences. Sixty-six new partial sequences representing 36 taxa were generated and 29 sequences were downloaded from GenBank. Our results indicate that Lasioloma R. Sant. is nested within a paraphyletic Calopadia Vězda, whereas Fellhanera Vězda is polyphyletic and the phylogenetic relationships of Eugeniella Lücking et al. and Sporopodium Mont. with Fellhanera require further investigation. In addition, Tapellaria parvimuriformis W. C. Wang & J. C. Wei is described as a new species from Khao Yai National Park, Thailand, and is characterized by its small muriform ascospores, grey campylidia with a pale base, and short conidia. Eight new records of foliicolous lichens for Thailand are also listed.
No studies have reported on how to relieve distress or relax in medical health workers while wearing medical protective equipment in coronavirus disease 2019 (COVID-19) pandemic. The study aimed to establish which relaxation technique, among six, is the most feasible in first-line medical health workers wearing medical protective equipment.
This was a two-step study collecting data with online surveys. Step 1: 15 first-line medical health workers were trained to use six different relaxation techniques and reported the two most feasible techniques while wearing medical protective equipment. Step 2: the most two feasible relaxation techniques revealed by step 1 were quantitatively tested in a sample of 65 medical health workers in terms of efficacy, no space limitation, no time limitation, no body position requirement, no environment limitation to be done, easiness to learn, simplicity, convenience, practicality, and acceptance.
Kegel exercise and autogenic relaxation were the most feasible techniques according to step 1. In step 2, Kegel exercise outperformed autogenic relaxation on all the 10 dimensions among the 65 participants while wearing medical protective equipment (efficacy: 24 v. 15, no space limitation: 30 v. 4, no time limitation: 31 v. 4, no body position requirement: 26 v. 4, no environment limitation: 30 v. 11, easiness to learn: 28 v. 5, simplicity: 29 v. 7, convenience: 29 v. 4, practicality: 30 v. 14, acceptance: 32 v. 6).
Kegel exercise seems a promising self-relaxation technique for first-line medical health workers while wearing medical protective equipment among COVID-19 pandemic.
Parabronema skrjabini is one of the most harmful nematodes to camels and is responsible for economic losses in animal husbandry industry. There is an urgent need for in-depth studies of potential vectors of the nematode due to its scant regarding information. As previous studies indicated that flies may be the vectors of P. skrjabini, we captured flies in the main camel-producing areas of Inner Mongolia. After autopsy of the specimens of two species of horn flies, we observed the morphology of the suspected nematode larvae found in them. Internal transcribed spacer ribosomal-DNA gene sequences were considered the best candidate to confirm the species of the larvae found. Our results showed that the homology compared with P. skrjabini was 99.5% in GenBank. Subsequently, we preliminarily identified two species of horn flies through morphological observation and then sequenced the mitochondrial-DNA-gene cytochrome oxidase subunit I obtained from two species of horn flies, with 100 and 99.2% similarity to sequences deposited in GenBank, respectively. Thus, we identified Haematobia titillans and Haematobia irritans and provided evidence for their potential role as vectors of parabronemosis. Our study provides reference for future research on the life history of the nematode and the vectors of parabronemosis.