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The epidemic of drug-resistant tuberculosis (DR-TB) has become a major concern in global TB control. This study aimed to investigate the patterns and trend of DR-TB epidemic between different time periods in Chongqing.
Methods:
A total of 985 and 835 culture positive TB patients with drug susceptibility testing (DST) results admitted to the hospital in 2016 and 2019, respectively, were included. Chi-square testing was used to compare the prevalence and trends of DR-TB in 2016 and 2019.
Results:
The proportion of previously treated TB cases with culture positivity was 45.7% in 2019, significantly higher than that in 2016 (39.1%, P = 0.004). The overall rate of drug resistance in 2019 was 43.1%, higher than that in 2016 (40.2%). The rates of multi-drug resistant TB (MDR-TB) and pre-extensively drug resistant TB (pre-XDR-TB) increased significantly from 2016 to 2019 among all TB cases (MDR: 25% vs 33.4%, P < 0.001 and pre-XDR: 7.1% vs 12.8%, P < 0.001, respectively) and previously treated TB cases (MDR: 46.5% vs 56%, P = 0.008 and pre-XDR: 13.2% vs 21.5%, P = 0.003, respectively).
Conclusions:
Our findings indicated that the prevalence of DR-TB remains high in Chongqing. The trend of resistance to anti-TB drugs beccame worse between 2016 and 2019. Moreover, acquired MDR may play a major role in MDR-TB epidemic in Chongqing. Therefore, rapid diagnosis and effective treatment of TB patients will be important to reduce the burden of DR-TB in Chongqing.
Lower-crust-derived adakitic rocks in the Gangdese belt provide important constraints on the timing of Tibetan crustal thickening and on the relative contributions of magmatic and tectonic processes. Here we present geochronological and geochemical data for the Wangdui porphyritic monzogranites in the western Gangdese belt. Zircon U–Pb dating yields emplacement ages of 46–44 Ma. All samples have high Sr (321–599 ppm), low Yb (0.76–1.33 ppm) and Y (10.6–18.3 ppm) contents, with high La/Yb (51.1–72.3) and Sr/Y (21.0–51.4) ratios, indicating adakitic affinities. The low MgO (0.97–1.76 wt %), Cr (7.49–53.6 ppm) and Ni (4.75–29.1 ppm) contents, as well as high 87Sr/86Sr(i) (0.7143–0.7145), low ϵNd(t) (−10.4 to −9.8) and zircon ϵHf(t) (−17.7 to 0.4) values, suggest that the Wangdui pluton most likely originated from partial melting of the thickened ancient lower crust. In combination with previously published data, despite the east–west-trending heterogeneity of crustal composition in the Gangdese belt, the La/Yb ratios of magmatic rocks reveal that both western and eastern segments experienced remarkable crustal thickening in the Eocene. However, in contrast to the thickened juvenile lower crust in the eastern segment formed by the underplating of mantle-derived magmas, tectonic shortening plays a more crucial role in thickening of the ancient basement in western Gangdese. In fact, such Eocene-thickened ancient lower-crust-derived adakitic rocks are widely distributed in the central Himalayan–Tibetan orogen. This, together with the extensive development of fold–thrust belts, suggests that tectonic shortening might be the main mechanism accounting for the crustal thickening associated with the India–Asia collision.
Demodex infestation and density changes remain one of the main challenges in some clinical settings. Tumour necrosis factor-α (TNF-α) inhibitors have been recommended as a first-line treatment for ankylosing spondylitis (AS). However, there have been no studies investigating the impact of TNF-α inhibitor adalimumab on changes in the Demodex density in patients with AS. The aim of this study was to investigate Demodex density changes before and after adalimumab treatment and analyse the relationship between the Demodex density and clinical characteristics in AS. It was found that the Demodex density was positively correlated with age and C-reactive protein levels and the number of Demodex mites could increase after adalimumab treatment in AS.
Little is known about how sociodemographic and clinical factors affect the caregiving burden of persons with schizophrenia (PwSs) with transition in primary caregivers.
Aims
This study aimed to examine the predictive effects of sociodemographic and clinical factors on the caregiving burden of PwSs with and without caregiver transition from 1994 to 2015 in rural China.
Method
Using panel data, 206 dyads of PwSs and their primary caregivers were investigated in both 1994 and 2015. The generalised linear model approach was used to examine the predictive effects of sociodemographic factors, severity of symptoms and changes in social functioning on the caregiving burden with and without caregiver transition.
Results
The percentages of families with and without caregiver transition were 38.8% and 61.2%, respectively. Among families without caregiver transition, a heavier burden was significantly related to a larger family size and more severe symptoms in PwSs. Deteriorated functioning of ‘social activities outside the household’ and improved functioning of ‘activity in the household’ were protective factors against a heavy caregiving burden. Among families with caregiver transition, younger age, improved marital functioning, deteriorated self-care functioning, and better functioning of ‘social interest or concern’ were significant risk factors for caregiving burden.
Conclusions
The effects of sociodemographic and clinical correlates on the caregiving burden were different among families with and without caregiver transition. It is crucial to explore the caregiver arrangement of PwSs and the risk factors for burden over time, which will facilitate culture-specific family interventions, community-based mental health services and recovery.
This study investigates the dynamics of low-viscosity nanodroplets impacting surfaces with static contact angles from θ = 73° to 180° via molecular dynamics (MD) simulations. Two typical morphologies of impacting nanodroplets are observed at the maximum spreading state, a Hertz-ball-like in a low-Weber-number range and a thin-film-like in a high-Weber-number range. Only inertial and capillary forces dominate the impact for the former, whereas viscous force also becomes dominant for the latter. Regardless of morphologies at the maximum spreading state, the ratio of spreading time to contact time always remains constant on an ideal superhydrophobic surface with θ = 180°. With the help of different kinematic approximations of the spreading time and scaling laws of the contact time, scaling laws of the maximum spreading factor ${\beta _{max}}\sim W{e^{1/5}}$ in the low-Weber-number range (capillary regime) and ${\beta _{max}}\sim W{e^{2/3}}R{e^{ - 1/3}}$ (or ${\beta _{max}}\sim W{e^{1/2}}O{h^{1/3}}$) in the high-Weber-number range (cross-over regime) are obtained. Here, We, Re, and Oh are the Weber number, Reynolds number, and Ohnesorge number, respectively. Although the scaling laws are proposed only for the ideal superhydrophobic surface, they are tested valid for θ over 73° owing to the ignorable zero-velocity spreading effect. Furthermore, combining the two scaling laws leads to an impact number, $W{e^{3/10}}O{h^{1/3}} = 2.1$. This impact number can be used to determine whether viscous force is ignorable for impacting nanodroplets, thereby distinguishing the capillary regime from the cross-over regime.
This retrospective study investigated the predictive value of the Controlling Nutritional Status (CONUT) score in patients with intermediate-stage hepatocellular carcinoma (HCC) who received transarterial chemoembolization (TACE). Nomograms were developed to predict progression-free and overall survival (PFS, OS). The medical data of 228 patients with HCC and treated with TACE were collected. The patients were apportioned to 2 groups according to CONUT score: low or high (<4, ≥4). Univariate and multivariate analyses were performed using Cox regression for OS and PFS. OS and PFS were estimated by the Kaplan-Meier curve and compared with the log-rank test. Nomograms were constructed to predict patient OS and PFS. The nomograms were evaluated for accuracy, discrimination, and efficiency. The cut-off value of CONUT score was 4. The higher the CONUT score, the worse the survival; Kaplan-Meier curves showed significant differences in OS and PFS between the low and high CONUT score groups (P = 0·033, 0·047). The nomograms including CONUT, based on the prognostic factors determined by the univariate and multivariate analyses, to predict survival in HCC after TACE were generated. The CONUT score is an important prognostic factor for both OS and PFS for patients with intermediate HCC who underwent TACE. The cut-off value of the CONUT score was 4. A high CONUT score suggests poor survival outcomes. Nomograms generated based on the CONUT score were good models to predict patient OS and PFS.
Insulin-like growth factor 1 receptor (IGF1R) is a cell surface receptor, belonging to the tyrosine kinase receptor superfamily. IGF1R plays a role not only in normal cell development but also in malignant transformation, which has become a candidate therapeutic target for the treatment of human cancer. This study aimed to explore insertions and deletions (indels) in IGF1R gene and investigate their association with growth traits in four Chinese cattle breeds (Xianan cattle, Jinnan cattle, Qinchuan cattle and Nanyang cattle). The current paper identified a 28-bp indel by polymerase chain reaction within IGF1R gene. The analysis showed that there was a significant correlation between the locus and the hucklebone width of Nanyang cattle in four periods, in which it was highly correlated at 6, 12 and 18 months. At the age of 6 months, it was also significantly correlated with body height, body weight and body length. Association analysis showed that the locus in Jinnan cattle was extremely significantly correlated with body slanting length and body weight, and significantly correlated with chest circumference. There was no significant correlation between this locus and growth traits of Xianan cattle and Qinchuan cattle. The detected indel in the IGF1R gene was significantly associated with growth traits in Jinnan and Nanyang cattle, and could be used as a molecular marker for growth trait selection.
Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development.
Aims
This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge.
Method
Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted.
Results
Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = −1.15, 95% CI = −1.70, −0.33) or death (adjusted B = −1.55, 95% CI = −2.62, −0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = −0.26, 95% CI = −0.31, −0.20), anxiety symptoms (adjusted B = −0.25, 95% CI = −0.33, −0.17), post-traumatic stress disorders (adjusted B = −0.16, 95% CI = −0.22, −0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10).
Conclusions
COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.
This paper presents a method to solve the kinematics of a rigid-flexible and variable-diameter continuous manipulator. The multi-segment underwater manipulator is driven by McKibben water hydraulic artificial muscle (WHAM). Considering the effect of elasticity and friction, we optimized the static mathematical model of WHAM. The kinematic model of the manipulator with load is established based on the hypothesis of piecewise constant curvature (PCC). We developed an optimization algorithm to calculate the length of the WHAMs according to the principle of minimum strain energy and obtain the configuration space parameters of the kinematic model. Based on the infinitesimal method, the homogeneous transformation matrices of the variable-diameter bending sections are computed, and the terminal position and attitude are obtained. In this paper, we studied the working space of the manipulator by quantitative analysis of the impact factors including pressure and load. A deep neural network (DNN) with six hidden layers is designed to solve inverse kinematics. The forward kinematic results are used to train and test the DNN, and the correlation coefficient between the output and target samples reaches 0.945. We carried out an underwater experiment and verified the effectiveness of the kinematic modeling and solution method.
The late Palaeozoic Yong’an–Meizhou depression belt is an important iron (Fe) and polymetallic metallogenic belt in southern China. It has undergone a transformation from Tethys to the circum-Pacific tectonic domain. The Luoyang deposit is one of the typical Fe skarn deposits in the Yong’an–Meizhou depression belt of eastern China. Garnet is a characteristic mineral in the deposit. Two generations of garnets are detected in the deposit based on their textural characteristics and trace-element contents, and are represented by Fe-enriched andradite. The first generation of garnets (Grt1) have two types of garnets (Grt1-A and Grt1-B). Type A garnets of the first generation (Grt1-A) (Adr80-88) replaced by massive diopside-magnetite assemblage exhibit distinct oscillatory zonings and display patterns of enriched light rare earth elements (LREE) to weak heavy rare earth elements (HREE), with weak negative to positive Eu anomalies, and highest U, ΣREE and Sn contents. Type B garnets of the first generation (Grt1-B) are irregular zones (Adr94-96) coexisting with magnetite, in which Grt1-A is generally dissolved, and have obviously LREE-enriched and HREE-depleted patterns, with weak negative to positive Eu anomalies, and moderate U, ΣREE and Zn contents. Garnets of the second generation (Grt2) (Adr96-99) that replaced massive magnetite together with sphalerite show unzoned patterns, with a flat REE pattern and pronounced negative Eu anomalies as well as contents of lowest U and ΣREE, and highest W. The substitution of REEs in garnets occurs as [X2+]VIII –1[REE3+]VIII +1[Si4+]IV –1[Z3+]IV +1in an Al-enriched environment. Luoyang hydrothermal fluids shifted from reducing conditions with relatively high-U and -ΣREE characteristics to oxidizing conditions with relatively low-U and -ΣREE characteristics. The reduced siderophile elements and increased fO2 in fluid during Grt1-B formation caused magnetite mineralization and reduced Zn contents during Grt2 formation, causing the deposition of sphalerite. All garnets formed from magmatic fluid and were controlled by infiltrative metasomatism in an opened system.
The present study evaluated whether fat mass assessment using the triceps skinfold (TSF) thickness provides additional prognostic value to the Global Leadership Initiative on Malnutrition (GLIM) framework in patients with lung cancer (LC). We performed an observational cohort study including 2672 LC patients in China. Comprehensive demographic, disease and nutritional characteristics were collected. Malnutrition was retrospectively defined using the GLIM criteria, and optimal stratification was used to determine the best thresholds for the TSF. The associations of malnutrition and TSF categories with survival were estimated independently and jointly by calculating multivariable-adjusted hazard ratios (HR). Malnutrition was identified in 808 (30·2 %) patients, and the best TSF thresholds were 9·5 mm in men and 12 mm in women. Accordingly, 496 (18·6 %) patients were identified as having a low TSF. Patients with concurrent malnutrition and a low TSF had a 54 % (HR = 1·54, 95 % CI = 1·25, 1·88) greater death hazard compared with well-nourished individuals, which was also greater compared with malnourished patients with a normal TSF (HR = 1·23, 95 % CI = 1·06, 1·43) or malnourished patients without TSF assessment (HR = 1·31, 95 % CI = 1·14, 1·50). These associations were concentrated among those patients with adequate muscle mass (as indicated by the calf circumference). Additional fat mass assessment using the TSF enhances the prognostic value of the GLIM criteria. Using the population-derived thresholds for the TSF may provide significant prognostic value when used in combination with the GLIM criteria to guide strategies to optimise the long-term outcomes in patients with LC.
Sarcopenic obesity is regarded as a risk factor for the progression and development of non-alcoholic fatty liver disease (NAFLD). Since male sex is a risk factor for NAFLD and skeletal muscle mass markedly varies between the sexes, we examined whether sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio (SVR), that is, an index of skeletal muscle mass combined with abdominal obesity, and the histological severity of NAFLD. The SVR was measured by bioelectrical impedance in a cohort of 613 (M/F = 443/170) Chinese middle-aged individuals with biopsy-proven NAFLD. Multivariable logistic regression and subgroup analyses were used to test the association between SVR and the severity of NAFLD (i.e. non-alcoholic steatohepatitis (NASH) or NASH with the presence of any stage of liver fibrosis). NASH was identified by a NAFLD activity score ≥5, with a minimum score of 1 for each of its categories. The presence of fibrosis was classified as having a histological stage ≥1. The SVR was inversely associated with NASH in men (adjusted OR 0·62; 95 % CI 0·42, 0·92, P = 0·017 for NASH, adjusted OR 0·65; 95 % CI 0·43, 0·99, P = 0·043 for NASH with the presence of fibrosis), but not in women (1·47 (95 % CI 0·76, 2·83), P = 0·25 for NASH, and 1·45 (95 % CI 0·74, 2·83), P = 0·28 for NASH with the presence of fibrosis). There was a significant interaction for sex and SVR (Pinteraction = 0·017 for NASH and Pinteraction = 0·033 for NASH with the presence of fibrosis). Our findings show that lower skeletal muscle mass combined with abdominal obesity is strongly associated with the presence of NASH only in men.
Nowadays, automated essay evaluation (AEE) systems play an important role in evaluating essays and have been successfully used in large-scale writing assessments. However, existing AEE systems mostly focus on grammar or shallow content measurements rather than higher-order traits such as ideas. This paper proposes a new formulation of graph-based features for concept maps using word embeddings to evaluate the quality of ideas for Chinese compositions. The concept map derived from the student’s composition is composed of the concepts appearing in the essay and the co-occurrence relationship between the concepts. By utilizing real compositions written by eighth-grade students from a large-scale assessment, the scoring accuracy of the computer evaluation system (named AECC-I: Automated Evaluation for Chinese Compositions—Ideas) is higher than the baselines. The results indicate that the proposed method deepens the construct-relevant coverage of automatic ideas evaluation in compositions and that it can provide constructive feedback for students.
With the characteristics of full autonomy and no accumulated errors, polarisation navigation shows tremendous prospects in underwater scenarios. In this paper, inspired by the polarisation vision of aquatic organisms, a novel point-source polarisation sensor with high spectral adaptability (400 nm–760 nm) is designed for underwater orientation. To enhance the environmental applicability of the underwater polarisation sensor, a novel sensor model based on the underwater light intensity attenuation coefficient and optical coupling coefficient is established. In addition, concerned with the influence of light intensity uncertainty on sensor performance underwater, an antagonistic polarisation algorithm is adopted for the first time, to improve the accuracy of angle of polarisation and degree of polarisation in the low signal-to-noise ratio environment underwater. Finally, indoor and outdoor experiments are carried out to evaluate the performance of the designed polarisation sensor. The results show that the designed point-source polarisation sensor can acquire polarised light and be used for heading determination underwater.
Supraglacial lakes and rivers dominate the storage and transport of meltwater on the southwest Greenland Ice Sheet (GrIS) surface. Despite functioning as interconnected hydrologic networks, supraglacial lakes and rivers are commonly studied as independent features, resulting in an incomplete understanding of their collective impact on meltwater storage and routing. We use Landsat 8 satellite imagery to assess the seasonal evolution of supraglacial lakes and rivers on the southwest GrIS during the 2015 melt season. Remotely sensed meltwater areas and volumes are compared with surface runoff simulations from three climate models (MERRA-2, MAR 3.6 and RACMO 2.3), and with in situ observations of proglacial discharge in the Watson River. We find: (1) at elevations >1600 m, 21% of supraglacial lakes and 28% of supraglacial rivers drain into moulins, signifying the presence of high-elevation surface-to-bed meltwater connections even during a colder-than-average melt season; (2) while supraglacial lakes dominate instantaneous surface meltwater storage, supraglacial rivers dominate total surface meltwater area and discharge; (3) the combined surface area of supraglacial lakes and rivers is strongly correlated with modeled surface runoff; and (4) of the three models examined here, MERRA-2 runoff yields the highest overall correlation with observed proglacial discharge in the Watson River.
ABSTRACT IMPACT: Our study will integrate state-of-the-art methods in pathogen genomics, epidemiology, and geospatial analysis to identify both host- and pathogen-factors driving the MDR-TB transmission and the study outcome can inform the design of targeted interventions OBJECTIVES/GOALS: The emergence of multidrug-resistant tuberculosis (MDR-TB) poses serious challenges for the global eradication of tuberculosis. Recent research has shown that transmission is now the dominant driver of MDR-TB. However, our limited understanding of where and among whom MDR-TB is transmitted hampers efforts to control person-to-person spread. METHODS/STUDY POPULATION: We used several analytic approaches to characterize the dynamics of MDR-TB transmission in Shanghai, China. We identified all culture-confirmed MDR cases between 2009-2016 in the city and 1) estimated individual-level risk factors for MDR disease; 2) mapped the TB cases by their home addresses and used a Bayesian spatial disease mapping method to identify regions with an elevated risk of MDR-TB; and 3) we sequenced all MDR isolates to understand whether transmission explained variance in risk that was not attributable to the distribution of individual or location-specific risk variates. RESULTS/ANTICIPATED RESULTS: There were 1034 MDR-TB cases among 16,315 culture-confirmed TB cases during the study period. Bayesian disease mapping identified spatial heterogeneity of MDR-TB and determined four hotspots with an elevated risk of MDR-TB, none of which were fully explained by individual or regional-covariates (Figure 1). Sequencing revealed that more than 40% of the MDR-TB strains were in genomic clusters, indicating recent MDR-TB transmission. Most importantly, MDR-TB cases in three of the four large clades (>8 isolates) were spatially concentrated in three strain-specific hotspots (Figure 2). DISCUSSION/SIGNIFICANCE OF FINDINGS: With the combination of traditional epidemiological tools, geographical, and genomic methods, this study revealed multiple loci of transmission of specific MDR-TB clades within a single city. Identification of where and among whom MDR-TB is transmitted can inform the design of targeted interventions.
This study explores the effects of intergroup vicarious ostracism on individual prejudicial attributions and aggressive intentions. It takes Tibetan and Hui college students in northwestern China as participants. Study 1 and Study 2 explore the difference in observers' prejudicial attributions and aggressive intentions, respectively, when the group members who experienced ostracism (Tibetan college students) observed an in-group member being ostracized by out-group members versus an in-group member being ostracized by in-group members. Results show that those in-group participants, i.e., the Tibetan college students, who observed an in-group member being ostracized by out-group members, showed much higher prejudicial attributions, F(1, 106) = 19.65, p < .001, ηp2 = .156, and aggressive intentions, F(1, 108) = 10.51, p = .002, ηp2 = .089, toward ostracizers than those who observed an in-group member being ostracized by in-group members. In Study 3, Hui college students were recruited as participants to further test the results of Study 1 and Study 2. In addition, we also found that under the out-group conditions, prejudicial attribution mediates the effects of inclusionary status on aggressive intentions (95% bias-corrected confidence interval did not include zero; 95% CI [0.15, 0.69]). This study shows that ostracizers’ group membership could affect observers' prejudicial attributions and their aggressive intentions toward the ostracizers.
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.