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More than 80% COVID-19 cases are mild or moderate. In this study, a risk model was developed for predicting rehabilitation duration of the mild-moderate COVID-19 cases, thereby conducting refined risk management for different risk population.
90 consecutive mild-moderate COVID-19 cases were enrolled. Large-scale datasets were extracted from clinical practices. Through the multivariable linear regression analysis, the model was based on significant risk factors and was developed for predicting the rehabilitation duration of mild-moderate COVID-19. According to the local epidemic situation, risk management was conducted by weighing the risk assessment for different risk populations.
Ten risk factors from 44 high-dimensional clinical datasets were significantly correlated to rehabilitation duration (P < 0.05). Among these, five risk predictors were incorporated into a risk model. Individual rehabilitation durations were effectively calculated. Weighing the local epidemic situation, threshold probability was classified for low risk, intermediate risk, and high risk. According to this classification, risk management was based on a treatment flowchart for tailored clinical decisions-making.
The proposed model is a useful tool for the individualized risk management of mild-moderate COVID-19 cases for the first time, and it may readily facilitate dynamic clinical decision-making for different risk populations.
A surfactant-covered droplet on a solid surface subject to a three-dimensional shear flow is studied using a lattice-Boltzmann and finite-difference hybrid method, which allows for the surfactant concentration beyond the critical micelle concentration. We first focus on low values of the effective capillary number (
) and study the effect of
, viscosity ratio (
) and surfactant coverage on the droplet behaviour. Results show that at low
the droplet eventually reaches steady deformation and a constant moving velocity
. The presence of surfactants not only increases droplet deformation but also promotes droplet motion. For each
, a linear relationship is found between contact-line capillary number and
, but not between wall stress and
due to Marangoni effects. As
decreases monotonically, but the deformation first increases and then decreases for each
. Moreover, increasing surfactant coverage enhances droplet deformation and motion, although the surfactant distribution becomes less non-uniform. We then increase
and study droplet breakup for varying
, where the role of surfactants on the critical
) of droplet breakup is identified by comparing with the clean case. As in the clean case,
first decreases and then increases with increasing
, but its minima occurs at
in the clean case. The presence of surfactants always decreases
, and its effect is more pronounced at low
. Moreover, a decreasing viscosity ratio is found to favour ternary breakup in both clean and surfactant-covered cases, and tip streaming is observed at the lowest
in the surfactant-covered case.
Most skarns are found near the pluton or in lithologies containing at least some limestone. However, recent research has shown that neither a pluton nor limestone is necessarily required to form a skarn deposit. The newly discovered Bagenheigeqier Pb–Zn skarn deposit is located in NE China. The skarn and Pb–Zn orebodies occur in volcanic lithologies of the Baiyin’gaolao Formation and are controlled by NE–SW-trending faults. The nearest pluton is a granite porphyry, at a distance of 20–250 m from the orebodies. Five paragenetic stages at Bagenheigeqier are recognized: (I) skarn; (II) oxide; (III) early sulphide; (IV) late sulphide; and (V) late quartz–calcite. The fluid inclusions from stages II to V homogenized at temperatures of 402–452, 360–408, 274–319 and 167–212°C, respectively. The hydrogen and oxygen isotope compositions (δ18OH2O, –12.4‰ to +9.3‰; δDH2O, –156.5‰ to –99.1‰) indicate that the ore-fluids were primarily of magmatic origin, with the proportion of meteoric water increasing during the progression of ore formation. Sulphur isotope values (δ34SVCDT, 1.4–5.5‰), lead isotope values (206Pb/204Pb, 18.184–18.717; 207Pb/204Pb, 15.520–15.875; 208Pb/204Pb, 37.991–38.379) and the initial 187Os/188Os ratios of the pyrite (0.307 ± 0.06) suggest that the ore metals were derived from the granite porphyry and Baiyin’gaolao Formation. Re–Os dating of pyrite intergrown with galena and sphalerite yielded a well-constrained isochron age of 151.2 ± 4.7 Ma, which is coeval with the laser ablation – inductively coupled plasma – mass spectrometry zircon U–Pb age of 154 ± 1 Ma for the granite porphyry. The deposit was therefore formed during Late Jurassic time.
Distinguished by a marked combination of high strength and high fracture toughness, 18Ni-300 maraging steel (MS) is widely used for intricate tool and die applications. MS is also amenable to the powder bed fusion additive manufacturing process, providing unique opportunities to make small features and incorporate cooling channels in molds. In this study, tensile test samples were fabricated using selective laser melting to investigate the effects of built height and orientations on the evolution of the microstructure and the mechanical properties of the samples. The microstructure of the as-fabricated samples consists of the primary α-martensite phase and fine cellular microstructure (~0.66–0.83 μm) with the retained austenite γ-phase aggregated at the boundaries of the cells, resulting in an enhanced mechanical performance compared with traditional counterparts under the same condition (without post-heat treatments). Random grain orientations with weak textures are revealed in all samples. The XY-built samples display better tensile performance when compared to the Z-built samples due to the fine grain sizes and the retained γ phase. The bottom of the Z-built sample exhibits a higher hardness than other parts of the sample, which could be attributed to its finer cellular structure.
The role of severe respiratory coronavirus virus 2 (SARS-CoV-2)–laden aerosols in the transmission of coronavirus disease 2019 (COVID-19) remains uncertain. Discordant findings of SARS-CoV-2 RNA in air samples were noted in early reports.
Sampling of air close to 6 asymptomatic and symptomatic COVID-19 patients with and without surgical masks was performed with sampling devices using sterile gelatin filters. Frequently touched environmental surfaces near 21 patients were swabbed before daily environmental disinfection. The correlation between the viral loads of patients’ clinical samples and environmental samples was analyzed.
All air samples were negative for SARS-CoV-2 RNA in the 6 patients singly isolated inside airborne infection isolation rooms (AIIRs) with 12 air changes per hour. Of 377 environmental samples near 21 patients, 19 (5.0%) were positive by reverse-transcription polymerase chain reaction (RT-PCR) assay, with a median viral load of 9.2 × 102 copies/mL (range, 1.1 × 102 to 9.4 × 104 copies/mL). The contamination rate was highest on patients’ mobile phones (6 of 77, 7.8%), followed by bed rails (4 of 74, 5.4%) and toilet door handles (4 of 76, 5.3%). We detected a significant correlation between viral load ranges in clinical samples and positivity rate of environmental samples (P < .001).
SARS-CoV-2 RNA was not detectable by air samplers, which suggests that the airborne route is not the predominant mode of transmission of SARS-CoV-2. Wearing a surgical mask, appropriate hand hygiene, and thorough environmental disinfection are sufficient infection control measures for COVID-19 patients isolated singly in AIIRs. However, this conclusion may not apply during aerosol-generating procedures or in cohort wards with large numbers of COVID-19 patients.
Major depressive disorder is characterized by a high risk of relapse. We aimed to compare the prophylactic effects of different antidepressant medicines (ADMs).
PubMed, Cochrane Central Register of Controlled Trials, Embase and the Web of Science were searched on 4 July 2019. A pooled analysis of parametric survival curves was performed using a Bayesian framework. The main outcomes were hazard ratios (HRs), relapse-free survival and mean relapse-free months.
Forty randomized controlled trials were included. The 1-year relapse-free survival for ADM (76%) was significantly better than that for placebo (56%). Most of the relapse difference (86.5%) occurred in the first 6 months. Most HRs were not constant over time. Proof of benefit after 6 months of follow-up was not established partially because of small differences between the drug and placebo after 6 months. Almost all studies used an ‘enriched’ randomized discontinuation design, which may explain the high relapse rates in the first 6 months after randomization.
The superiority of ADM v. placebo was mainly attributed to the difference in relapse rates that occurred in the first 6 months. Our analysis provided evidence that the prophylactic efficacy was not constant over time. A beneficial effect was observed, but the prevention of new episodes after 6 months was questionable. These findings may have implications for clinical practice.
To identify the association of the glucokinase gene (GCK) rs4607517 polymorphism with gestational diabetes mellitus (GDM) and determine whether sweets consumption could interact with the polymorphism on GDM in Chinese women.
We conducted a case–control study at a hospital including 1015 participants (562 GDM cases and 453 controls). We collected the data of pre-pregnancy BMI, sweets consumption and performed genotyping of the GCK rs4607517 polymorphism. Logistic regression was performed to test the association between the rs4607517 polymorphism and GDM, and the stratified analyses by sweets consumption were conducted, using an additive genetic model.
A case–control study of women at a hospital in Beijing, China.
One thousand and fifteen Chinese women.
The GCK rs4607517 A allele was significantly associated with GDM (OR 1·35, 95 % CI 1·03, 1·77; P = 0·028). Furthermore, stratified analyses showed that the A allele increased the risk of GDM only in women who had a habitual consumption of sweet foods (sweets consumption ≥ once per week) (OR 1·61, 95 % CI 1·17, 2·21; P = 0·003). Significant interaction on GDM was found between the rs4607517 A allele and sweets consumption (P = 0·004).
This study for the first time reported the interaction between the GCK rs4607517 polymorphism and sweets consumption on GDM. The results provided novel evidence for risk assessment and personalised prevention of GDM.
The objective of the present study was to elucidate whether resveratrol could facilitate the survival of boar sperm during liquid preservation and fast cooling processes. Boar semen were diluted with Modena extender containing different concentrations of resveratrol. Sperm motility was evaluated by visual estimation. Membrane integrity, acrosome integrity and mitochondrial membrane potentials were measured by SYBR-14/PI, FITC-PNA and JC-1 staining, respectively. Moreover, the levels of reactive oxygen species (ROS), malonaldehyde (MDA) and total antioxidant capacity (T-AOC) were measured using commercial assay kits. B-cell lymphoma protein-2 (BCL2) content was determined by western blotting. During liquid preservation at 17oC, the addition of 50 μM resveratrol to the Modena extender significantly improved sperm motility, membrane integrity, acrosome integrity, and sperm mitochondrial membrane potentials. Similar results were also observed in the 150 μM resveratrol group during the fast cooling process. Furthermore, addition of resveratrol led to a decrease of ROS and MDA, and an increase in the content of T-AOC and BCL2. These observations suggest that addition of resveratrol to Modena extender protects boar sperm against oxidative stress. The optimal concentrations of resveratrol are 50 μM and 150 μM during liquid preservation and fast cooling process, respectively.
Silicon nanowires (SiNWs) were fabricated in a metal-assisted chemical etching method with two steps including dipping silicon wafers in AgNO3/HF solutions and then in H2O2/HF solutions. Grazing incidence X-ray diffraction measurements with a set of incidence angles were carried out on the resulting samples to detect characteristics of silver nanoparticles in the etched silicon. Compared with the uniform size of silver nanoparticles on the surface, the silver nanoparticles in etched silicon were found with size increasing and content decreasing corresponding to the depths. Based on the silver size increasing phenomenon, a detailed supplementary hypothesis about SiNWs formation was proposed about silver disintegration and redeposition in the later stage of silicon etching. For 2, 3, 4, and 8 mM AgNO3 solutions used to study their effect on the SiNWs, it was found that a higher quantity of Ag+ concentration such as 8 mM were not beneficial for producing good quality SiNWs.
In this paper, the generation of relativistic electron mirrors (REM) and the reflection of an ultra-short laser off the mirrors are discussed, applying two-dimension particle-in-cell simulations. REMs with ultra-high acceleration and expanding velocity can be produced from a solid nanofoil illuminated normally by an ultra-intense femtosecond laser pulse with a sharp rising edge. Chirped attosecond pulse can be produced through the reflection of a counter-propagating probe laser off the accelerating REM. In the electron moving frame, the plasma frequency of the REM keeps decreasing due to its rapid expansion. The laser frequency, on the contrary, keeps increasing due to the acceleration of REM and the relativistic Doppler shift from the lab frame to the electron moving frame. Within an ultra-short time interval, the two frequencies will be equal in the electron moving frame, which leads to the resonance between laser and REM. The reflected radiation near this interval and corresponding spectra will be amplified due to the resonance. Through adjusting the arriving time of the probe laser, a certain part of the reflected field could be selectively amplified or depressed, leading to the selective adjustment of the corresponding spectra.
Bile acids (BA) have emerged as signalling molecules regulating intestinal physiology. The importance of intestinal microbiota in production of secondary BA, for example, lithocholic acid (LCA) which impairs enterocyte proliferation and permeability, triggered us to determine the effects of oral probiotics on intestinal BA metabolism. Piglets were weaned at 28 d of age and allocated into control (CON, n 14) or probiotic (PRO, n 14) group fed 50 mg of Lactobacillus plantarum daily, and gut microbiota and BA profile were determined. To test the potential interaction of LCA with bacteria endotoxins in inducing damage of enterocytes, IPEC-J2 cells were treated with LCA, lipopolysaccharide (LPS) and LCA + LPS and expressions of genes related to inflammation, antioxidant capacity and nutrient transport were determined. Compared with the CON group, the PRO group showed lower total LCA level in the ileum and higher relative abundance of the Lactobacillus genus in faeces. In contrast, the relative abundances of Bacteroides, Clostridium_sensu_stricto_1, Parabacteroides and Ruminococcus_1, important bacteria genera in BA biotransformation, were all lower in the PRO than in the CON group. Moreover, PRO piglets had lower postprandial glucagon-like peptide-1 level, while higher glucose level than CON piglets. Co-administration of LPS and LCA led to down-regulated expression of glucose and peptide transporter genes in IPEC-J2 cells. Altogether, oral L. plantarum altered BA profile probably by modulating relative abundances of gut microbial genera that play key roles in BA metabolism and might consequently impact glucose homoeostasis. The detrimental effect of LCA on nutrient transport in enterocytes might be aggravated under LPS challenge.
Clonorchis sinensis (C. sinensis) is one of the most serious food-borne parasites, which can lead to liver fibrosis or cholangiocarcinoma. Effective measures for clonorchiasis prevention are still urgently needed. Bacillus subtilis (B. subtilis) is an effective antigen delivery platform for oral vaccines. Chonorchis sinensis serpin (CsSerpin) was proved to be potential vaccine candidates. In this study, CsSerpin3 was displayed on the surface of B. subtilis spore and recombinant spores were orally administrated to BALB/C mice. CsSerpin3-specific IgA levels in faecal, bile and intestinal mucous increased at 4–8 weeks after the first administration compared with those in control groups. The mucus production and the number of goblet cells in intestinal mucosa elevated in B.s-CotC-CsSerpin3 (CotC, coat protein of B. subtilis spore) spores treated group compared to those in blank control. No significant difference in the activities of glutamic-pyruvic transaminase/ alanine aminotransferase and glutamic oxalacetic transaminase/aspartate aminotransferase were observed between groups. There was no side effect inflammation and observable pathological damage in the liver tissue of mice after administration. Moreover, collagen deposition and Ishak score were statistically reduced in B.s-CotC-CsSerpin3 spores treated mice. In conclusion, B. subtilis spores displaying CsSerpin3 could be investigated further as an oral vaccine against clonorchiasis.
The core toroidal plasma intrinsic rotation has been studied by experiments and simulations in the Joint Texas Experimental Tokamak (J-TEXT). The direction of core intrinsic rotation in the J-TEXT plasma is counter-current. As the plasma density ramps up, the rotation velocity increases in the counter-current direction. By comparing four different electron densities, linear local gyrokinetic simulations have been performed by the Gyrokinetic Electromagnetic Numerical Experiment code for the first time on J-TEXT. It is found that the most dominant turbulence is the ion temperature gradient at
is the minor radius of the plasma and this is unchanged during the plasma density ramp up. By scanning the radial wave vectors, it is found that the residual stress term reverses from negative to positive when the plasma density exceeds a certain threshold. The pinch term is larger than the residual stress term at all four electron densities, which means that the pinch term is always dominant in the core of a J-TEXT plasma.
Helicity, as one of only two inviscid invariants in three-dimensional turbulence, plays an important role in the generation and evolution of turbulent flows. Through theoretical analyses, we find that there are two channels in the helicity cascade process, which differs dramatically from the traditional viewpoint. In this paper, we have conducted important research on the newly proposed dual-channel helicity cascade theory, including vortex dynamic processes, intermittent discrepancies, tensor geometries, etc. The first channel mainly originates from the vortex twisting process, and the second channel mainly originates from the vortex stretching process. Antisymmetric tensors are introduced to the derivations of dual-channel helicity cascade theory, and a complex rotation frame leads to a higher helicity transfer efficiency. By analysing data from direct numerical simulations of typical turbulent flows, we find that these two channels behave differently. The ensemble averages of helicity flux in different channels are equal in homogeneous and isotropic turbulence, while they are different in other types of turbulent flows. The intermittency of the second channel is stronger than that of the first channel. In addition, we find a novel mechanism of hindered or even inverse energy cascades, which could be attributed to the second-channel helicity flux.
To investigate the association of folic acid (FA) supplementation with birth weight, the risk of small for gestational age (SGA) and low birth weight (LBW) in singleton and twin pregnancy.
A population-based cross-sectional survey.
Twenty counties and ten districts in Shaanxi Province of northwestern China, 2013.
28 174 pregnant women with their infants, covering 27 818 single live births and 356 twin live births.
The prevalence of FA supplementation in singletons and twins was 63·9 and 66·3 %. The mean birth weight was 3267 (sd 459·1) g, 2525 (sd 534·0) g and 2494 (sd 539·5) g; the prevalence of SGA was 14·3, 51·4 and 53·4 %; the prevalence of LBW was 3·4, 42·4 and 46·6 % among singleton, twin A and twin B, respectively. Compared with non-users, women with FA supplementation were (β 17·3, 95 % CI 6·1, 28·4; β 166·3, 95 % CI 69·1, 263·5) associated with increased birth weight, lower risk of SGA (OR 0·85, 95 % CI 0·80, 0·92; OR 0·45, 95 % CI 0·30, 0·68) and LBW (OR 0·82, 95 % CI 0·71, 0·95; OR 0·50, 95 % CI 0·33, 0·75) in singletons and twins, and more prominent effects in twins. Moreover, there were significant interactions between FA supplementation and plurality on birth weight, SGA and LBW.
The present study suggests the association of periconceptional 0·4 mg/d FA supplementation with increased birth weight and reduced risk of SGA and LBW in both singletons and twins, and this association may be more prominent in twins.
We aimed to explore and create an evaluation model to assess hospital response capability for a public health emergency (PHE).
Grounded theory was used to construct a comprehensive evaluation index system. Combining with the index system and previous studies and policy documents, we investigated surge capability of hospitals in a PHE. The factor analysis method was used to establish the model.
The comprehensive evaluation system with 11 primary and 30 secondary indicators was constructed. A total of 89 secondary and tertiary hospitals were surveyed in China. The evaluation model (C = 0.587C1 + 0.151C2 + 0.140C3 + 0.122C4) was established. Four factors were identified, namely, preparation factor, treatment factor, emergency awareness factor, and prehospital first-aid factor.
A public health emergency could bring huge losses and a capable hospital response was necessary. There was an urgent need to evaluate hospital capability for a PHE.