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Dysregulation in hepatic lipid synthesis by excess dietary carbohydrate intake is often relevant with the occurrence of fatty liver; therefore, the thorough understanding of the regulation of lipid deposition and metabolism seems crucial to search for potential regulatory targets. In the present study, we examined TAG accumulation, lipid metabolism-related gene expression, the enzyme activities of lipogenesis-related enzymes, the protein levels of transcription factors or genes involving lipogenesis in the livers of yellow catfish fed five dietary carbohydrate sources, such as glucose, maize starch, sucrose, potato starch and dextrin, respectively. Generally speaking, compared with other carbohydrate sources, dietary glucose promoted TAG accumulation, up-regulated lipogenic enzyme activities and gene expressions, and down-regulated mRNA expression of genes involved in lipolysis and small ubiquitin-related modifier (SUMO) modification pathways. Further studies found that sterol regulatory element binding protein 1 (SREBP1), a key transcriptional factor relevant to lipogenic regulation, was modified by SUMO1. Mutational analyses found two important sites for SUMOylation modification (K254R and K264R) in SREBP1. Mutant SREBP lacking lysine 264 up-regulated the transactivation capacity on an SREBP-responsive promoter. Glucose reduced the SUMOylation level of SREBP1 and promoted the protein expression of SREBP1 and its target gene stearoyl-CoA desaturase 1 (SCD1), indicating that SUMOylation of SREBP1 mediated glucose-induced hepatic lipid metabolism. Our study elucidated the molecular mechanism of dietary glucose increasing hepatic lipid deposition and found that the SREBP-dependent transactivation was regulated by SUMO1 modification, which served as a new target for the transcriptional programmes governing lipid metabolism.
Staff surveillance is crucial during the containment phase of a pandemic to help reduce potential healthcare-associated transmission and sustain good staff morale. During an outbreak of SARS-COV-2 with community transmission, our institution used an integrated strategy for early detection and containment of COVID-19 cases among healthcare workers (HCWs).
Our strategy comprised 3 key components: (1) enforcing reporting of HCWs with acute respiratory illness (ARI) to our institution’s staff clinic for monitoring; (2) conducting ongoing syndromic surveillance to obtain early warning of potential clusters of COVID-19; and (3) outbreak investigation and management.
Over a 16-week surveillance period, we detected 14 cases of COVID-19 among HCWs with ARI symptoms. Two of the cases were linked epidemiologically and thus constituted a COVID-19 cluster with intrahospital HCW–HCW transmission; we also detected 1 family cluster and 2 clusters among HCWs who shared accommodation. No transmission to HCWs or patients was detected after containment measures were instituted. Early detection minimized the number of HCWs requiring quarantine, hence preserving continuity of service during an ongoing pandemic.
An integrated surveillance strategy, outbreak management, and encouraging individual responsibility were successful in early detection of clusters of COVID-19 among HCWs. With ongoing local transmission, vigilance must be maintained for intrahospital spread in nonclinical areas where social mingling of HCWs occurs. Because most individuals with COVID-19 have mild symptoms, addressing presenteeism is crucial to minimize potential staff and patient exposure.
To determine whether ambient air pollutants and meteorological variables are associated with daily COVID-19 incidence.
A retrospective cohort from January 25 to February 29, 2020.
Cities of Wuhan, Xiaogan, and Huanggang, China.
The COVID-19 cases detected each day.
We collected daily data of COVID-19 incidence, 8 ambient air pollutants (particulate matter of ≤2.5 µm [PM2.5], particulate matter ≤10 µm [PM10], sulfur dioxide [SO2], carbon monoxide [CO], nitrogen dioxide [NO2], and maximum 8-h moving average concentrations for ozone [O3-8h]) and 3 meteorological variables (temperature, relative humidity, and wind) in China’s 3 worst COVID-19–stricken cities during the study period. The multivariate Poisson regression was performed to understand their correlation.
Daily COVID-19 incidence was positively associated with PM2.5 and humidity in all cities. Specifically, the relative risk (RR) of PM2.5 for daily COVID-19 incidences were 1.036 (95% confidence interval [CI], 1.032–1.039) in Wuhan, 1.059 (95% CI, 1.046–1.072) in Xiaogan, and 1.144 (95% CI, 1.12–1.169) in Huanggang. The RR of humidity for daily COVID-19 incidence was consistently lower than that of PM2.5, and this difference ranged from 0.027 to 0.111. Moreover, PM10 and temperature also exhibited a notable correlation with daily COVID-19 incidence, but in a negative pattern The RR of PM10 for daily COVID-19 incidence ranged from 0.915 (95% CI, 0.896–0.934) to 0.961 (95% CI, 0.95–0.972, while that of temperature ranged from 0.738 (95% CI, 0.717–0.759) to 0.969 (95% CI, 0.966–0.973).
Our data show that PM2.5 and humidity are substantially associated with an increased risk of COVID-19 and that PM10 and temperature are substantially associated with a decreased risk of COVID-19.
Age effects may be important for improving models for the prediction of conversion to psychosis for individuals in the clinical high risk (CHR) state. This study aimed to explore whether adolescent CHR individuals (ages 9–17 years) differ significantly from adult CHR individuals (ages 18–45 years) in terms of conversion rates and predictors.
Consecutive CHR individuals (N = 517) were assessed for demographic and clinical characteristics and followed up for 3 years. Individuals with CHR were classified as adolescent (n = 244) or adult (n = 273) groups. Age-specific prediction models of psychosis were generated separately using Cox regression.
Similar conversion rates were found between age groups; 52 out of 216 (24.1%) adolescent CHR individuals and 55 out of 219 (25.1%) CHR adults converted to psychosis. The conversion outcome was best predicted by negative symptoms compared to other clinical variables in CHR adolescents (χ2 = 7.410, p = 0.006). In contrast, positive symptoms better predicted conversion in CHR adults (χ2 = 6.585, p = 0.01).
Adolescent and adult CHR individuals may require a different approach to early identification and prediction. These results can inform the development of more precise prediction models based on age-specific approaches.
Varicella is an acute respiratory infectious diseases, with high transmissibility and quick dissemination. In this study, an SEIR (susceptible-exposed-infected-recovered) dynamic model was established to explore the optimal prevention and control measures according to the epidemiological characteristics about varicella outbreak in a school in a central city of China. Berkeley Madonna 8.3.18 and Microsoft Office Excel 2010 software were employed for the model simulation and data management, respectively. The result showed that the simulated result of SEIR model agreed well with the reported data when β (infected rate) equal to 0.067. Models showed that the cumulative number of cases was only 13 when isolation adopted when the infected individuals were identified (assuming isolation rate was up to 100%); the cumulative number of cases was only two and the TAR (total attack rate) was 0.56% when the vaccination coefficient reached 50%. The cumulative number of cases did not change significantly with the change of efficiency of ventilation and disinfection, but the peak time was delayed; when δ (vaccination coefficient) = 0.1, m (ventilation efficiency) = 0.7 or δ = 0.2, m = 0.5 or δ = 0.3, m = 0.1 or δ = 0.4 and above, the cumulative number of cases would reduce to one case and TAR would reduce to 0.28% with combined interventions. Varicella outbreak in school could be controlled through strict isolation or vaccination singly; combined interventions have been adopted when the vaccination coefficient was low.
Aiming at the influence of coupling coefficient variation on the output voltage of a high-power LCC-S topology inductively coupled power transfer (ICPT) system, a synchronous three-phase triple-parallel Buck converter is used as the voltage adjustment unit. The control method for the three-phase current sharing of synchronous three-phase triple-parallel Buck converter and the constant voltage output ICPT system under the coupling coefficient variation is studied. Firstly, the hybrid model consisting of the circuit averaging model of the three-phase triple-parallel Buck converter and the generalized state-space average model for the LCC-S type ICPT system is established. Then, the control methods for three-phase current sharing of the synchronous three-phase triple-parallel Buck converter and constant voltage output of ICPT system are studied to achieve the multi-objective integrated control of the system. Finally, a 3.3 kW wireless charging system platform is built, the experimental results have verified the effectiveness of the proposed modeling and control method, and demonstrated the stability of the ICPT system.
A scalable battery recycling strategy to recover and regenerate solid electrolytes and cathode materials in spent all solid-state batteries, reducing energy consumption and greenhouse gases.
With the rapidly increasing ubiquity of lithium-ion batteries (LIBs), sustainable battery recycling is a matter of growing urgency. The major challenge faced in LIB sustainability lies with the fact that the current LIBs are not designed for recycling, making it difficult to engineer recycling approaches that avoid breaking batteries down into their raw materials. Thus, it is prudent to explore new approaches to both fabricate and recycle next-generation batteries before they enter the market. Here, we developed a sustainable design and scalable recycling strategy for next-generation all solid-state batteries (ASSBs). We use the EverBatt model to analyze the relative energy consumption and environmental impact compared to conventional recycling methods. We demonstrate efficient separation and recovery of spent solid electrolytes and electrodes from a lithium metal ASSB and directly regenerate them into usable formats without damaging their core chemical structure. The recycled materials are then reconstituted to fabricate new batteries, achieving similar performance as pristine ASSBs, completing the cycle. This work demonstrates the first fully recycled ASSB and provides critical design consideration for future sustainable batteries.
Influenza activity is subject to environmental factors. Accurate forecasting of influenza epidemics would permit timely and effective implementation of public health interventions, but it remains challenging. In this study, we aimed to develop random forest (RF) regression models including meterological factors to predict seasonal influenza activity in Jiangsu provine, China. Coefficient of determination (R2) and mean absolute percentage error (MAPE) were employed to evaluate the models' performance. Three RF models with optimum parameters were constructed to predict influenza like illness (ILI) activity, influenza A and B (Flu-A and Flu-B) positive rates in Jiangsu. The models for Flu-B and ILI presented excellent performance with MAPEs <10%. The predicted values of the Flu-A model also matched the real trend very well, although its MAPE reached to 19.49% in the test set. The lagged dependent variables were vital predictors in each model. Seasonality was more pronounced in the models for ILI and Flu-A. The modification effects of the meteorological factors and their lagged terms on the prediction accuracy differed across the three models, while temperature always played an important role. Notably, atmospheric pressure made a major contribution to ILI and Flu-B forecasting. In brief, RF models performed well in influenza activity prediction. Impacts of meteorological factors on the predictive models for influenza activity are type-specific.
Multiple sulphur isotope compositions of sedimentary pyrites across the Ediacaran–Cambrian (Ed–C) transition and into the early Cambrian from the Xiaotan section, Yunnan, South China, are presented to explore the evolution of the sulphur cycle. The values of δ34Spy range from 13.5 ‰ to 35.8 ‰, and the values of Δ33Spy range from −0.044 ‰ to 0.063 ‰. The first-order observation of highly positive δ34Spy is consistent with sulphur isotope records from other sedimentary successions (with various degrees of enrichment in 34S), reflecting a common feature in cycling of sulphur among ocean basins. The positive values suggest that pyrite was formed in a depositional setting with limiting availability of sulphate that suppressed the expression of microbial fractionations. The first-order observation of a 10-million-year period of negative Δ33Spy beginning around the Ed–C boundary likely reflects changes in isotopic compositions of sulphur influx to the oceans. Such changes are suggested to be linked to a pulse of preferred weathering of sulphides (with negative Δ33S) relative to sulphate, which may reflect enhanced exposure of pyrites in continental margins due to reorganization of continents at this time. Both δ34Spy and Δ33Spy data imply low seawater sulphate levels, and possibly heterogeneity in sulphate concentrations in the world’s coastal oceans. The predictions about sulphur isotope signatures of evolved seawater (with highly positive δ34S and negative Δ33S) at the Xiaotan section are testable with future measurements of carbonate-associated sulphate (CAS), a proxy of ancient oceanic sulphate that carries information about the operation of sulphur cycling on a global scale.
Spray-painting equipments are important for the automatic spraying of long conical objects such as rocket fairing. This paper proposes a spray-painting equipment that consists of a feed worktable, a gantry frame and two serial–parallel mechanisms and investigates the optimal design of PRR–PRR parallel manipulator in serial–parallel mechanisms. Based on the kinematic model of the parallel manipulator, the conditioning performance, workspace and accuracy performance indices are defined. The dynamic model is derived using virtual work principle and dynamic evaluation index is defined. The conditioning performance, workspace, accuracy performance and dynamic performance are involved in multi-objective optimization design to determine the optimal geometrical parameters of the parallel manipulator. Furthermore, the geometrical parameters of the gantry frame are optimized. An example is given to show how to determine these parameters by taking a long object with conical surface as painted object.
Evaluation of Cr, Mn, Fe, Zn and Se in humans is challenged by the potentially high within-individual variability of these elements in biological specimens, which are poorly characterised. This study aimed to evaluate their within-day, between-day and between-month variability in spot samples, first-morning voids and 24-h collections. A total of 529 spot urine samples (including eighty-eight first-morning voids and 24-h collections) were collected from eleven Chinese adult men on days 0, 1, 2, 3, 4, 30, 60 and 90 and analysed for these five elements using inductively coupled plasma-MS. Intraclass correlation coefficients (ICC) were utilised to characterise the reproducibility, and their sensitivity and specificity were analysed to assess how well a single measurement classified individuals’ 3-month average exposures. Serial measurements of Zn in spot samples exhibited fair to good reproducibility (creatinine-adjusted ICC = 0·47) over five consecutive days, which became poor when the samples were gathered months apart (creatinine-adjusted ICC = 0·33). The reproducibility of Cr, Mn, Fe and Se in spot samples was poor over periods ranging from days to months (creatinine-adjusted ICC = 0·01–0·12). Two spot samples were sufficient for classifying 60 % of the men who truly had the highest (top 33 %) 3-month average Zn concentrations; for Cr, Mn, Fe and Se, however, at least three specimens were required to achieve similar sensitivities. In conclusion, urinary Cr, Mn, Fe, Zn and Se concentrations showed a strong within-individual variability, and a single measurement is not enough to efficiently characterise individuals’ long-term exposures.
A seismic change in the residential pattern is emerging in rural China today: traditional rural houses have been rapidly erased from the face of the countryside with large numbers of peasants being relocated to modern high-rise buildings. This process of “peasant elevation” has had a monumental impact on rural China. It redefines the entitlement to land use by the rural citizenry and negotiations for a new regime of property rights concerning land administration, while, most importantly, it undermines the position of the local state in rural China, whose authority is an aggregation of three distinctive elements: coercive power inherent in the state apparatus, control over economic resources, and resonance with local morality. Based on original data collected in Chongqing, Nantong and Dezhou, this paper argues that the comprehensive uprooting of the Chinese peasantry from the land and the resulting complications have caused moral disorientation among the relocated peasants and fragmentation of local authority. The difficulty in establishing community identity in the new setting has further undermined local governance. This may in turn trigger a wave of social and political tensions that may eventually turn out to be a major political challenge to the regime for years to come.
Radiation exposure during paediatric cardiac catheterisation procedures should be minimised to “as low as reasonably achievable”. The aim of this study was to evaluate the effectiveness of a modified radiation safety protocol in reducing patient dose during paediatric interventional cardiac catheterisation.
Radiation dose data were retrospectively extracted from January 2014 to December 2015 (Standard group) and prospectively collected from January 2016 to December 2017 (Low-dose group) after implementation of a modified radiation safety protocol. Both groups included five most common procedures: atrial septal defect closure, patent ductus arteriosus closure, perimembranous ventricular septal defect closure, pulmonary valvuloplasty, and supraventricular tachycardia ablation.
Median air Kerma was 48.4, 50.5, 29.75, 149, 218, and 12.9 mGy for atrial septal defect closure, pulmonary valvuloplasty, patent ductus arteriosus closure <20 kg, ventricular septal defect closure <20 kg, ventricular septal defect closure ≧20 kg, and supraventricular tachycardia ablation in Standard group, respectively, which significantly decreased to 18.75, 20.7, 11.5, 41.9, 117, and 3.3 mGy in Low-dose group (p < 0.05). This represents a reduction in dose to each patient between 46 and 74%. Among five procedural types in Low-dose group, dose of ventricular septal defect closure was the highest with median air Kerma of 62.5 mGy, dose area product of 364.7 μGy.m2, and dose area product per body weight of 21.5 μGy.m2/kg, respectively, along with the longest fluoroscopy time of 9.9 minutes.
We provided a feasible radiation safety protocol with specific settings on a case-by-case basis. Increasing awareness and adequate training of a practical radiation dose reduction program are essential to improve radiation protection for children.
Challenges remain in the judgement of pathological murmurs in newborns at maternity hospitals, and there are still many simple major CHD patients in developing countries who are not diagnosed in a timely fashion. This study aimed to evaluate the accuracy of cardiac auscultation on neonatal CHD by general paediatricians.
We conducted a prospective study at three hospitals. All asymptomatic newborns underwent auscultation, pulse oximetry monitoring, and echocardiography. Major CHD was classified and confirmed through follow-up. We evaluated the accuracy of various degrees of murmurs for detecting major CHD to determine the most appropriate standards and time of auscultation.
A total of 6750 newborns were included. The median age of auscultation was 43 hours. Cardiac murmurs were identified in 6.6% of newborns. For all CHD, 44.4% had varying degrees of murmurs. A murmur of grade ≥2 used as a reference standard for major CHD had a sensitivity of 89.58%. The false positive rate of murmurs of grade ≥2 for detecting major CHD was significantly negatively related to auscultation time, with 84.4% of false positives requiring follow-up for non-major CHD cardiac issues. Auscultation after 27 hours of life could reduce the false positive rate of major CHD from 2.7 to 0.9%.
With appropriate training, maternity hospital’s paediatricians can detect major CHD with high detection rates with an acceptable false positive rate.
Cerebrovascular disease is the most common cause of death in China, and the incidence of ischemic stroke (240 per 100,000 people) is higher than that of hemorrhagic stroke (82 per 100,000 people). More than 80 percent of strokes can be prevented by early control of risk factors. Therefore, identifying and managing high-risk groups is a top priority in preventing stroke. The CHA2DS2-VASc score is a key prediction tool for stratifying stroke risk in individuals with atrial fibrillation (AF) as follows: zero score is low risk; one is intermediate risk; and two is high risk. The present study was undertaken to evaluate the accuracy of the CHA2DS2-VASc scoring system for stratifying ischemic stroke risk in the non-AF population.
We searched PubMed, EMBASE, and the Cochrane Library in June 2018 for relevant diagnostic studies. Study selection, data extraction, and quality assessment (using the QUADAS-2 criteria) were performed independently by two authors. Methodological variation across the selected studies precluded meta-analysis, so the results were synthesized narratively.
Seven prospective studies involving 50,652 patients (6,760 with ischemic stroke) were included. The treatment threshold ranged from two to four across the studies. Three studies reported diagnostic accuracy at a threshold of two, with a sensitivity above 0.8 and a specificity ranging from 0.32 to 0.68. The diagnostic odds ratio was greater than two (seven studies). The two studies using a treatment threshold of four reported a sensitivity of 0.59 to 0.76 and a specificity of 0.43 to 0.69. One study used a threshold of three, with a sensitivity of 0.79 and a specificity of 0.39.
The CHA2DS2-VASc score may be used to predict ischemic stroke in the non-atrial fibrillation population. Treatment thresholds greater than two provide more optimal diagnostic accuracy, although the predictive performance of the CHA2DS2-VASc score may be better in patients with chronic obstructive pulmonary disease but not AF.
In 2007, Taiwan began conducting health technology assessments (HTA) to support the National Health Insurance Administration (NHIA) in its reimbursement decisions for drugs, medical devices, and medical services.
In this study, the development, missions, and procedures of the implementation of HTA in Taiwan are briefly introduced. Moreover, the value of HTA is examined by reviewing the outcomes and impacts of recent HTA-related research projects, which are classified into five categories: (i) pharmaceutical products, (ii) medical procedures, (iii) medical devices, (iv) health policy, and (v) social care.
Overall, the 10-year implementation of HTA has not only supported the government's decision making but also enhanced patient care. Furthermore, patient evidence has been highlighted, and patient care pathways have been transformed through patient involvement in HTA.
In conclusion, HTA's value has been determined by both government and social aspects in Taiwan.
Conotruncal heart defects are considered to be one of the most common types of birth defect worldwide. Genetic disturbances in folate metabolism such as Thymidylate synthase may increase risk for conotruncal heart defects. We evaluated two common Thymidylate synthase polymorphisms, including the 28 bp tandem repeat in the promoter enhancer region of the 5′-untranslated region and the 6 bp deletion in the 3′-untranslated region, as risk factors of conotruncal heart defects including various subtypes of malformations, in a total of 193 mothers with conotruncal heart defect in offspring and 234 healthy controls in the Chinese population. Logistic regression analyses revealed that mothers who were homozygotes with deletion (−/−) had a 1.8-fold (odds ratio: 1.8; 95% confidence interval: 1.0–3.0, p = 0.040) increased risk for conotruncal heart defect in offspring, respectively, when compared with mothers carrying the wild type (+/+) genotype. Consistently, individuals carrying the genotype −/− of the Thymidylate synthase 6 bp deletion also had higher plasma homocysteine levels compared to the mothers carrying the genotype +/+ in the control and conotruncal heart defect groups (p = 0.006 and p = 0.004, respectively). However, our results showed that Thymidylate synthase 28 bp tandem repeat polymorphism was not associated with risk for conotruncal heart defect and plasma homocysteine level. In conclusion, our data suggest that the maternal Thymidylate synthase 6 bp deletion polymorphism might be associated with plasma homocysteine level and risk for conotruncal heart defect in offspring.
Field bindweed, a member of the Convolvulaceae family, is a problematic perennial weed in cotton fields and orchards in northwest China. The species exhibits strong seed dormancy, causing delayed germination. A clear understanding of the mechanisms involved in alleviating seed dormancy is important for effective plant propagation and successful management of field bindweed. Experiments were conducted to investigate seed germination and radicle growth of field bindweed by breaking seed dormancy using mechanical scarification, sulfuric acid, hot-water scarification, cold stratification, and chemical treatment. Chemical treatments (gibberellic acid or potassium nitrate) had no effect on breaking seed dormancy, whereas mechanical scarification (sandpaper and blade) resulted in 92% to 98% seed germination, indicating that seed dormancy of field bindweed was mainly due to the presence of a hard seed coat. Seeds pretreated with 80% sulfuric acid for 15 to 60 min or 98% sulfuric acid for 15 to 30 min had germination rates above 80%, and soaking seeds in 70 C water for 4 to 16 min or in boiling water for 5 to 20s were effective in breaking seed dormancy but had no effect on the radicle growth of field bindweed. Cold stratification at 5 C for 2 to 8wk partially accelerated seed dormancy release, resulting in 53% to 67% seed germination. Results indicated that field bindweed could potentially form a persistent soil seed bank with physically dormant seed; therefore, strategies for eliminating seed production should be adopted.