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Coronavirus disease 2019 (COVID-19) patients were classified into four clinical stages (uncomplicated illness, mild, severe and critical pneumonia) depending on disease severity. We aim to investigate the corresponding clinical, radiological and laboratory characteristics between different clinical stages. A retrospective, single-centre study of 101 confirmed patients with COVID-19 at Renmin Hospital of Wuhan University from 2 January to 28 January 2020 was enrolled; follow-up endpoint was on 8 February 2020. Clinical data were collected and compared during the course of illness. The median age of the 101 patients was 51.0 years and 33.6% were medical staff. Fever (68%), cough (50%) and fatigue (23%) are the most common symptoms. About 26% patients underwent the mechanical ventilation and 98% patients were treated with antibiotics. Thirty-seven per cent patients were cured and 11 died. On admission, the number of patients with uncomplicated illness, mild, severe and critical pneumonia were 2 [2%], 86 [85%], 11 [11%] and 2 [2%]. Forty-four of the 86 mild pneumonia progressed to severe illness within 4 days, with nine patients worsened due to critical pneumonia within 4 days. Two of the 11 severe patients improved to mild condition while three others deteriorated. Significant differences were observed among groups of different clinical stages in numbers of influenced pulmonary segments (6 vs. 12 vs. 17, P < 0.001). A significantly upward trend was witnessed in ground-glass opacities overlapped with striped shadows (33% vs. 42% vs. 55% vs. 80%, P < 0.001), while pure ground-glass opacities gradually decreased as disease progressed (45% vs. 35% vs. 24% vs. 13%, P < 0.001) within 12 days. Lymphocytes, prealbumin and albumin showed a downtrend as disease progressed from mild to severe or critical condition, an uptrend was found in white blood cells, C-reactive protein, neutrophils and lactate dehydrogenase. The proportions of serum amyloid A > 300 mg/l in mild, severe and critical conditions were 18%, 46% and 71%, respectively.
The X chromosome is known to play an important role in many sex-specific diseases. However, only a few single-nucleotide polymorphisms on the X chromosome have been found to be associated with diseases. Compared to the autosomes, conducting association tests on the X chromosome is more intractable due to the difference in the number of X chromosomes between females and males. On the other hand, X-chromosome inactivation takes place in female mammals, which is a phenomenon in which the expression of one copy of two X chromosomes in females is silenced in order to achieve the same gene expression level as that in males. In addition, imprinting effects may be related to certain diseases. Currently, there are some existing approaches taking X-chromosome inactivation into account when testing for associations on the X chromosome. However, none of them allows for imprinting effects. Therefore, in this paper, we propose a robust test, ZXCII, which accounts for both X-chromosome inactivation and imprinting effects without requiring specifying the genetic models in advance. Simulation studies are conducted in order to investigate the validity and performance of ZXCII under various scenarios of different parameter values. The simulation results show that ZXCII controls the type I error rate well when there is no association. Furthermore, with regards to power, ZXCII is robust in all of the situations considered and generally outperforms most of the existing methods in the presence of imprinting effects, especially under complete imprinting effects.
Yaks (Bos grunniens) live primarily in the Qinghai-Tibetan plateau (altitude: 2000–5000 m). Their milk presents unusual characteristics, containing large amounts of solids including fat and protein, and it is, therefore, important to understand the genetic makeup of the yak. To identify potentially critical genes playing a role in yak mammary tissue from colostrum to mature milk phase of lactogenesis, the early lactation (colostrum) stage (ELS; day 1 after parturition) and mature lactation (milk) stage (MLS; day 15) were chosen for comparison. An ELS-specific cDNA library was established by suppression subtractive hybridization and 25 expressed sequence tags at ELS were identified by sequencing and alignment. To further confirm our results the expression levels of 21 genes during the lactation cycle were measured using quantitative real-time RT-PCR (qRT-PCR). The qRT-PCR results confirmed 9 significantly up-regulated genes at ELS vs. MLS in yak mammary tissue, in which the l-amino acid oxidase 1 (LAO1) and collagen, type I, alpha I (COL1A1) were the most significantly up-regulated. During the lactation cycle, the highest expression of some milk fat genes (i.e., XDH and FABP3) in yak mammary tissue appears earlier than that in dairy cow. Our data also indicate MYC potentially playing a central role through putative regulation of COL1A1, CD44, SPARC, FASN and GPAM.
The microbiota–gut–brain axis, especially the microbial tryptophan (Trp) biosynthesis and metabolism pathway (MiTBamp), may play a critical role in the pathogenesis of major depressive disorder (MDD). However, studies on the MiTBamp in MDD are lacking. The aim of the present study was to analyze the gut microbiota composition and the MiTBamp in MDD patients.
We performed shotgun metagenomic sequencing of stool samples from 26 MDD patients and 29 healthy controls (HCs). In addition to the microbiota community and the MiTBamp analyses, we also built a classification based on the Random Forests (RF) and Boruta algorithm to identify the gut microbiota as biomarkers for MDD.
The Bacteroidetes abundance was strongly reduced whereas that of Actinobacteria was significantly increased in the MDD patients compared with the abundance in the HCs. Most noteworthy, the MDD patients had increased levels of Bifidobacterium, which is commonly used as a probiotic. Four Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologies (KOs) (K01817, K11358, K01626, K01667) abundances in the MiTBamp were significantly lower in the MDD group. Furthermore, we found a negative correlation between the K01626 abundance and the HAMD scores in the MDD group. Finally, RF classification at the genus level can achieve an area under the receiver operating characteristic curve of 0.890.
The present findings enabled a better understanding of the changes in gut microbiota and the related Trp pathway in MDD. Alterations of the gut microbiota may have the potential as biomarkers for distinguishing MDD patients form HCs.
The condition of caregivers is important to the quality of care received by people with Parkinson’s disease (PD), especially at the late disease stages. This study addresses the distress placed on caregivers by participants’ neuropsychiatric symptoms at different stages of PD in Taiwan
This prospective study enrolled 108 people with PD. All participants were examined with the Unified Parkinson’s Disease Rating Scale (UPDRS), Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), and Clinical Dementia Rating (CDR) scale. Caregiver distress was measured using the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D). Statistical analysis was used to explore the PD-related factors that contribute to caregiver distress.
The mean follow-up interval in the 108 PD participants were 24.0 ± 10.2 months with no participant lost to follow-up due to death. NPI-distress (the sum of NPI caregiver distress scale across the 12 domains of the NPI) was positively correlated with NPI-sum (the total score across the 12 domains of the NPI) (r = 0.787, p < 0.001), CDR (r = 0.403, p < 0.001), UPRDS (r = 0.276, p = 0.004), and disease duration (r = 0.246, p = 0.002), but negatively correlated with CASI (r = −0.237, p = 0.043) and MMSE (r = −0.281, p < 0.001). Multiple linear regression analysis showed that only NPI-sum and disease duration were independently correlated with NPI-distress.
The disease duration and NPI-sum are independent predictors of caregiver distress in Taiwanese populations with PD. Early detection and reduction of neuropsychiatric symptoms in people with PD can help decrease caregiver distress.
In the three-phase (pure donor, pure acceptor, and mixed phases) morphologies of organic solar cells, the mixed phases produce an energy cascade that promotes the generation of free carriers. However, how to optimize the content of the mixed phases is a challenging problem. The authors proposed to control different content of mixed phases in DRTB-T and IDIC blends by additive and solvent vapor annealing (SVA). The authors first formed the largest extent amount of mixed phases by the additive cinene (2%) to inhibit the crystallization of DRTB-T and IDIC. And then, different amounts of mixed phases were achieved by further SVA for different times (from 0 to 50 s) to increase the content of pure DRTB-T and IDIC phases. The energetic offsets (ΔE) of pure and mixed phases gradually decrease from 0.529 to 0.477 eV for different content of mixed phases. When ΔE was 0.498 eV, the highest photocurrent density (Jsc) was obtained. The power conversion efficiency was increased from 3.23% (without any treatment) to 8.54%. Therefore, the authors demonstrated that the optimized content of the mixed phases is critical to device performance.
Human-like motion of robots can improve human–robot interaction and increase the efficiency. In this paper, a novel human-like motion planning strategy is proposed to help anthropomorphic arms generate human-like movements accurately. The strategy consists of three parts: movement primitives, Bayesian network (BN), and a novel coupling neural network (CPNN). The movement primitives are used to decouple the human arm movements. The classification of arm movements improves the accuracy of human-like movements. The motion-decision algorithm based on BN is able to predict occurrence probabilities of the motions and choose appropriate mode of motion. Then, a novel CPNN is proposed to solve the inverse kinematics problems of anthropomorphic arms. The CPNN integrates different models into a single network and reflects the features of these models by changing the network structure. Through the strategy, the anthropomorphic arms can generate various human-like movements with satisfactory accuracy. Finally, the availability of the proposed strategy is verified by simulations for the general motion of humanoid NAO.
Bearded sprangletop [Diplachne fusca (L.) P. Beauv. ex Roem. & Schult. ssp. fascicularis (Lam.) P. M. Peterson & N. Snow] is a noxious annual grass weed of paddy fields, distributed in coastal regions of the Jiangsu and Hebei provinces in China. Cyhalofop-butyl has been widely used to control grass weeds since 2006 in China. Overreliance on cyhalofop-butyl has led to the evolution of resistant weeds. In this study, the resistance level and cyhalofop-butyl resistance mechanisms were investigated in the putative resistant (JSHH) population. The dose–response experiments showed that the JSHH D. fusca population had evolved 8.9-fold resistance to cyhalofop-butyl. Acetyl-CoA carboxylase (ACCase) sequencing revealed a point mutation (GGC to GCC) at amino acid position 2096, resulting in a Gly-2096-Ala substitution in the resistant population. To our knowledge, this is the first case of cyhalofop-butyl resistance in D. fusca and the first report of a target-site mutation conferring resistance to ACCase-inhibiting herbicides in D. fusca. In addition, the resistant D. fusca population (JSHH) with the Gly-2096-Ala mutation was cross-resistant to the aryloxyphenoxypropionate herbicide metamifop, the cyclohexanedione herbicide sethoxydim, and the phenylpyrazolin herbicide pinoxaden.
In this contribution, we devoted ourselves to fabricating aggregation-induced emission (AIE) activity copolymers via one-pot combination of RAFT polymerization and Biginelli reaction for the first time. When the feeding ratio of TPB was 33.5%, the molar fraction of TPB was, respectively, about 14.2 and 22.5% in PEG-PTE1 copolymers by two-step strategy and PEG-PTE2 copolymers by one-pot strategy with the similar structure. The Mn of PEG-PTE1 increased to 59,300 from 52,800 of PEG-AE presoma with narrow PDI, which was more than Mn of PEG-PTE2 with 52,300. As compared with PEG-PTE2, when the feeding ratio of TPB was 48.6%, the molar fraction of TPB increased to 32.6% in PEG-PTE3. In aqueous solution, the as-obtained PEG-PTE2 copolymers can self-assemble into fluorescent organic nanoparticles (FONs) with 100–180 nm spherical morphology, the maximal emission peak of which presented at 460 nm with the obvious AIE phenomenon. Moreover, due to the low toxicity and excellent cell dyeing behavior, the as-prepared PEG-PTE2 copolymers displayed great potential for biomedical applications.
In order to increase the speed, precision and robustness against the engine failure in solving optimal endo-atmospheric ascent trajectory of a launch vehicle, a rapid multi-layer solving method with improved numerical algorithms was proposed. The proposed method is capable of decomposing a large number of intervals into multiple layers with advantageous convergence property. Firstly, the problem of solving optimal endo-atmospheric ascent trajectory, which was subjected to path constraints and terminal constraints, was transformed into a Hamilton Two Point Boundary Value Problem (TPBVP). Then, through the finite difference method and numerical solving algorithm, the Hamilton TPBVP was iteratively solved with fewer initial discrete intervals. The initial values of higher-layer iterations were obtained by interpolating convergent solutions at sparse nodes into the doubly discrete nodes of high layers. The process was repeatedly performed until the solving precision met the requirements. To decrease the calculation load in solving TPBVPs, two improved solving algorithms without and with fewer Jacobian calculations were studied, respectively the Derivative-free Spectral Algorithm for Nonlinear Equations(DF-SANE) combined with the improved derivative-free nonmonotone line search strategy, and the Modified Newton method with a relaxation factor in combination with the Inverse Broyden Quasi-Newton method, denoted as ‘MN-IBQ’. Simulation verifications showed that the multi-layer method had significantly higher solving speed than the single-layer method. For the improved numerical algorithms, the DF-SANE was trapped in the local convergence problem. While using the proposed MN-IBQ can further increase the solving rate. Typical engine failure simulations showed that the multi-layer method with the MN-IBQ algorithm had not only significantly higher solving speed but also stronger robustness, where the traditional single-layer method could not adapt. In addition, the thrust loss tolerance limits for the multi-layer solving method were given for different engine failure times. The results show promising potential of the proposed approach in trajectory online generation and closed-loop guidance of launch vehicles at the endo-atmospheric ascent stage.
Maternal one-carbon metabolism during pregnancy is crucial for fetal development and programming by DNA methylation. However, evidence on one-carbon biomarkers other than folate is lacking. We, therefore, investigated whether maternal plasma methyl donors, that is, choline, betaine and methionine, are associated with birth outcomes. Blood samples were obtained from 115 women during gestation (median 26·3 weeks, 90 % range 22·7–33·0 weeks). Plasma choline, betaine, methionine and dimethylglycine were measured using HPLC-tandem MS. Multivariate linear and logistic regression models were used to estimate the association between plasma biomarkers and birth weight, birth length, the risk of small-for-gestational-age and large-for-gestational-age (LGA). Higher level of maternal betaine was associated with lower birth weight (–130·3 (95 % CI –244·8, –15·9) per 1 sd increment for log-transformed betaine). Higher maternal methionine was associated with lower risk of LGA, and adjusted OR, with 95 % CI for 1 sd increase in methionine concentration was 0·44 (95 % CI 0·21, 0·89). Stratified analyses according to infant sex or maternal plasma homocysteine status showed that reduction in birth weight in relation to maternal betaine was only limited to male infants or to who had higher maternal homocysteine status (≥5·1 µmol/l). Higher maternal betaine status was associated with reduced birth weight. Maternal methionine was inversely associated with LGA risk. These findings are needed to be replicated in future larger studies.
Information systems (IS) have facilitated workflow in the health care system for years. However, the utilization of IS in disaster medical assistance teams (DMATs) has been less studied.
In Taiwan, we started a program in 2008 to build up an information system, MEDical Assistance and Information Dashboard (MED-AID), to improve the capability and increase the efficiency of our national DMAT.
Method: The mission of our national DMAT was to provide acute trauma care and subacute outpatient care in the field after an emergency event (e.g., earthquakes). We built the IS through a user-oriented process to fit the need of the DMAT. We first analyzed the response work in the DMAT missions and reviewed the current paperwork. We evaluated the eligibility and effectiveness of the core functions of DMATs by experts in Taiwan and then developed the IS. The IS was then tested and revised each year in two table-top exercises and one regional full-scale exercise by the DMAT staffs who came from different hospitals in Taiwan.
During the past 10 years, we identified several core concepts of IS of DMAT: patient tracking, medical record, continuity of care, integration of referral resources, disease surveillance, patient information reporting, and medical resources management. The application of the IS facilitate the DMAT in providing safe patient care with continuous recording and integrate patient referral resources based on geographic information. The IS also help the planning in real-time disease surveillance and logistic function in the medical resources monitoring.
Information systems could facilitate patient care and relieve the workload on information analysis and resources management for DMATs.
In a rice (Oryza sativa L.)–wheat (Triticum aestivum L.) rotation system, a study was conducted to determine the effects of different fertilization regimens (no fertilization, replacement of a portion of chemical fertilizer with composted pig manure, chemical fertilizer only, and straw return combined with chemical fertilizer) on the weed communities and wheat yields after 4 and 5 yr. The impact of the long-term recurrent fertilization regimen initiated in 2010 on the composition and diversity of weed communities and the impact of the components and total amount of fertilizer on wheat yields were assessed in 2014 and 2015. Totals of 19 and 16 weed species were identified in experimental wheat fields in 2014 and 2015, respectively, but the occurrence of weed species varied according to the fertilization regimen. American sloughgrass [Beckmannia syzigachne (Steud.) Fernald], water starwort [Myosoton aquaticum (L.) Moench], and lyrate hemistepta (Hemistepta lyrata Bunge.) were adapted to all fertilization treatments and were the dominant weed species in the experimental wheat fields. The greatest number of weed species were observed under the no-fertilization treatment, in which 40% of the weed community was composed of broadleaf weeds and the lowest wheat yields were obtained. With fertilizer application, the number of weed species was reduced, the height of weeds increased significantly, the density of broadleaf weeds was significantly reduced, the biodiversity indices of weed communities decreased significantly, and higher wheat yields were obtained. Only the chemical fertilizer plus composted pig manure treatment and the chemical fertilizer–only treatment increased the density of grassy weeds and the total weed community density. The treatment with chemical fertilizer only also resulted in the highest density of B. syzigachne. Rice straw return combined with chemical fertilizer yielded the lowest total weed density, which suggests that it inhibited occurrence of weeds. The different fertilizer regimens not only affected the weed species composition, distribution, and diversity, but also the weed density. Our study provides new information from a rice–wheat rotation system on the relationship between soil amendments and agricultural weed infestation.
The output performances of a bidirectional ring amplifier with twin pulses are demonstrated. Compared to the extraction efficiency of 32% for single-pulse injection, the extraction efficiency of stored energy for twin-pulse injection with bidirectional propagation is increased to 60%. The maximum output energies of the twin pulses are 347 mJ and 351 mJ, and the output energy of a single pulse is only 373 mJ under the same amplifier operating conditions. The experimental results show that the bidirectional ring amplifier with twin pulses can achieve a higher extraction efficiency of stored energy at a lower operating fluence, and has potential applications in high-power and high-energy laser facilities.
Catchweed bedstraw (Galium aparine L.) is a problematic dicot weed that occurs in major winter wheat (Triticum aestivum L.) fields in China. Tribenuron-methyl has been widely used to control broadleaf weeds since 1988 in China. However, overuse has led to the resistance evolution of G. aparine to tribenuron-methyl. In this study, 20 G. aparine populations collected from Shandong and Henan provinces were used to determine tribenuron-methyl resistance and target-site resistance mechanisms. In dose–response experiments, 12 G. aparine populations showed different resistance levels (2.92 to 842.41-fold) to tribenuron-methyl compared with the susceptible population. Five different acetolactate synthase (ALS) mutations (Pro-197-Leu, Pro-197-Ser, Pro-197-His, Asp-376-Glu, and Trp-574-Leu) were detected in different resistant populations. Individuals heterozygous for Pro-197-Ser and Trp-574-Leu mutations were also observed in a resistant population (HN6). In addition, pHB4 (Pro-197-Ser), pHB7 (Pro-197-His), pHB8 (Pro-197-Leu), pHB5 (Asp-376-Glu), and pHB3 (Trp-574-Leu) subpopulations individually homozygous for specific ALS mutations were generated to evaluate the cross-resistance to ALS-inhibiting herbicides. The pHB4, pHB7, pHB8, pHB5, and pHB3 subpopulations all were resistant to sulfonylurea, pyrazosulfuron-ethyl, triazolopyrimidine, flumetsulam, sulfonylamino-carbonyl-triazolinone, flucarbazone-sodium, pyrimidinyl thiobenzoate, pyribenzoxim, and the imidazolinone imazethapyr. These results indicated the diversity of the resistance-conferring ALS mutations in G. aparine, and all these mutations resulted in broad cross-resistance to five kinds of ALS-inhibiting herbicides.
The Chinese Crested Tern Thalasseus bernsteini (CCT) is likely the most critically endangered seabird species in Asia. The Matsu, Penghu, Jiushan, and Wuzhishan Archipelagos along the China coastline, plus Yeonggwang County in South Korea, are the five areas where this species is currently confirmed to breed. According to census and historical data collected in the Matsu Archipelago from 2004 to 2017, there was an average of 10 ± 4 adult CCT individuals at the Matsu Islands Tern Refuge (MITR) during the breeding season. CCT nested only in association with Greater Crested Terns T. bergii (GCT) among seven protected islands in the MITR, and the numbers of observed breeding individuals of the two species were positively correlated (r = 0.59, P < 0.001). We used generalized linear models to examine the effects of chlorophyll-a concentrations in surrounding marine habitats, typhoon frequency, and in-season shifts in colony location on inter-annual variation in numbers of breeding individuals and productivity (chick:adult ratios) of both CCT and GCT at the MITR from 2004 to 2017. Average chlorophyll-a concentrations during July-August obtained from the MODIS satellite were positively correlated with the annual maximum number of GCT at the MITR, but not that of CCT. In addition, we found that nest abandonment events during early incubation at the mixed-species colonies were associated with in-season shifts in colony location and delayed nesting chronology, thereby extending nesting into the peak typhoon season during July and August. The effects of in-season colony shifts on nesting chronology and the additive effects of typhoons caused a significant decline in CCT breeding success during the study period. We propose more rigorous monitoring to ascertain the root causes of in-season colony shifts of terns and then determine possible solutions. Additionally, creating educational programmes to increase public awareness towards seabird conservation could prove beneficial.
Northeastern China is a region of high tick abundance, multiple tick-borne pathogens and likely human infections. The spectrum of diseases caused by tick-borne pathogens has not been objectively evaluated in this region for clinical management and for comparison with other regions globally where tick-transmitted diseases are common. Based on clinical symptoms, PCR, indirect immunofluorescent assay and (or) blood smear, we identified and described tick-borne diseases from patients with recent tick bite seen at Mudanjiang Forestry Central Hospital. From May 2010 to September 2011, 42% (75/180) of patients were diagnosed with a specific tick-borne disease, including Lyme borreliosis, tick-borne encephalitis, human granulocytic anaplasmosis, human babesiosis and spotted fever group rickettsiosis. When we compared clinical and laboratory features to identify factors that might discriminate tick-transmitted infections from those lacking that evidence, we revealed that erythema migrans and neurological manifestations were statistically significantly differently presented between those with and without documented aetiologies (P < 0.001, P = 0.003). Twelve patients (6.7%, 12/180) were co-infected with two tick-borne pathogens. We demonstrated the poor ability of clinicians to identify the specific tick-borne disease. In addition, it is necessary to develop specific laboratory assays for optimal diagnosis of tick-borne diseases.