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A fever clinic within a hospital plays a vital role in pandemic control because it serves as an outpost for pandemic discovery, monitoring and handling. As the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan was gradually brought under control, the fever clinic in the West Campus of Wuhan Union Hospital introduced a new model for construction and management of temporary mobile isolation wards. A traditional battlefield hospital model was combined with pandemic control regulations, to build a complex of mobile isolation wards that used adaptive design and construction for medical operational, medical waste management and water drainage systems. The mobile isolation wards allowed for the sharing of medical resources with the fever clinic. This increased the capacity and efficiency of receiving, screening, triaging and isolation and observation of patients with fever. The innovative mobile isolation wards also controlled new sudden outbreaks of COVID-19. We document the adaptive design and construction model of the novel complex of mobile isolation wards and explain its characteristics, functions and use.
This study aimed to identify clinical features for prognosing mortality risk using machine-learning methods in patients with coronavirus disease 2019 (COVID-19). A retrospective study of the inpatients with COVID-19 admitted from 15 January to 15 March 2020 in Wuhan is reported. The data of symptoms, comorbidity, demographic, vital sign, CT scans results and laboratory test results on admission were collected. Machine-learning methods (Random Forest and XGboost) were used to rank clinical features for mortality risk. Multivariate logistic regression models were applied to identify clinical features with statistical significance. The predictors of mortality were lactate dehydrogenase (LDH), C-reactive protein (CRP) and age based on 500 bootstrapped samples. A multivariate logistic regression model was formed to predict mortality 292 in-sample patients with area under the receiver operating characteristics (AUROC) of 0.9521, which was better than CURB-65 (AUROC of 0.8501) and the machine-learning-based model (AUROC of 0.4530). An out-sample data set of 13 patients was further tested to show our model (AUROC of 0.6061) was also better than CURB-65 (AUROC of 0.4608) and the machine-learning-based model (AUROC of 0.2292). LDH, CRP and age can be used to identify severe patients with COVID-19 on hospital admission.
Many emotional experiences such as anxiety and depression are influenced by negative affect (NA). NA has both trait and state features, which play different roles in physiological and mental health. Attending to NA common to various emotional experiences and their trait-state features might help deepen the understanding of the shared foundation of related emotional disorders.
The principal component of five measures was calculated to indicate individuals' NA level. Applying the connectivity-based correlation analysis, we first identified resting-state functional connectives (FCs) relating to NA in sample 1 (n = 367), which were validated through an independent sample (n = 232; sample 2). Next, based on the variability of FCs across large timescale, we further divided the NA-related FCs into high- and low-variability groups. Finally, FCs in different variability groups were separately applied to predict individuals' neuroticism level (which is assumed to be the core trait-related factor underlying NA), and the change of NA level (which represents the state-related fluctuation of NA).
The low-variability FCs were primarily within the default mode network (DMN) and between the DMN and dorsal attention network/sensory system and significantly predicted trait rather than state NA. The high-variability FCs were primarily between the DMN and ventral attention network, the fronto-parietal network and DMN/sensory system, and significantly predicted the change of NA level.
The trait and state NA can be separately predicted by stable and variable spontaneous FCs with different attentional processes and emotion regulatory mechanisms, which could deepen our understanding of NA.
Current available antidepressants exhibit low remission rate with a long response lag time. Growing evidence has demonstrated acute sub-anesthetic dose of ketamine exerts rapid, robust, and lasting antidepressant effects. However, a long term use of ketamine tends to elicit its adverse reactions. The present study aimed to investigate the antidepressant-like effects of intermittent and consecutive administrations of ketamine on chronic unpredictable mild stress (CUMS) rats, and to determine whether ketamine can redeem the time lag for treatment response of classic antidepressants. The behavioral responses were assessed by the sucrose preference test, forced swimming test, and open field test. In the first stage of experiments, all the four treatment regimens of ketamine (10 mg/kg ip, once daily for 3 or 7 consecutive days, or once every 7 or 3 days, in a total 21 days) showed robust antidepressant-like effects, with no significant influence on locomotor activity and stereotype behavior in the CUMS rats. The intermittent administration regimens produced longer antidepressant-like effects than the consecutive administration regimens and the administration every 7 days presented similar antidepressant-like effects with less administration times compared with the administration every 3 days. In the second stage of experiments, the combination of ketamine (10 mg/kg ip, once every 7 days) and citalopram (20 mg/kg po, once daily) for 21 days caused more rapid and sustained antidepressant-like effects than citalopram administered alone. In summary, repeated sub-anesthestic doses of ketamine can redeem the time lag for the antidepressant-like effects of citalopram, suggesting the combination of ketamine and classic antidepressants is a promising regimen for depression with quick onset time and stable and lasting effects.
In the livestock husbandry compensatory growth may be explored as a means to improve nutrient utilization, to reduce gut health problems due to excess protein intake, to simplify feeding strategies and thus to improve production efficiencies. This study investigated the effects of early protein restriction (EPR) and early antibiotic intervention (EAI) on growth performance, intestinal morphology, colonic bacteria, metabolites and mucosal gene expressions during the restriction phase and re-alimentation phase. A total of 64 piglets (10.04 ± 0.73 kg) were randomly divided into four treatment groups according to a 2 × 2 factorial arrangement with two levels of proteins (14% v. 20%) and two levels of antibiotics (0 v. 50 mg/kg kitasamycin and 20 mg/kg colistin sulphate). After a 30-day restriction phase with four kinds of diets, all groups were fed the same diets for another 74 days. The results showed that EPR decreased BW, average daily gain (ADG), average daily feed intake in the restriction phase (P < 0.01) and increased ADG on days 66 to 104 of the late re-alimentation phase. Early protein restriction could decrease the villus height in the jejunum (P < 0.05), while shifting to the same diets restored the villus height. Meanwhile, during the re-alimentation phase, pigs in the protein restriction groups had increased concentrations of total short chain fatty acids (P < 0.05), and modified the abundances of Firmicutes and Bacteroidetes in the colon. Furthermore, the lower microbial diversity caused by EPR was improved, and gene expression analysis indicated a better barrier function in the colon. During the whole trial, EAI had no interaction with EPR and played a dispensable role in compensatory growth. Collectively, the retardation of growth caused by EPR can be compensated for in the later stages of pig raising, and accompanied by altered intestinal morphology, microbial composition.
The aim of the present study was to explore the influence of tea consumption on diabetes mellitus in the Chinese population. This multi-centre, cross-sectional study was conducted in eight sites from south, east, north, west and middle regions in China by enrolling 12 017 subjects aged 20–70 years. Socio-demographic and general information was collected by a standardised questionnaire. A standard procedure was used to measure anthropometric characteristics and to obtain blood samples. The diagnosis of diabetes was determined using a standard 75-g oral glucose tolerance test. In the final analysis, 10 825 participants were included and multiple logistic models and interaction effect analysis were applied for assessing the association between tea drinking with diabetes. Compared with non-tea drinkers, the multivariable-adjusted OR for newly diagnosed diabetes were 0·80 (95 % CI 0·67, 0·97), 0·88 (95 % CI 0·71, 1·09) and 0·86 (95 % CI 0·67, 1·11) for daily tea drinkers, occasional tea drinkers and seldom tea drinkers, respectively. Furthermore, drinking tea daily was related to decreased risk of diabetes in females by 32 %, elderly (>45 years) by 24 % and obese (BMI > 30 kg/m2) by 34 %. Moreover, drinking dark tea was associated with reduced risk of diabetes by 45 % (OR 0·55; 95 % CI 0·42, 0·72; P < 0·01). The results imply that drinking tea daily was negatively related to risk of diabetes in female, elderly and obese people. In addition, drinking dark tea was associated with decreased risk of type 2 diabetes mellitus.
Nucleos(t)ide analogues (NAs) are widely used for antiviral therapy in patients with chronic hepatitis B (CHB), but real-world data on treatment patterns and long-term clinical outcomes are not always available. Using data from electronic medical records between January 2011 and December 2016 in Shanghai, China, we evaluated patient characteristics, treatment patterns and clinical outcomes in patients with CHB. There were 6688 patients in the study cohort. The incidences of cirrhosis and hepatocellular carcinoma (HCC) were 41.0‰ and 6.8‰ person-years, respectively. There were more cirrhosis and HCC cases among patients who had shorter NA treatment duration (<365 days), or who were less compliant (<80%). In addition, increased risk of cirrhosis and HCC was observed in patients who did not achieve hepatitis B surface antigen (HBsAg) loss/seroconversion. Moreover, patients with cirrhosis developed after antiviral treatments had a higher incidence of HCC (adjusted hazard ratio 15.86, 95% confidence interval 7.35–34.24). Good compliance with treatment and longer treatment duration significantly decreased the risk of developing cirrhosis and HCC. HBsAg loss seemed to be a protective factor for cirrhosis/HCC in NAs-treated patients with CHB, and cirrhosis was a confirmed risk factor for HCC development as expected.
CrFeNiTix (x = 0.2, 0.3, 0.4, 0.5, and 0.6 molar ratio) compositionally complex alloys were fabricated by vacuum arc melting to investigate the microstructure, hardness, and compressive properties. The results revealed that CrFeNiTix alloys consisted of the principal face-centered cubic (FCC) phase and body-centered cubic (BCC) solid solution, with an amount of (Ni, Ti)-rich hexagonal close-packed phase. CrFeNiTix alloys exhibited the typical dendrite. Ti0.2 and Ti0.3 alloys were composed of FCC and BCC solid solutions in the dendrite, as well as ε (Ni3Ti) and R (Ni2.67Ti1.33) phases in the inter-dendrite, simultaneously. For Ti0.4, Ti0.5, and Ti0.6 alloys, (Fe, Cr)-rich solid solution separated out and ε phase transformed into R phase gradually. Meanwhile, TEM analysis indicated that Ti0.4 alloy matrix consisted of the principal FCC phase containing (Ni, Ti)-rich intragranular nanoprecipitates. The hardness values of CrFeNiTix alloys were increased with the addition of Ti content and the high compressive strength of CrFeNiTix alloys was maintained, which was attributed to the solid solution strengthening and precipitation hardening.
It remains unclear whether a crystalline basement exists in SE China (including Taiwan), whether the formation of the Tananao metamorphic belt in Taiwan was linked to subduction of the Palaeo-Pacific Plate, and whether the source rocks of the sedimentary sequences in the metamorphic belts are late Mesozoic or Palaeozoic in age. Field investigations and zircon age data in the present study indicate that there is no pre-Palaeozoic gneiss (crystalline basement) in Taiwan (although orthogneisses were produced during deformation and metamorphism of Mesozoic granites), and investigations of the metasediments show that the sedimentary sequences in the Tailuko and Yuli belts are similar. Moreover, LA-ICP-MS dating of detrital zircons from the Pingtan–Dongshan belt in Fujian Province yields a cluster of 206Pb–238U ages at ~ 210–190 Ma, and the Tailuko and Yuli belts in Taiwan have similar clusters of detrital zircon ages at 200 Ma, 160 Ma, 120 Ma and 110 Ma, as well as a later overprinting caused by arc–continent collision. The cathodoluminescence images and trace-element characteristics of the zircons show that they were originally magmatic in origin. This finding, combined with the Hf isotope data, indicates that the sources of sediments in the Tananao belt (Tailuko and Yuli belts) were relatively close to an active continental margin, and that both the Tailuko and Yuli belts have similar sedimentary sources. From the margin of the Chinese mainland to Taiwan, the metasediments seem to represent a continuous sequence of deposits ranging in age from Jurassic to Cretaceous, but with the sediments becoming progressively younger towards the east. It can be inferred that the sediments in the Tailuko and Yuli belts were continental-shelf sequences with sources in SE China.
To retrospectively analyze the rescue and treatment of pediatric patients by the Chinese Red Cross medical team during the Nepal earthquake relief.
The medical team set up a field hospital; the pediatric clinic consisted of 1 pediatrician and several nurses. Children younger than 18 years old were placed in the pediatric clinic for injury examination and treatment.
During the 7-day period of medical assistance (the second to third week after the earthquake), a total of 108 pediatric patients were diagnosed and treated, accounting for 2.8% of the total patients. The earthquake-related injuries mainly required surgical dressing and debridement. No severe limb fractures or traumatic brain injuries were found. Infection of the respiratory tract, the gastrointestinal tract, and the skin were the most common ailments, accounting for 42.3%, 18.5%, and 16.7%, respectively, of the total treated patients.
Two to 3 weeks after the earthquake, the admitted pediatric patients mainly displayed respiratory and gastrointestinal infections. When developing a rescue plan and arranging medical resources, we should consider the necessity of treating non–disaster-related conditions. (Disaster Med Public Health Preparedness. 2016;page 1 of 4)
Changes in soil chemistry in response to varying climatic regimes can alter the equilibria of soil systems and result in different clay minerals. Variations in phyllosilicate clay composition can reflect temporal and spatial climatic changes, such as summer/winter monsoon cycles. The objective of this research was to investigate the mineralogy of the clay fractions as a proxy for determining variations in the East Asian monsoon climate, based on a section at Chaoyang in China spanning the last 0.423 Ma BP. The clay mineralogy record in the Chaoyang section was compared with other proxies as recorded in this section and with other palaeoclimatic indicators, including oxygen isotopes from oceanic sediments and loess–palaeosol sections on the Chinese Loess Plateau (CLP). The results from clay mineralogy and related climatic studies show that the summer monsoon has a trend of four increased stages and four decreased stages; whereas the winter monsoon displays the opposite trend. During the last 0.423 Ma BP, the strongest winter monsoon occurred around 0.243–0.311 Ma BP. During this period, which included an intense winter monsoon, the soil in the section had the least illite, one of the smallest kaolinite and illite/Chlorite (I/C) indices and an overall decreasing clay content. The period 0.225–0.243 Ma BP had the strongest summer monsoon over the last 0.423 Ma BP. This period had the greatest amount of illite, the highest I/C index, greater overall clay content and the strongest magnetic susceptibility signal. Additionally, this section contained the smallest mean grain size. The multi-monsoon climate cycles of alternating cold-dry and warm-moist conditions as recorded in the Chaoyang section corresponded well with multiple glaciation cycles based on deep sea sediments. This indicates that the Chaoyang section provides a record of palaeoclimate changes in northeast China that can be linked to mineralogical suites to assist in reconstructing the palaeoclimate over the Late Middle Pleistocene, and complements the global palaeoclimate records in the CLP.
The aim of the present study was to investigate the prevalence of hyperhomocysteinaemia (HHCY; total plasma homocysteine (tHcy) concentration >15 μmol/l) and its major determinants in healthy Chinese northerners. A descriptive and cross-sectional study was conducted in Shaanxi Province, China. The study sample included 2645 participants (1042 men and 1603 women) aged >20 years. Demographic characteristics and lifestyle factors were assessed via questionnaire interviews and physical examination. Plasma levels of homocysteine and folate and methylenetetrahydrofolate reductase (MTHFR) gene polymorphism were determined according to standard methods. The prevalence of HHCY was 67·7 % (81·4 % in men and 58·8 % in women). The geometric mean of tHcy concentration was 19·1 μmol/l. The OR of HHCY were 0·44 (95 % CI 0·34, 0·57) for women v. men; 1·95 (95 % CI 1·41, 2·70), 1·41 (95 % CI 1·05, 1·88) and 0·76 (95 % CI 0·64, 0·89) for participants with smoking and alcohol drinking cessation and improved physical activity levels, respectively; 0·25 (95 % CI 0·17, 0·38), 0·33 (95 % CI 0·22, 0·49) and 0·56 (95 % CI 0·36, 0·88) for participants with an education level of elementary school, secondary school and university v. illiterate, respectively; 1·41 (95 % CI 1·13, 1·75) and 3·05 (95 % CI 2·35, 3·97) for participants with CT and TT v. CC genotype at MTHFR 677C → T polymorphism, respectively. These results demonstrate that the prevalence of HHCY is considerably high in Chinese northerners, especially in TT subjects, suggesting that implementation of tHcy-lowering strategies, such as lifestyle changes, is necessary.
The relationship between hydrophobicity and the protective effect of whey protein hydrolysates (WPHs) against oxidative stress was studied. Whey protein was first hydrolysed by pepsin and trypsin to obtain WPHs. After absorbed by macroporous adsorption resin DA201-C, three fractions named as M20, M40, and M60 were eluted by various concentrations of ethanol. The hydrophobicity showed a trend of increase from M20 to M60. Antioxidant ability test in vitro indicated that all the three components of WPHs displayed reasonably good antioxidant ability. Moreover, with the increase of hydrophobicity, antioxidant ability of WPHs improved significantly. Then rat pheochromocytoma line 12 (PC12) cells oxidative model was built to evaluate the suppression of oxidative stress of three components on PC12 cells induced by H2O2. Morphological alterations, cell viability, apoptosis rate, and intracellular antioxidase system tests all indicated that WPHs exert significant protection on PC cells against H2O2-induced damage. Among them, M60 had the highest protective effect by increasing 19·3% cell survival and reducing 28·6% cell apoptosis. These results suggested hydrophobicity of WPHs was contributing to the antioxidant ability and the protective effect against oxidative damage.
Clownfish and their associated sea anemones are icons of tropical and
subtropical coastal ecosystems, but bleaching and collecting for the
aquarium trade has reduced their population densities in several
Indo-Pacific locations. We surveyed four Entacmaea
quadricolor populations and their associated clownfish
Amphiprion clarkii in Hong Kong. These assemblages
represented a combination of exposed and sheltered, flat bottomed and sloped
conditions. Different from tropical areas, where E.
quadricolor is usually found in sheltered shallow waters, the
four populations in Hong Kong were distributed in 4–10 m depths, being
densest on a 40 × 80 m slope of volcanic rocks (34.2–76.6% substrate cover
and 48.7–102.1 ind m−2) at an exposed site. This distribution
pattern could be explained by the high turbidities associated with river
discharge and sedimentation rates in local waters, which discourage the
establishment of E. quadricolor populations in sheltered bays; shallow
habitats might not be suitable for E. quadricolor in Hong
Kong due to strong wave actions generated by typhoons. Amphiprion
clarkii was present at low densities
(0.07–0.26 fish m−2) across the sites. Our data provide a
baseline for monitoring the changes of these conspicuous members of shallow
water communities in Hong Kong.
The sandstone composition analysis carried out on the samples from three different sections (western section, middle section and eastern section) of the Upper Jurassic Emuerhe Formation in the Mohe Basin, northeastern China, reveals that the Okhotsk orogenic belt and the Ergun massif basement are the source areas for the Emuerhe Formation. The source area of the western section and the A segment of the middle section is the Okhotsk orogenic belt. The tectonic attributes of the Okhotsk orogenic belt are those of a dissected arc. The transportation distance of clastic rocks from these sections gradually lengthened, and the uplift rate of the Okhotsk orogenic belt gradually increased. The source area of the eastern section and the B segment of the middle section is the Ergun massif basement. Compared with the Okhotsk orogenic belt, the tectonic attributes and uplift rate of the Ergun massif basement are different from the former. The attributes of the Ergun massif basement are those of basement uplift. The transportation distance of clastic rocks from the eastern section and the B segment of the middle section gradually shortened, and the uplift rate of the Ergun massif basement gradually decreased. These conclusions are consistent with the characteristics of a foreland basin. Thus, we can draw the conclusion that the Mohe Basin belongs to the foreland basin.
Using the Delingha 13.7 m telescope with a 9-beam SIS superconducting receiver installed, we carried out mapping of C18O and C17O J = (1 − 0) toward molecular clouds in the central molecular zone (CMZ) and in the halo of our galaxy. From the integrated intensity ratio of C18O to C17O, the isotope ratio 18O/17O ratio can be estimated, which is considered to be one of the most useful tracers of nuclear processing and metal enrichment. Here preliminary results are presented toward Sgr A, Sgr B2, Sgr C, Sgr D, and the 1.°3 complex in the CMZ and M+5.3–0.3 in the halo.
Dietary fibre has been linked to lower levels of glycosylated haemoglobin A1c (HbA1c) among diabetes patients. The present study aimed to evaluate the long-term effect of dietary fibre on HbA1c levels among Chinese patients with type 2 diabetes mellitus.
Two cross-sectional surveys were conducted in 2006 and 2011, with the second one being a repeat survey on a sub-sample from the initial one. In both surveys, an in-person interview was conducted to collect information on demographic characteristics and lifestyles following a similar protocol. Dietary intake was assessed with a validated FFQ. Anthropometric measures and biochemical assays were performed at the interview.
Communities in Pudong New Area of Shanghai, China.
Chinese patients (n 934) with type 2 diabetes mellitus.
An inverse association was observed between dietary fibre and glycaemic status indicated by HbA1c level in both surveys, although it was significant only in the first survey. Among 497 patients participating in both surveys, dietary fibre intake at the first survey was inversely associated with uncontrolled glycaemic status at the second survey, with adjusted odds ratios across the tertiles of intake being 1·00, 0·72 (95 % CI 0·43, 1·21) and 0·58 (95 % CI 0·34, 0·99; Ptrend = 0·048). The change in fibre intake was slightly associated with glycaemic status, with each increase in tertile scores of intake linked to a 0·138 % (β = −0·138; 95 % CI −0·002, 0·278) decrease in HbA1c value and a 19 % (OR = 0·81; 95 % CI 0·65, 1·02) reduced risk of uncontrolled glycaemic status at the second survey.
Dietary fibre may have a long-term beneficial effect on HbA1c level among Chinese diabetes patients.
Fast linear transformer driver (FLTD) has some advantages in repetitive operation compared with traditional pulsed power generators. However, different types of gas switches applied in the field of pulsed power technology in recent years cannot reach the requirements of repetitive operation of FLTD. Therefore, the capability of repetitive operation of a multigap gas switch has been investigated in a circuit similar to the basic discharge loop named as brick in this paper. The switch has been triggered more than 2000 times and the distribution of delay time and switch jitter are analyzed and reported. Also, the self-breakdown voltages of the switch during different segments of the triggered breakdown experiment have been tested. The experimental results indicate that the delay time obeys the Gauss distribution and the jitter of 2000 times of discharge is about 2.3 ns.
The purpose of the present study was to evaluate the impact of a lifestyle intervention programme, combined with a daily low-glycaemic index meal replacement, on body-weight and glycaemic control in subjects with impaired glucose regulation (IGR). Subjects with IGR were randomly assigned to an intervention group (n 46) and a control group (n 42). Both groups received health counselling at baseline. The intervention group also received a daily meal replacement and intensive lifestyle intervention to promote healthy eating habits during the first 3 months of the study, and follow-up visits performed monthly until the end of the 1-year study. Outcome measurements included changes in plasma glucose, glycated Hb (HbA1c), plasma lipids, body weight, blood pressure and body composition (such as body fat mass and visceral fat area). The results showed that body-weight loss after 1 year was significant in the intervention group compared with the control group ( − 1·8 (sem 0·35) v.− 0·6 (sem 0·40) 2·5 kg, P< 0·05). The 2 h plasma glucose concentration decreased 1·24 mmol/l in the intervention group and increased 0·85 mmol/l in the control group (P< 0·05) compared with their baseline, respectively. A 5 kg body-weight loss at 1 year was associated with a decrease of 1·49 mmol/l in 2 h plasma glucose (P< 0·01). The incidence of normal glucose regulation (NGR) in the two groups was significantly different (P= 0·001). In conclusion, the combination of regular contact, lifestyle advice and meal replacement is beneficial in promoting IGR to NGR.