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Abstract Background Reform of the health care system in China has prompted concerns about the utilization of mental health services. This study aims to compare the utilization of mental health services among inpatients in various types of health institutions in Shanghai (community health care centres, secondary general hospitals, tertiary general hospitals, and specialty hospitals). Methods Based on electronic health record (EHR) data, we extracted all of the mental hospitalization data from various types of public health institutions in Pudong New Area, Shanghai, China, from 2013 to 2016. The distribution of mentally ill inpatients and the possible factors contributing to the observed differences in these institutions were analysed. Results Specialty psychiatric hospitals in Pudong New Area, Shanghai, admitted more inpatients and treated in patients with more severe disorders (49.73%). However, those who were male (OR = 0.545), were elderly (OR = 20.133), had inferior insurance (urban social insurance for citizens: OR = 4.013; paying themselves, OR = 29.489), had a longer length of stay (OR = 1.001) and had lower costs (OR = 0.910) were more likely to choose community health centres than specialty hospitals. Those who preferred the secondary and tertiary hospitals to the specialty ones were more likely to be in the male, elderly, married, shorter length of stay and higher-cost groups. Notably, compared to those with urban social insurance for workers, those who had urban social insurance for citizens (OR = 3.136) or paid out-of-pocket (OR = 9.822) were significantly clustered in the tertiary hospitals rather than the specialty hospitals. Conclusions Inpatients who were male, were older, had inferior insurance, had a longer length of stay and had lower costs preferred the elementary health services. However, the utilization of mental health care in high-tier institutions reflected defects, especially the fact that the current health insurance system does not adequately restrict patients’ choices, and those who paid more tended to choose tertiary hospitals instead of professional specialty ones. We suggest that psychiatric services should be enhanced by instituting reforms, including public education, improved health insurance, a forceful referral system, and competency reinforcement for primary care physicians, to provide a more integrated mental health system.

Abstract Background There is increasing interest in examining the consequences of simultaneous exposures to chemical mixtures. However, a consensus or recommendations on how to appropriately select the statistical approach analyzing the health effects of mixture exposures which best aligns with study goals has not been well established. We recognize the limitations that existing methods have in effectively reducing data dimension and detecting interaction effects when analyzing chemical mixture exposures collected in high dimensional datasets with varying degrees of variable intercorrelations. In this research, we aim to examine the performance of a two-step statistical approach in addressing the analytical challenges of chemical mixture exposures using two simulated data sets, and an existing data set from the Navajo Birth Cohort Study as a representative case study. Methods We propose to use a two-step approach: a robust variable selection step using the random forest approach followed by adaptive lasso methods that incorporate both dimensionality reduction and quantification of the degree of association between the chemical exposures and the outcome of interest, including interaction terms. We compared the proposed method with other approaches including (1) single step adaptive lasso; and (2) two-step Classification and regression trees (CART) followed by adaptive lasso method. Results Utilizing simulated data sets and applying the method to a real-life dataset from the Navajo Birth Cohort Study, we have demonstrated good performance of the proposed two-step approach. Results from the simulation datasets indicated the effectiveness of variable dimension reduction and reliable identification of a parsimonious model compared to other methods: single-step adaptive lasso or two-step CART followed by adaptive lasso method. Conclusions Our proposed two-step approach provides a robust way of analyzing the effects of high-throughput chemical mixture exposures on health outcomes by combining the strengths of variable selection and adaptive shrinkage strategies.

Clinical trials that study immunogenicity of combination vaccines often have less power than desirable. To make up for the reduction in statistical power at the study level, researchers have to increase the study sample size. To study immunogenicity variables, we used the geometric mean concentration of immune response after vaccination as immunologic endpoint and compared 3 sample size calculation methods: the “Inflation factors” method, the “Incrementing” method, and the “Bonferroni correction” method when there are multiple continuous co-primary endpoints. The parameters were set according to the actual situation of the use of combination vaccines and the simulation results were used as reference. The present study demonstrates that all 3 methods are applicable when the effect size of each endpoint is similar and the endpoints are at most weakly correlated, but when there is a true difference in effect sizes among endpoints, the “Incrementing” method has the best performance.

Background: Investigation of haplotype/allele frequency data of Y-STR loci in ethnically diverse populations is essential for forensic reference database construction and genetic application. However, the population genetic characteristics of the Chinese Miao minority from Guizhou Province remain uncharacterised. Aim: To assess forensic characteristics for 23 Y-Chromosomal STR loci in Guizhou Miao and explore population genetic relationships with geographically neighbouring populations. Subjects and methods: Twenty-three Y-Chromosomal STRs were genotyped using the Powerplex® Y23 system in 103 unrelated Chinese Miao males from Guizhou Province, southwest China. Haplotypes and forensic parameters were obtained. Population relationships of Guizhou Miao with others were revealed using AMOVA and an MDS plot. Results: A total of 96 haplotypes were identified with overall haplotype diversity (HD) and discrimination capacity (DC) of 0.9985 and 0.9320, respectively. Genetic differentiation was observed with most of the comparison populations, prominently for Guizhou Shui. Conclusion: The 23 Y-STR loci were highly polymorphic and discriminating in the Guizhou Miao population and could be used for forensic practice and population genetic studies. Population relationship analysis revealed Guizhou Miao had a close genetic relationship with geographically close Guizhou Gelao, as well as Han majorities derived from different regions.

Carbonate gas reservoir in the eastern area on the Right Bank of the Amu Darya River, Turkmenistan, are of low-porosity and with developed fractures. In this area, fractures control reservoir properties and natural gas production, and karst fractures are the most important kind of fractures, so their identification and evaluation are quite necessary. In this paper, fracture types were identified and their occurrence was extracted by using conventional logging and image logging data after core calibration. Then, the distribution characteristics of karst fractures and their controlling effect on reservoirs were studied according to the identification results. And the following research results were obtained. First, karst fractures are mainly of high angle with the characteristic of mono system and the interactive relation of genesis. Second, they are mainly distributed in the upper XVhp layer of Callovian–Oxford Stage and the lower XVa2–XVI layer. Third, they are the main effective fractures in this area. The dissolved pores are connected effectively through the expanded karst fractures by dissolution, and consequently reservoirs of high porosity and permeability are formed and they are the important reservoir type and high-yield gas reservoir in this area. Fourth, karst fractures are related to high-yield wells and high-yield layers in this area, and they also control the distribution of high-yield reservoirs in the lower part of Callovian–Oxford Stage. It is concluded that by virtue of imaging logging and conventional logging data, karst fractures, unfilled fractures, semi-filled fractures and fully filled fractures can be identified and evaluated better. Furthermore, the identification and evaluation of karst fractures deepen the understanding on fractured reservoirs in this area, improve the reservoir evaluation effect, and provide the basis for the target horizon and azimuth optimization of horizontal wells and highly deviated wells. And it is also indicated that the reservoirs with developed karst fractures are the subsequent important drilling targets. Keywords: Turkmenistan, Eastern area on the Right Bank of Amu Darya, Carbonate gas reservoir, Karst fractures, Filling characteristic, Imaging logging, Log response, Natural gas production rate

The measurement error of the inertial measurement unit (IMU) significantly affects the navigation accuracy of the grid strap-down inertial navigation system (SINS) applied in polar regions. In this paper, the single-axis rotation modulation grid SINS is designed to suppress the navigation error caused by IMU constant error. Then on the basis of rotation modulation scheme, a novel external horizontal damping algorithm based on a Kalman filter is conducted to further suppress the 84.4 min Schuler oscillation caused by IMU random error. The Kalman filter is established based on the error model of shipborne grid SINS. When the reference velocity provided by Doppler velocity log is usable, the Schuler oscillation can be restrained through feedback calibration by calibrating the grid horizontal attitude errors and grid horizontal velocity errors. The simulation results demonstrate that the proposed external horizontal damping algorithm can efficiently suppress the Schuler oscillation, meanwhile compared with traditional external horizontal damping algorithm based on damping network, the proposed algorithm has the advantage of reducing the overshoot errors in the process of state switching.

A new robust strap-down inertial navigation system (SINS) and Doppler velocity log (DVL) integrated navigation algorithm are proposed in this paper with a focus on suppressing the process uncertainty and measurement outliers induced by severe manoeuvering. In the proposed algorithm, the one-step predicted probability density function is modeled as Student's t-distribution to deal with the heavy-tailed process noise, and hierarchical Gaussian state-space model for SINS/DVL integrated navigation algorithm is constructed. To detect and eliminate the measurement outliers, each measurement is marked by a binary indicator variable modeled as a beta-Bernoulli distribution. The variational Bayesian approach is used to jointly estimate state vector, auxiliary random variable, scale matrix, Bernoulli variable, and beta variable. The experimental results illustrate that the proposed algorithm has better robustness and navigation accuracy to deal with process uncertainty and measurement outliers than existing state-of-the-art algorithms.

Circular RNAs (circRNAs) are generated by head-to-tail splicing and are ubiquitously expressed in all multicellular organisms. Their important biological functions are increasingly recognized. Cerebral ischemia reperfusion injury-induced brain microvascular endothelial cell dysfunction is an initial stage of blood-brain barrier disruption. The expression profile and potential function of circRNAs in brain microvascular endothelial cells is unknown. Rat brain microvascular endothelial cells were extracted and cultured in glucose-free medium for 4 hours with 5% CO2 and 95% N2, and the medium was then replaced with complete growth medium for 6 hours. The RNA in these cells was then extracted. The circRNA was identified by Find_circ and CIRI2 software. Functional and pathway enrichment analysis of genes that were common to differentially expressed mRNAs and circRNA host genes was performed by the Database for Annotation, Visualization and Integrated Discovery Functional Annotation Tool. Miranda software was used to predict microRNAs that were potentially spong-ed by circRNAs. Furthermore, cytoscape depicted the circR-NA-microRNA interaction network. The results showed that there were 1288 circRNAs in normal and oxygen-glucose deprived/recovered primary brain microvascular endothelial cells. There are 211 upregulated and 326 downregulated differentially expressed circRNAs. The host genes of these differentially expressed circRNAs overlapped with those of differentially expressed mRNAs. The shared genes were further studied by functional enrichment analyses, which revealed that circRNAs may contribute to calcium ion function and the cyclic guanosine 3′,5′-monophosphate (CAMP) dependent protein kinase (PKα) signaling pathway. Next, quantitative reverse transcription polymerase chain reaction assays were performed to detect circRNA levels transcribed from the overlapping host genes. Eight out of the ten circRNAs with the highest fold-change identified by sequencing were successfully verified. Subsequently, the circRNA-microRNA interaction networks of these eight circRNAs were explored by bioinformatic analysis. These results demonstrate that altered circRNAs may be important in the pathogenesis of cerebral ischemia reperfusion injury and consequently may also be potential therapeutic targets for cerebral ischemia diseases. All animal experiments were approved by the Chongqing Medical University Committee on Animal Research, China (approval No. CQMU20180086) on March 22, 2018.

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is closely linked to obesity, type 2 diabetes and other metabolic disorders worldwide. Crocin is a carotenoid compound possessing various pharmacological activities. In the present study, we aimed to investigate the effect on fatty liver under diabetic and obese condition and to examine the possible role of AMP-activated protein kinase (AMPK) signaling. Methods db/db mice were administrated with crocin and injected with LV-shAMPK or its negative control lentivirus. Metabolic dysfunction, lipogenesis and fatty acid-oxidation in liver were evaluated. Results In db/db mice, we found that oral administration of crocin significantly upregulated the phosphorylation of AMPK and downregulated the phosphorylation of mTOR in liver. Crocin reduced liver weight, serum levels of alanine aminotransferase, alanine aminotransferase, and liver triglyceride content, and attenuated morphological injury of liver in db/db mice. Crocin inhibited the mRNA expression of lipogenesis-associated genes, including sterol regulatory element binding protein-1c, peroxisome proliferator-activated receptor γ, fatty acid synthase, stearoyl-CoA desaturase 1, and diacylglycerol acyltransferase 1, and increased the mRNA expression of genes involved in the regulation of β-oxidation of fatty acids, including PPARα, acyl-CoA oxidase 1, carnitine palmitoyltransferase 1, and 3-hydroxy-3-methylglutaryl-CoA synthase 2. Moreover, treatment of crocin resulted in a amelioration of general metabolic disorder, as evidenced by decreased fasting blood glucose, reduced serum levels of insulin, triglyceride, total cholesterol, and non-esterified fatty acid, and improved glucose intolerance. Crocin-induced protective effects against fatty liver and metabolic disorder were significantly blocked by lentivirus-mediated downregulation of AMPK. Conclusions The results suggest that crocin can inhibit lipogenesis and promote β-oxidation of fatty acids through activation of AMPK, leading to improvement of fatty liver and metabolic dysfunction. Therefore, crocin may be a potential promising option for the clinical treatment for NAFLD and associated metabolic diseases.

Cancer has emerged as one of the world’s most concerning health problems. The progression and metastasis mechanisms of cancer are complex, including metabolic disorders, oxidative stress, inflammation, apoptosis, and intestinal microflora disorders. These pose significant challenges to our efforts to prevent and treat cancer and its metastasis. Natural drugs have a long history of use in the prevention and treatment of cancer. Many effective anti-tumor drugs, such as Paclitaxel, Vincristine, and Camptothecin, have been widely prescribed for the prevention and treatment of cancer. In recent years, a trend in the field of antitumor drug development has been to screen the active antitumor ingredients from natural drugs and conduct in-depth studies on the mechanisms of their antitumor activity. In this review, high-frequency keywords included in the literature of several common Chinese and English databases were analyzed. The results showed that five Chinese herbal medicines (Radix Salviae, Panax Ginseng C. A. Mey, Hedysarum Multijugum Maxim, Ganoderma, and Curcumaelongae Rhizoma) and three natural compounds (quercetin, luteolin, and kaempferol) were most commonly used for the prevention and treatment of cancer and cancer metastasis. The main mechanisms of action of these active compounds in tumor-related research were summarized. Finally, we found that four natural compounds (dihydrotanshinone, sclareol, isoimperatorin, and girinimbin) have recently attracted the most attention in the field of anti-cancer research. Our findings provide some inspiration for future research on natural compounds against tumors and new insights into the role and mechanisms of natural compounds in the prevention and treatment of cancer and cancer metastasis.

The cell division of the alfalfa symbiont, Sinorhizobium meliloti, is dictated by a cell cycle regulatory pathway containing the key transcription factors CtrA, GcrA, and DnaA. In this study, we found that NtrX, one of the regulators of nitrogen metabolism, can directly regulate the expression of ctrA, gcrA, and dnaA from the cell cycle pathway. Three sets of S. meliloti ntrX mutants showed similar cell division defects, such as slow growth, abnormal morphology of some cells, and delayed DNA synthesis. Transcription of ctrA and gcrA was upregulated, whereas the transcription of dnaA and ftsZ1 was downregulated in the insertion mutant and the strain of Sm1021 expressing ntrXD53E. Correspondingly, the inducible transcription of ntrX activates the expression of dnaA and ftsZ1, but represses ctrA and gcrA in the depletion strain. The expression levels of CtrA and GcrA were confirmed by Western blotting. The transcription regulation of these genes requires phosphorylation of the conserved 53rd aspartate in the NtrX protein that binds directly to the promoter regions of ctrA, gcrA, dnaA, and ftsZ1 by recognizing the characteristic sequence CAAN2-5TTG. Our findings suggest that NtrX affects S. meliloti cell division by regulating the transcription of the key cell cycle regulatory genes.

The subfamily Eumeninae plays a significant role in the biological control of agricultural pests. However, the characteristics of eumenine mitogenomes that are important molecular markers for phylogenetics are not clearly revealed. Here, 52 eumenine mitogenomes are newly sequenced and annotated, and the phylogenetic relationships of the subfamily are comprehensively analyzed based on 87 vespid mitogenomes. Through the comparative analysis of the 54 eumenine mitogenomes, the gene compositions of about one half of the 54 species match with ancestral insect mitogenome, and remaining others contain two trnM which are highly similar, with 51.86% (Eumenes tripunctatus) to 90.65% (Pseumenes nigripectus) sequence identities, which is unique among the reported mitogenomes of the family Vespidae. Moreover, the translocation trnL1 upstream of nad1 is a common rearrangement event in all eumenine mitogenomes. The results of phylogenetic analyses support the paraphyly of the subfamily Eumeninae and the tribe Odynerini, respectively, and the monophyly of the tribe Eumenini, and verify that the tribe Zethini is a valid subfamily Zethinae. In this study, the relationships between some genera such as Allorhynchium and Pararrhynchium or the taxonomic status of the subgenera such as Eremodynerus and Dirhynchium are found to be confusing and there should be further inquiry with more samples.

The microphysical parameters of snowfall directly impact hydrological and atmospheric models. During the International Collaborative Experiment hosted at the Pyeongchang 2018 Olympic and Paralympic Winter Games (ICE-POP 2018), dual-frequency radar retrievals of particle size distribution (PSD) parameters were produced and assessed over complex terrain. The NASA Dual-frequency Dual-polarized Doppler Radar (D3R) and a collection of second-generation Particle Size and Velocity (PARSIVEL2) disdrometer observations were used to develop retrievals. The conventional look-up table method (LUT) and random forest method (RF) were applied to the disdrometer data to develop retrievals for the volume-weighted mean diameter (Dm), the shape factor (mu), the normalized intercept parameter (Nw), the ice water content (IWC), and the snowfall rate (S). Evaluations were performed between the D3R radar and disdrometer observations using these two methods. The mean errors of the retrievals based on the RF method were small compared with those of the LUT method. The results indicate that the RF method is a promising way of retrieving microphysical parameters, because this method does not require any assumptions about the PSD of snowfall.

Light-emitting diodes based on colloidal quantum dots (QLEDs) show a good prospect in commercial application due to their narrow spectral linewidths, wide color range, excellent luminance efficiency, and long operating lifetime. However, the toxicity of heavy-metal elements, such as Cd-based QLEDs or Pb-based perovskite QLEDs, with excellent performance, will inevitably pose a serious threat to people’s health and the environment. Among heavy-metal-free materials, InP quantum dots (QDs) have been paid special attention, because of their wide emission, which can, in principle, be tuned throughout the whole visible and near-infrared range by changing their size, and InP QDs are generally regarded as one of the most promising materials for heavy-metal-free QLEDs for the next generation displays and solid-state lighting. In this review, the great progress of QLEDs, based on the fundamental structure and photophysical properties of InP QDs, is illustrated systematically. In addition, the remarkable achievements of QLEDs, based on their modification of materials, such as ligands exchange of InP QDs, and the optimization of the charge transport layer, are summarized. Finally, an outlook is shown about the challenge faced by QLED, as well as possible pathway to enhancing the device performance. This review provides an overview of the recent developments of InP QLED applications and outlines the challenges for achieving the high-performance devices.

Calcium sulfate hemihydrate whiskers (CSHW), a multi-functional and high value-added building material, were prepared with flue gas desulfurization (FGD) gypsum by hydrothermal method, which could be a reasonable disposal of FGD gypsum. In order to obtain CSHW of a high aspect ratio, a series of manufacturing parameters such as reaction temperature, stirring speed, material–water ratio, and reaction time were investigated. The effect of stabilizing treatment and glycerol concentration on CSHW morphology were also studied by environmental scanning electron microscopy (ESEM) and statistical analysis. The results showed that the optimum preparing conditions of reaction temperature, stirring speed, water–material ratio, and reaction time were 160 °C, 200~300 rpm, 11:1 and 1 h, respectively. Furthermore, stabilizing treatment with octodecyl betaine was necessary for the preparation of CSHW. The final prepared whiskers had smooth surface, uniform morphology, a diameter of 260 nm, and a corresponding aspect ratio of 208.2. Moreover, the addition of glycerol reduced the activity of water, contributing to a lower reaction temperature and much smaller diameter.

Coxsackievirus A6 emerged as one of the predominant causative agents of hand, foot and mouth disease epidemics in many provinces of China in 2013 and 2015. This virus strain accounted for 25.9% of mild and 15.2% of severe cases in 2013 and 25.8% of mild and 16.9% of severe cases in 2015.

In an effort to understand the difference between melanomas diagnosed in Australia (New South Wales) and Canada, where the incidence in New South Wales is almost three times greater than in Canada, and mortality is twice as high although survival is slightly more favorable, we had one pathologist review 1,271 melanomas from British Columbia and Ontario, Canada, to compare these to melanomas in New South Wales, Australia. We hypothesized that histopathologic characteristics might provide insight into divergent pathways to melanoma development. We found a number of differences in risk factors and tumor characteristics between the two geographic areas. There were higher mole counts and darker phenotypes in the Canadian patients, while the Australian patients had greater solar elastosis, more lentigo maligna melanomas, and more tumor infiltrating lymphocytes. We hypothesize that the differences observed may illustrate different etiologies – the cumulative exposure pathway among Australian patients and the nevus pathway among Canadian patients. This is one of the largest studies investigating the divergent pathway hypothesis and is particularly robust due to the evaluation of all lesions by one dermatopathologist.

Background: As an emerging infectious disease, the prevention and control of hand, foot, and mouth disease (HFMD) poses a significant challenge to the development of public health in China. In this study, we aimed to explore the mechanism of the seasonal transmission characteristics of HFMD and to reveal the correlation and potential path between key meteorological factors and the transmissibility of HFMD.Methods: Combined with daily meteorological data such as average temperature, average relative humidity, average wind velocity, amount of precipitation, average air pressure, evaporation capacity, and sunshine duration, a database of HFMD incidence and meteorological factors was established. Spearman rank correlation was used to calculate the correlation between the various meteorological factors and the incidence of HFMD. The effective reproduction number (Reff) of HFMD was used as an intermediate variable to further quantify the dynamic relationship between the average temperature and Reff.Results: A total of 43,659 cases of HFMD were reported in Xiamen from 2014 to 2018. There was a significantly positive correlation between the average temperature and the incidence of HFMD (r = 0.596, p < 0.001), and a significantly negative correlation between the average air pressure and the incidence of HFMD (r = −0.511, p < 0.001). There was no correlation between the average wind velocity (r = 0.045, p > 0.05) or amount of precipitation (r = 0.043, p > 0.05) and incidence. There was a temperature threshold for HFMD's transmissibility. Owing to the seasonal transmission characteristics of HFMD in Xiamen, the temperature threshold of HFMD's transmissibility was 13.4–18.4°C and 14.5–29.3°C in spring and summer and in autumn and winter, respectively.Conclusions: HFMD's transmissibility may be affected by the average temperature; the temperature threshold range of transmissibility in autumn and winter is slightly wider than that in spring and summer. Based on our findings, we suggest that the relevant epidemic prevention departments should pay close attention to temperature changes in Xiamen to formulate timely prevention strategies before the arrival of the high-risk period.

Female tick salivary glands undergo rapid degeneration several days post engorgement. This degeneration may be caused by the increased concentration of ecdysone in the hemolymph during the fast feeding period and both autophagy and apoptosis occur. In this work, we first proved autophagy-related gene (ATG) and caspase gene expression peaks during degeneration of the tick salivary glands. We explored the regulatory role of Rhipicephalus haemaphysaloides autophagy-related 5 (RhATG5) in the degeneration of tick salivary glands. During the fast feeding phase, RhATG5 was cleaved and both calcium concentration and the transcription of Rhcalpains increased in the salivary glands. Recombinant RhATG5 was cleaved by μ-calpain only in the presence of calcium; the mutant RhATG5191-199Δ was not cleaved. Treatment with 20-hydroxyecdysone (20E) led to programmed cell death in the salivary glands of unfed ticks in vitro, RhATG8-phosphatidylethanolamine (PE) was upregulated in ticks treated with low concentration of 20E. Conversely, RhATG8-PE decreased and Rhcaspase-7 increased in ticks treated with a high concentration of 20E and transformed autophagy to apoptosis. High concentrations of 20E led to the cleavage of RhATG5. Calcium concentration and expression of Rhcalpains were also upregulated in the tick salivary glands. RNA interference (RNAi) of RhATG5 in vitro inhibited both autophagy and apoptosis of the tick salivary glands. RNAi of RhATG5 in vivo significantly inhibited the normal feeding process. These results demonstrated that high concentrations of 20E led to the cleavage of RhATG5 by increasing the concentration of calcium and stimulated the transition from autophagy to apoptosis.

Background. The prognostic significance of the amino-terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP) in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) has not been fully elucidated. Major adverse cardiovascular events (MACEs) are clinically viable indicators for the accurate, rapid, and safe evaluation of patients with STEMI. This study was designed to investigate the relationship between NT-proBNP levels and the occurrence of short-term MACEs in patients with STEMI who underwent emergency PCI. Methods. This prospective cohort study included 405 patients with STEMI aged 20–90 years who underwent emergency PCI at the First People’s Hospital of Changde City from April 6, 2017, to May 31, 2019. Stent thrombosis, reinfarction, congestive heart failure, unstable angina, and cardiac death were considered as MACEs in this study. The target-independent and -dependent variables were NT-proBNP at baseline and MACE, respectively. Results. There were 28.25% of MACEs. Age, number of implanted stents, Killip class, infarction-related artery, applied intra-aortic balloon pump (IABP), creatine kinase (CK) peak value, CK-MB peak value, TnI peak value, and ST-segment resolution were independently associated with MACE (P11.66 (NT-proBNP >3.236 pg/mL).

We examined the feasibility of estimating the spatial distribution of urban populations based on first-aid calls based on one high-density place, the Shanghai urban area and one low-density place, the Nanhai District of Foshan City in Guangdong Province. We aggregated the population and the total number of first-aid calls on digital maps divided by grids based on a Geographic Information System (GIS). Geographically weighted regression was applied to test the correlation between the population distribution simulated by first-aid call data and the actual residency. The impact of different population densities, different grid cell sizes and different types of first-aid calls on simulation correlation were tested. We found that the use of first-aid call data could explain 60-95% of the actual population distribution in Shanghai using a grid with 1000*1000 m cell size, while the Nanhai experience was that first-aid calls could only explain 4-76% of the actual population distribution using a grid with 2000*2000 m cell size. Thus, the higher the population density, the better the simulation effect. For a high-population density area, the overall accuracy of simulation can reach as high as 0.878 at the 1-km2 resolution. However, there are different kinds of first-aid calls and for the best estimation of the population distribution in densely populated areas, we suggest using first-aid calls from people requiring acute medical care rather than all first-aid call data.

The present study aimed to investigate the growth, disease resistance and immune function of tilapia (Oreochromis niloticus) fed diets containing Enterococcus faecalis at levels of 0 (CG), 1 × 105 (EF1), 1 × 106 (EF2), 1 × 107 (EF3) or 1 × 108 CFU/g diet (EF4) for 56 days. The results showed that the EF3 group exhibited significantly increases in the final weight, weight gain and specific growth rate and a significantly decreased feed conversion ratio compared with those obtained from the CG group. The cumulative mortality was significantly decreased in the EF2, EF3 and EF4 groups. Serum alkaline phosphatase activity and tumour necrosis factor α gene expression in the hindgut were significantly increased in the EF1, EF2 and EF3 groups, and the serum complement 3 (C3) and C4 contents were significantly increased in the EF2, EF3 and EF4 groups. The gene expression of interleukin receptor-associated kinase-4, Toll-like receptor 2 and myeloid differentiation factor 88, claudin1 and interleukin 8 were significantly upregulated in all EF groups, and the activity of diamine oxidase was significantly reduced in the EF3 and EF4 groups. The gene expression of occludin was significantly upregulated in the EF1 and EF3 groups, and that of interleukin 10 was significantly upregulated in the EF3 group. No differences in serum lysozyme, d- lactic acid or endotoxin were found among the groups. These results showed that the optimal level of dietary E. faecalis enhanced the growth performance and disease resistance, and those effects might be related to increased humoural and intestinal immunity in tilapia. The optimal supplementation level of dietary E. faecalis for tilapia was found to be 1 × 107 CFU/g.

Abstract Background X‐chromosome short tandem repeats (X‐STRs) with unique sex‐linkage inheritance models play a complementary role in forensic science. Guizhou is a multiethnic province located in southwest China and some genetic evidence focusing on X‐STRs for various minorities was reported. However, population data of Guizhou Tujia are scarce. Methods A total of 507 Guizhou Tujia individuals were profiled using the AGCU X‐19 STR kit. Allele frequencies and forensic parameters were calculated. Additionally, population genetic relationships between Guizhou Tujia and other 19 populations were explored. Results A total of 257 alleles with the allele frequencies ranged from 0.0013 to 0.6098 were found. The combined power of discrimination in males and females and mean exclusion chances in all case scenarios were all greater than 0.99999. Population comparisons showed Guizhou Tujia had a homogeneity with all Han populations from different administrative regions, and other ethnic populations residing in Guizhou, while had obviously genetic heterogeneity with the Altaic family populations except Xibe. Conclusion Nineteen X‐STRs can afford a reliable and informative database of Guizhou Tujia population for human identification and paternity testing, especially in complex biological relations. The genetic relationships of Chinese are significantly influenced by the geographic position and ethnolinguistic origin.

Tsutsugamushi disease (TD) is an acute infectious disease caused by Orientia tsutsugamushi. This study aimed to analyze the epidemiological features of TD, investigate chigger mites and their hosts, and investigate the meteorological factors affecting TD incidence and the host of O. tsutsugamushi in Xiamen city, China. Data on reported TD cases were collected from 2006 to 2018. Spearman's correlation test were used for identifying the relationship between meteorological factors and TD incidence and whether meteorological factors affect the host of O. tsutsugamushi. The incidence of reported TD increased gradually from 2006, reached a peak of 4.59 per 100,000 persons in 2014, and then decreased gradually. The TD incidence was seasonal, with epidemic periods occurred mainly in summer and autumn. Patients aged 40-60 years had the highest proportion of cases, accounting for 44.44% of the total cases. Farmers had the largest number of cases among all occupational groups. Rattus Norvegicus was the most common host, accounting for the largest proportion of rats (73.00%), and the highest rat density was observed in March and October every year. There were significant positive correlations between the number of reported cases and average temperature, sunshine duration, and rainfall as well as between rat density and average temperature. On phylogenetic analysis, 7 sequences of hosts and human TD cases obtained from health records demonstrated the highest similarities to the Kato, Karp, and Gilliam strains. No correlations were observed between rat density, and sunshine duration and rainfall. The transmission of TD in Xiamen city, China, was seasonal, and its incidence was affected by several meteorological factors including average temperature, sunshine duration, and rainfall. However, the host of O. tsutsugamushi was only affected by average temperature.

Objectives: The status of children with comorbid congenital anomalies (CAs) and their effects on related hospital resource utilization have been minimally investigated. We aimed to describe the congenital anomalies comorbidity status and their effects on hospital resource utilization (length of stay, cost) by pediatric patients.Setting: This study was conducted in five tertiary care children's hospitals in Shanghai, China.Participants: Data were obtained from the inpatients' electronic health records; diagnoses were recorded using International Classification of Disease, Ninth Revision codes. In total, 7,890 children were diagnosed with congenital anomalies (13.13%), which were either primary or secondary.Primary and secondary outcome measures: The dependent variables were length of stay and cost. The independent variables were demographic and clinical characteristics and CA status.Results: In total, 50.98% of the hospitalized patients had comorbid CA conditions. Medical+CA patients were associated with a longer LOS (β = 2.656, P < 0.001), and CA+medical patients were associated with higher costs (β = 7.222, P < 0.001). Cardiovascular, musculoskeletal, and genitourinary diseases were the top three comorbid diseases. The average LOS for the top three comorbid diseases was longest in the medical+CA group, followed by CA+medical group. Cardiovascular disease was the most frequent comorbidity (ranking 1 in the medical+CA group and 2 in the CA+medical group), and the cost of cardiovascular disease was highest in all groups.Conclusions: A high prevalence of comorbid CA conditions was observed among pediatric inpatients in the sampled tertiary hospitals in China. Strategic planning should be improved to guide resource utilization for complex comorbid CA care.

At present, there are many opinions and much confusion in the discussion of the concepts of information, knowledge, data, digit, practice and intelligence, and even the regulations and appellations and their interrelations in the information society and intelligent society, which directly proves that it is necessary to find a reasonable explanation dimension to explain such concepts, appellations and their relations clearly and uniformly. This will certainly help to promote the progress of research in this field.

Abrin is a types II ribosome-inactivating protein (RIP) isolated from Abrus precatorious seeds, which comprises a catalytically active A chain and a lectin-like B chain linked by a disulfide bond. Four isotoxins of abrin have been reported with similar amino-acid composition but different cytotoxicity, of which abrin-a is the most potent toxin. High lethality and easy availability make abrin a potential bioterrorism agent. However, there are no antidotes available for managing abrin poisoning, and treatment is only symptomatic. Currently, neutralizing antibodies remain the most effective therapy against biotoxin poisoning. In this study, we prepared, identified, and acquired a high-affinity neutralizing monoclonal antibody (mAb) 10D8 with a potent pre- and post-exposure protective effect against cytotoxicity and animal toxicity induced by abrin-a or abrin crude extract. The mAb 10D8 could rescue the mouse injected intraperitoneally with a 25 × LD50 dose of abrin-a from lethality and prevent tissue damages. Results indicated that 10D8 does not prevent the binding and internalization of abrin-a to cells but inhibits the enzymatic activity of abrin-a and reduces protein synthesis inhibition of cells. The high affinity, good specificity, and potent antitoxic efficiency of 10D8 make it a promising candidate for therapeutic antibodies against abrin.

The present work aims to investigate the buckling performance of sandwich structure of functionally graded carbon nanotube-reinforced composite (FG-CNTRC). Through first-order shear deformation theory, an analytical model for the sandwich structure of FG-CNTRC was established. The governing equation for the prediction of the buckling performance of the sandwich structure of FG-CNTRC was obtained through energy method. There was analytical solution that can satisfy both boundary conditions. The theoretical model and method were verified by literature analysis, and the influence of each parameter on the buckling performance was evaluated and performed on the basis of the corroborated model. The findings can lay a solid foundation of the design and application of the sandwich structure of FG-CNTRC.

Respiratory burst oxidase homologs (Rbohs) are critical enzymes involved in the generation of reactive oxygen species (ROS) that play an important role in plant growth and development as well as various biotic and abiotic stresses in plants. Thus far, there have been few reports on the characterization of the Rboh gene family in Citrus. In this study, seven Rboh genes (CsRbohA~CsRbohG) were identified in the Citrus sinensis genome. The CsRboh proteins were predicted to localize to the cell membrane. Most CsRbohs contained four conserved domains, an EF-hand domain, and a transmembrane region. Phylogenetic analysis demonstrated that the CsRbohs were divided into five groups, suggesting potential distinct functions and evolution. The expression profiles revealed that these seven CsRboh genes displayed tissue-specific expression patterns, and five CsRboh genes were responsive to cold stress. Fourteen putative cis-acting elements related to stress response, hormone response, and development regulation were present within the promoters of CsRboh genes. The in-silico microRNA target transcript analyses indicated that CsRbohE might be targeted by csi-miR164. Further functional and physiological analyses showed that the knockdown of CsRbohD in trifoliate orange impaired resistance to cold stress. As a whole, our results provide valuable information for further functional studies of the CsRboh genes in response to cold stress.

Objectives Since 2010, the Chinese government has gradually increased its investment in the training of general practitioners (GPs) to support their role as ‘gatekeepers’ in the healthcare system. However, this training is still organised from the perspective of specialist care. We aimed to assess the appropriateness of the principal GP admission training programme curricula in China, including Residents Training for GPs (RTGP), Residents Training for Assistant GPs (RTAGP) and Training for Specialists with General Practice interest (TSGP).Setting The study focussed on GP training programmes in Shanghai, China.Participants Data on disease competences developed in three GP clinical training programmes (RTGP, RTAGP and TSGP) were derived from official programme training manuals. Data on the proportion of outpatient visits for each disease were taken from the Shanghai community healthcare centres grassroots outpatient database.Primary and secondary outcome measures We first conducted a quantitative analysis by comparing the structure of current training curricula with actual outpatient utilisation patterns across all community healthcare institutions in Shanghai from 2014 to 2018. Qualitative analysis was then conducted to evaluate GP training programmes based on Donabedian’s model.Results Quantitative analysis showed that the distribution of diseases for which competences were taught did not match the composition of outpatient visits in community healthcare institutions. Concerns identified through qualitative analysis included teachers who were mostly specialists, lack of equipment for differential diagnosis in community healthcare institutions, insufficient teaching of referral standards and GP training in large hospitals that consistently neglected communication skills.Conclusions The establishment and implementation of admission training programmes for GPs in China lacks a focus on general practice training and may be improved by adopting an evidence-based general perspective aligned with the medical needs of the community.

Phosphatidylinositol-3,4,5-trisphosphate [PI(3,4,5)P3] is a phosphorylated derivative of phosphatidylinositol 4-phosphate [PI(4)P] and phosphatidylinositol 4,5-bisphosphate [PI(4,5)P2], which recruit and activate AKT in the plasma membrane (PM) to promote cellular survival. ORP5 anchors at the endoplasmic reticulum (ER)-PM contact sites and acts as a PI(4)P and PI(4,5)P2/phosphatidylserine (PS) exchanger. Here, a lipidomics analysis of the sensorimotor cortex revealed that transient middle cerebral artery occlusion (tMCAO) disturbs the homeostasis of phosphatidylinositols (PIs) and PS between the PM and ER. Conditional knockout mice showed that ORP5 contributes to this abnormal distribution. Abolishing the ORP5 gene significantly inhibited apoptosis and autophagy. RNA sequencing and RNA pull down analyses confirmed a competing endogenous RNA pathway in which circ_0001449 sponges miR-124-3p and miR-32-5p to promote Osbpl5 translation. Our data showed that circRNA_0001449 regulates membrane homeostasis via ORP5 and is involved in the AKT survival pathway.

Cancer pain is one of the most common and serious symptoms of cancer patients. At present, the agents used for the prevention or treatment of cancer pain do not act with optimal safety and efficacy. The nuclear factor kappa B (NF-κB) signaling pathway and its downstream inflammatory factors interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) play an important regulatory role in the developmental process of cancer pain. IKKβ is a key molecule of the IκB (IKK) kinase that propagates cellular responses to inflammation. Previous studies have shown that phosphorylation and degradation of the IκBα protein promotes the activation of NF-κB and the expression of TNF-α, IL-1β, and IL-6, participating in the formation and development of cancer pain. Chanling Gao (CLG) is a compound preparation of traditional Chinese medicine. It contains specific functions, namely nourishing Yin, activating blood circulation and relieving pain and dysfunction syndrome. It is used in the treatment of a variety of pain disorders including cancer-induced bone pain (CIBP), which has a certain relief effect. However, its mechanism of action still remains unclear. In the present study, a rat model of tibia CIBP was successfully established using the Walker 256 breast cancer cell line. The IKKβ/NF-κB signaling pathway and its related factors TNF-α, IL-1β, and IL-6 were used as the entry points to explore the effect of CLG on CIBP and their possible mechanisms of action. The results indicated that CLG improved the body mass of the CIBP rat model and increased the pain threshold in rats. CLG significantly inhibited the degradation of IκBα and the levels of p-IκBα, p-IKKβ, and p-p65 NF-κB proteins in the spinal cord of CIBP rats, inhibiting the contents of TNF-α, IL-1β, and IL-6. Therefore, we conclude that the analgesic effect of CLG in this rat model of CIBP may be related to the inhibition of the IKKβ/NF-κB signaling pathway and the reduction of synthesis and release of TNF-α, IL-1β, and IL-6.

The giant panda (Ailuropoda melanoleuca) is a vulnerable species and a charismatic member of zoological collections worldwide. Despite its importance as a representative species for global wildlife conservation efforts, no studies to date have described normal cell morphology or cytoplasmic constituents by traditional techniques such as cytochemical staining and evaluation of ultrastructural features. The objective of this study was to accurately identify and characterize the leukocytes and platelets of clinically healthy giant pandas using routine Wright-Giemsa stain, eight cytochemical stains, immunocytochemistry (CD3), and transmission electron microscopy (TEM) to further the collective understanding of normal cellular morphological features, cytochemical reactivity, and cytoplasmic contents found in health. Voluntary venipuncture was performed on four healthy individual animals (two adults and two juveniles), as part of routine preventive health evaluation. Blood was collected for routine and cytochemical stains, and into 2.5% glutaraldehyde for TEM. On Wright-Giemsa-stained blood films, leukocytes were differentiated into granulocytes (neutrophils, eosinophils, basophils) and mononuclear cells (lymphocytes, monocytes). Cytochemical staining revealed similar leukocyte and platelet staining patterns to those reported in other mammals, with some notable differences. By TEM, leukocytes with nuclear and cytoplasmic features of mononuclear cells were readily differentiated from granulocytes, and platelets had similar ultrastructural features to those reported in other mammals. Neutrophils were the predominant cell type followed by lymphocytes, while basophils were rare. Rare large or reactive lymphocytes, rare reactive monocytes, and rare large platelets were noted in apparently healthy giant pandas of this study. A unique mononuclear cell, with a moderately indented nucleus and shared cytochemical and ultrastructural characteristics of lymphocytes and monocytes, was discovered in this species. The combined cytochemical, immunocytochemical (CD3), and ultrastructural features of these unique cells more closely resemble those of monocytes, but the definitive cell lineage remains unknown at this time. This study provides novel information on giant panda leukocyte morphology and cellular constituents in health, shows the importance of manual blood film review, has important implications for hemogram interpretation in future clinical cases and research, and provides a baseline for future characterization and understanding of hemogram changes in response to disease.

The effect of storage time and packing method on dried Lycium fruits was studied through an electronic olfactory system with the metal oxide sensor array that provides an overall perception of the volatile compounds presented in the sample headspace. Principle component analysis (PCA), canonical discriminant analysis (CDA), and cluster analysis (CA) were used for freshness and packing methods discrimination of dried Lycium fruits. The stale samples of 2015 and 2016 could be separated with those of 2017 by PCA, CDA, and CA analysis. Better discrimination results were obtained by CDA, with samples of 2015 and 2016 separated with each other. For samples of 2017, the unpackaged samples of 2017-4 were distinguished with the vacuumed samples, while samples of grade C were separated with B and D. For quantitative analysis, predictive models for prediction of the storage years of dried Lycium fruits were built with methods of partial least square (PLS) analysis, multiple linear regression (MLR), and back propagation neural network (BPNN). The model built by BPNN showed the best predict ability with R2 = 0.9994, while PLS and MLR were also effective in the prediction of storage years of dried Lycium fruits, with high determination coefficients of 0.9316 and 0.9330. These findings showed that E-nose can be used in the discrimination of the storage time and package method of dried Lycium fruits.

Changes in gene expression can correlate with poor disease outcomes in two ways: through changes in relative transcript levels or through alternative RNA splicing leading to changes in relative abundance of individual transcript isoforms. The objective of this research is to develop new statistical methods in detecting and analyzing both differentially expressed and spliced isoforms, which appropriately account for the dependence between isoforms and multiple testing corrections for the multi-dimensional structure of at both the gene- and isoform- level. We developed a linear mixed effects model-based approach for analyzing the complex alternative RNA splicing regulation patterns detected by whole-transcriptome RNA-sequencing technologies. This approach thoroughly characterizes and differentiates three types of genes related to alternative RNA splicing events with distinct differential expression/splicing patterns. We applied the concept of appropriately controlling for the gene-level overall false discovery rate (OFDR) in this multi-dimensional alternative RNA splicing analysis utilizing a two-step hierarchical hypothesis testing framework. In the initial screening test we identify genes that have differentially expressed or spliced isoforms; in the subsequent confirmatory testing stage we examine only the isoforms for genes that have passed the screening tests. Comparisons with other methods through application to a whole transcriptome RNA-Seq study of adenoid cystic carcinoma and extensive simulation studies have demonstrated the advantages and improved performances of our method. Our proposed method appropriately controls the gene-level OFDR, maintains statistical power, and is flexible to incorporate advanced experimental designs.

Objective: Melatonin has a protective role in adults with cardiovascular disease, but the effects of melatonin in children with cardiac dysfunction are not well understood. This study was designed to explore the variations in melatonin, myeloperoxidase, and caspase‐3 levels in children suffering from heart failure. Methods: Seventy‐two pediatric patients with heart failure and twelve healthy children were enrolled in this study. A modified Ross scoring system was used to evaluate clinical cardiac function. Patients with a score of >2 points were included in the study and were divided into three groups according to severity of heart failure: mild (score: 3–6), moderate (score: 7–9), and severe (score: 10–12). Echocardiographic parameters, laboratory data, and serum levels of melatonin, myeloperoxidase, and caspase‐3 were measured and analyzed in all patients. Results: Compared with patients with mild and moderate heart failure, patients in the severe heart failure group had significantly decreased left ventricular ejection fraction (p 2 pontos foram incluídas no estudo e foram divididos em três grupos de acordo com a gravidade da insuficiência cardíaca: leve (escore: 3‐6), moderada (escore: 7‐9) e grave (escore: 10‐12). Os parâmetros ecocardiográficos, dados laboratoriais e níveis séricos de melatonina, mieloperoxidase e caspase 3 foram medidos e analisados em todos os pacientes. Resultados: Em comparação com os pacientes com insuficiência cardíaca de gravidade leve e moderada, os pacientes no grupo de insuficiência cardíaca grave apresentaram redução significativa da fração de ejeção do ventrículo esquerdo (p

Modern East Asians derived from the admixture of aborigines and incoming farmers expanding from Yellow and Yangtze River Basins. Distinct genetic differentiation and subsequent admixture between Northeast Asians and Southeast Asians subsequently evidenced by the mitochondrial DNA, Y-chromosomal variations, and autosomal SNPs. Recently, population geneticists have paid more attention to the genetic polymorphisms and background of southern-Han Chinese and southern native populations. The genetic legacy of northern-Han remains uncharacterized. Thus, we performed this comprehensive population genetic analyses of modern and ancient genetic variations aiming to yield new insight into the formation of modern Han, and the genetic ancestry and phylogenetic relationship of the northern-Han Chinese population. We first genotyped 25 forensic associated markers in 3,089 northern-Han Chinese individuals using the new-generation of the Huaxia Platinum System. And then we performed the first meta-analysis focused on the genetic affinity between Asian Neolithic∼Iron Age ancients and modern northern-Han Chinese by combining mitochondrial variations in 417 ancient individuals from 13 different archeological sites and 812 modern individuals, as well as Y-chromosomal variations in 114 ancient individuals from 12 Neolithic∼Iron Age sites and 2,810 modern subjects. We finally genotyped 643,897 genome-wide nucleotide polymorphisms (SNPs) in 20 Shanxi Han individuals and combined with 1,927 modern humans and 40 Eurasian ancient genomes to explore the genetic structure and admixture of northern-Han Chinese. We addressed genetic legacy, population structure and phylogenetic relationship of northern-Han Chinese via various analyses. Our population genetic results from five different reference datasets indicated that Shanxi Han shares a closer phylogenetic relationship with northern-neighbors and southern ethnically close groups than with Uyghur and Tibetan. Genome-wide variations revealed that modern northern-Han derived their ancestry from Yakut-related population (25.2%) and She-related population (74.8%). Summarily, the genetic mixing that led to the emergence of a Han Chinese ethnicity occurred at a very early period, probably in Neolithic times, and this mixing involved an ancient Tibeto-Burman population and a local pre-Sinitic population, which may have been linguistically Altaic.

Abstract Background Many hospitals in China experience large volumes of emergency department (ED) radiology patients, thereby lengthening the wait times for non-emergency radiology patients. We examine whether an emergency reservation policy which deals with stochastic arrivals of ED patients can shorten wait times, and what effect it has on patient and hospital related metrics. Methods In this study, operations research models are used to develop an emergency reservation policy. First, we construct a discrete event simulation (DES) model based on the process of patients served by one computed tomography (CT) scanner at West China Hospital (WCH). Next, a newsvendor model is built to compute the daily reservation quantity for emergency patients. Based on the appointment scheduling rule and daily emergency reservation policies, the effects of the proposed policy on daily examination quantity, patient wait times, and equipment utilization are explicitly modeled. Finally, we evaluate the impact of different reservation policies on these system performance measures. Results Our analysis indicates that reserving capacity for emergency patients greatly shortens the delay for non-emergency patients with an average 43.9% reduction in total wait times. The pre-model utilization and average post-model utilization are 99.3% and 98.5%, respectively. In addition, the comparison of different reservation policies shows that there is no significant difference between any two policies in terms of patients’ wait times. Conclusions Reserving proper capacity for emergency patients not only positively affects the patients’ delay times, but also affects various aspects of the hospital. Our goal is to design a simple and implementable emergency reservation policy. DES proves to be an effective tool for studying the effects of proposed scenarios to optimize capacity allocation in radiology management.

Abstract Background Public health emergencies have challenged the public health emergency management systems (PHEMSs) of many countries critically and frequently since this century. As the world’s most populated country and the second biggest economy in the world, China used to have a fragile PHEMS; however, the government took forceful actions to build PHEMS after the 2003 SARS outbreak. After more than one decade’s efforts, we tried to assess the improvements and problems of China’s PHEMS between 2002 and 2012. Methods We conducted two rounds of national surveys and collected the data of the year 2002 and 2012, including all 32 provincial, 139 municipal, and 489 county CDCs. The municipal and county CDCs were selected by systematic random sampling. Twenty-one indicators of four stages (preparation, readiness, response and recovery) from the National Assessment Criteria for CDC Performance were chosen to assess the ten-year trends. Results At the preparation stage, organization, mechanisms, workforce, and stockpile across all levels and regions were significantly improved after one decade’s efforts. At the readiness stage, the capability for formulating an emergency plan was also significantly improved during the same period. At the response stage, internet-based direct reporting was 98.8%, and coping scores were nearly full points of ten in 2012. At the recovery stage, the capabilities were generally lower than expected. Conclusions Due to forceful leadership, sounder regulations, and intensive resources, China’s PHEMS has been improved at the preparation, readiness, and response stages; however, the recovery stage was still weak and could not meet the requirements of crisis management and preventive governance. In addition, CDCs in the Western region and counties lagged behind in performance on most indicators. Future priorities should include developing the recovery stage, establishing a closed feedback loop, and strengthening the capabilities of CDCs in Western region and counties.

With the popularization and application of fast drilling technology in Sichuan–Chongqing gas provinces, the returned cuttings are fine and even powdered, so the traditional cutting lithology identification methods are not applicable any longer. In this paper, qualitative lithology identification and quantitative interpretation based on element logging were conducted on the key oil and gas bearing layers in this area according to the principle of elemental geochemistry. The study results show that: (1) different lithologies can be identified easily because of their different element logging characteristics. For example, basalts have the element characteristics of 0.35 0.55. (2) Clastic rocks, carbonate rocks, sulphate and transition rocks in the category of sedimentary rocks can be identified based on the element combination of (Al + Si + Fe) and (Ca + Mg + S). Among them, clastic rocks have (Al + Si + Fe) >31%, carbonate rocks have (Al + Si + Fe) 36%. (3) Then, based on the element combination of (Si + K + Ca)+Si/Al and (Al + Si + Fe + K)+(Ca + S)/Mg, sandstone, mudstone (shale), gypsum, dolomite, limestone and transition rocks can be identified. Finally, a qualitative identification chart and a set of quantitative interpretation software of element logging on key horizons in Sichuan–Chongqing gas provinces were developed to make this method convenient for field application. This method was applied on site in ten wells (such as Well MX207) in Sichuan–Chongqing gas provinces. It is indicated that the coincidence rate of lithology identification is in the range of 88.75–95.22% (averaging 92.42%). Obviously, it can satisfy the requirements of fast lithology identification while drilling of key oil and gas horizons in Sichuan–Chongqing gas provinces. Keywords: Sichuan–Chongqing gas provinces, Key horizon, Element logging, Lithologic identification while drilling, Quantitative lithologic interpretation, Qualitative identification chart, Interpretation software

Using China’s national surveillance data on hand, foot and mouth disease (HFMD) for 2008–2015, we described the epidemiologic and virologic features of recurrent HFMD. A total of 398,010 patients had HFMD recurrence; 1,767 patients had 1,814 cases of recurrent laboratory-confirmed HFMD: 99 reinfections of enterovirus A71 (EV-A71) with EV-A71, 45 of coxsackievirus A16 (CV-A16) with CV-A16, 364 of other enteroviruses with other enteroviruses, 383 of EV-A71 with CV-A16 and CV-A16 with EV-A71, and 923 of EV-A71 or CV-A16 with other enteroviruses and other enteroviruses with EV-A71 or CV-A16. The probability of HFMD recurrence was 1.9% at 12 months, 3.3% at 24 months, 3.9% at 36 months, and 4.0% at 38.8 months after the primary episode. HFMD severity was not associated with recurrent episodes or time interval between episodes. Elucidation of the mechanism underlying HFMD recurrence with the same enterovirus serotype and confirmation that HFMD recurrence is not associated with disease severity is needed.

A super-resolution enhancement algorithm was proposed based on the combination of fractional calculus and Projection onto Convex Sets (POCS) for unmanned aerial vehicles (UAVs) images. The representative problems of UAV images including motion blur, fisheye effect distortion, overexposed, and so on can be improved by the proposed algorithm. The fractional calculus operator is used to enhance the high-resolution and low-resolution reference frames for POCS. The affine transformation parameters between low-resolution images and reference frame are calculated by Scale Invariant Feature Transform (SIFT) for matching. The point spread function of POCS is simulated by a fractional integral filter instead of Gaussian filter for more clarity of texture and detail. The objective indices and subjective effect are compared between the proposed and other methods. The experimental results indicate that the proposed method outperforms other algorithms in most cases, especially in the structure and detail clarity of the reconstructed images.

Objective: To estimate the incidence and related risk factors of sepsis between road traffic injuries (RTIs) and non-RTIs. Methods: Clinical data of 339 patients with severe trauma who were admitted into ICU in both Third Affiliated Hospital of Army Military Medical University and ChongGang General Hospital from January 2012 to December 2015 were retrospectively analyzed. Twenty items of potential risk factors affecting sepsis were evaluated by univariate and multivariate Logistic Analysis with the purpose of drawing a comparison between RTI patients and non-RTI patients. Results: There were 154 cases of RTI and 185 cases of non-RTI entering the study period. The significant independent risk factor of sepsis in RTIs was SOFA 11 (OR=4.821; 95% CI=1.901-12.226; P=0.001). The significant independent risk factors of sepsis in non-RTIs were SOFA 11 (OR=12.410; 95% CI=2.559-60.185; P=0.002), tracheal intubation (OR=8.913; 95% CI=2.322-34.206; P=0.001), APACHE II 15 (OR=3.684; 95% CI=1.750-7.753; P=0.001). Conclusions: The clinical medical personnel should not give equal treatment to RTI patients and non-RTI patients admitted in ICU in that factors predicting sepsis within above two groups are different. The sample volume should be increased and validated in further prospective research.

The echo of weather radar is seriously disturbed by clear-air turbulence echo (CAT) which needs identifying and eliminating to improve the data quality of weather radar. Using the data observed with the five X-band dual polarimetric radars in Changping, Fangshan, Miyun, Shunyi, and Tongzhou, Beijing in 2018, the probability density distribution (PDD) of the horizontal texture of four radar moments reflectively factor (ZH), differential reflectivity (ZDR), correlation coefficient (ρHV), differential propagation phase shift (ΦDP), and then the CAT is identified and removed using Bayesian method. The results show that the radar data can be effectively improved after the CAT has been eliminated, which include: (1) the removal rate of CAT is more than 98.2% in the analyzed cases. (2) In the area with high-frequency distribution of CAT, the CAT can be effectively suppressed; in the area with low-frequency distribution, some weather echo in the edge with SNR < 15 dB may be mistakenly identified as CAT, but the proportion of meteorological echoes to the total echoes is more than 85%, which indicate that the error rate is very low and does not affect the radar operation.

Disdrometer observations obtained by an OTT Parsivel2 during the 2017 Great Hunan Flood from 1:00 a.m. LST 23 June 2017 to 4:00 a.m. LST 2 July 2017 in Changsha, Hunan Province, southern China, are analyzed to diagnose characteristics of raindrop size distribution (DSD). This event was characterized by a large number of small- to medium-sized raindrops (diameters smaller than 1.5 mm) and the mean median volume diameter (D0) is about 1.04 mm. The median values of rain rate R (1.57 mm h−1), liquid water content W (0.10 g m−3), and radar reflectivity Z (25.7 dBZ) are smaller than that of the 2013 Great Colorado Flood. This event was composed of two intense rainfall periods and a stratiform period, and notable distinctions of rainfall microphysics among the three rainfall episodes are observed. Two intense rainfall periods were characterized by widespread and intense convection rains with a surface reflectivity of 48.8~56.7 dBZ. A maximum diameter of raindrops up to 7.5 mm was observed, as well as high concentrations of small and midsize drops, resulting in large rainfall amounts during the two intense rainfall episodes. The mean radar reflectivity of 22.6 dBZ, total rainfall of 17.85 mm and the maximum raindrop of approximately 4.25 mm were observed during the stratiform rainfall episode. The composite DSD for each rainfall episode peaked at 0.56 mm but higher concentrations of raindrops appeared in the two intense rainfall episodes. The Z-R relationships derived from the disdrometer measurements reflect the unusual characteristics of DSD during the flood. As a result, the standard NEXRAD Z-R relationship (Z = 300R1.4) strongly underestimated hourly rainfall by up to 27.5%. In addition, the empirical relations between rainfall kinetic energy (KE) versus rainfall intensity (R) and mean mass diameter (Dm) are also derived using DSDs to further investigate the impacts of raindrop properties on the rainfall erosivity.

In response to COVID-19 in December 2019, China imposed a strict lockdown for the following two months, which led to an unprecedented reduction in industrial activities and transportation. However, haze pollution was still recorded in many Chinese cities during the lockdown period. To explore temporal and spatial variations in urban haze pollution, concentrations of air pollutants (PM2.5, PM10, SO2, CO, NO, NO2, and O3) from April 2017 to March 2020 were observed at 23 monitoring stations throughout Nanchang City (including one industrial site, sixteen urban central sites, two mountain sites, and four suburban sites). Overall, the highest concentrations of PM2.5, PM10, and SO2 were observed at industrial sites and the highest CO and NOx (NO and NO2) concentrations were recorded at urban sites. The air pollutants at mountain sites all showed the lowest concentrations, which indicated that anthropogenic activities are largely responsible for air pollutants. Concentrations of PM2.5, PM10, CO, NO, and NO2 showed similar season trends, that is, the highest levels in winter and lowest concentrations in summer, but an opposite season pattern for O3. Except for a sharply dropping pattern from January to May 2018, there were no seasonal patterns for SO2 concentration in all the observed sites. Daily PM2.5, PM10, CO, NOx, and SO2 concentrations showed a peak during the morning commute, which indicated the influences of anthropogenic activities on PM2.5, PM10, CO, NOx, and SO2. PM2.5, PM10, NOx, and CO concentrations at industrial, urban, and suburban sites were higher during nighttime than during daytime, but they showed the opposite pattern at mountain sites. In addition, PM2.5, PM10, CO, and NOx concentrations were lower during the lockdown period (D2) than those before the lockdown (B1). After the lockdown was lifted (A3), PM2.5, PM10, CO, and NOx concentrations showed a slowly increasing trend. However, O3 concentrations continuously increased from B1 to A3.

The city landscape is largely related to the design concept and aesthetics of planners. Influenced by globalization, planners and architects have borrowed from available designs, resulting in the “one city with a thousand faces” phenomenon. In order to create a unique urban landscape, they need to focus on local urban characteristics while learning new knowledge. Therefore, it is particularly important to explore the characteristics of cities’ landscapes. Previous researchers have studied them from different perspectives through social media data such as element types and feature maps. They only considered the content information of a image. However, social media images themselves have a “photographic cultural” character, which affects the city character. Therefore, we introduce this characteristic and propose a deep style learning for the city landscape method that can learn the global landscape features of cities from massive social media images encoded as vectors called city style features (CSFs). We find that CSFs can describe two landscape features: (1) intercity landscape features, which can quantitatively assess the similarity of intercity landscapes (we find that cities in close geographical proximity tend to have greater visual similarity to each other), and (2) intracity landscape features, which contain the inherent style characteristics of cities, and more fine-grained internal-city style characteristics can be obtained through cluster analysis. We validate the effectiveness of the above method on over four million Flickr social media images. The method proposed in this paper also provides a feasible approach for urban style analysis.

Background: Viruses from two antigenically distinct influenza B strains have co-circulated since the mid-1980s, yet inactivated trivalent influenza vaccines (TIVs) with either the Victoria or Yamagata lineage could only provide limited protection from influenza B strain. Quadrivalent influenza vaccine (QIV) including both influenza B lineages can improve protection against circulating influenza B viruses. Methods: Participants >/ = 3 years of age were recruited, stratified by age, and then randomly allocated at a ratio of 2:1:1 to receive one-injection of the experimental QIV, TIV-Victoria (Vic) or TIV-Yamagata (Yam). The primary objective of this study was to demonstrate that the hemagglutination-inhibition (HI) antibodies induced by the QIV candidate are not inferior to the licensed TIVs. Results: First, 3661 participants received the inoculation. The QIV was found to be non-inferior to TIVs in terms of the geometric mean titers (GMTs) and seroconversion rates (SCRs) of the HI antibodies against shared strains 28 days after completion of inoculation, and was superior to the TIVs against the alternate B strain, which is absent from the TIVs. The occurrences of adverse events (AEs) post-vaccination were similar across the treatment groups. Conclusion: The experimental QIV showed good immunogenicity and an acceptable safety profile.