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Biliary atresia is the most common cause of childhood liver disease and is the main cause of liver replacement. The use of an effective early screening technique can efficiently improve the therapeutic effect on children with biliary atresia, especially those in the remote rural areas. This study introduces a novel method for detecting direct bilirubin by Raman spectroscopy using composite surface-enhanced Raman spectroscopy (SERS) chips. These chips were created by spreading silver nanowires on the nanostructure surface of an anodic aluminum oxide substrate. Experimental results demonstrated that the detection limit of direct bilirubin concentration vastly improved far below the disease criteria of bilirubin in adults and infants. Meanwhile, using only $10~\mu \text{L}$ of direct bilirubin, a wide detection range from 10−7 to 10−4 M was obtained, covering the clinic reference range with R2 of 0.98336 at the peak value of 1.616 cm−1. Furthermore, the results revealed that the proposed composite SERS substrates possessed good statistical relative standard deviation and reproducibility (N = 3) of 4.6% and 2.2%, respectively. Thus, the composite SERS chip combined with the Raman spectroscopy approach can be integrated with portable Raman spectrometer for the effective clinical detection of direct bilirubin.

This study proposed nitrogen addition experiments to analyze the effects of exogenous nitrogen addition on soil fungal diversity in alpine meadow. All the experiments were performed in degraded alpine meadow with two different slopes (gentle slope and steep slope) in Guoluo Prefecture of the Sanjiangyuan Region, and the sequence and analysis of ITS of soil fungi were performed using MiSeq PE250 sequencing technology. Comparative analysis was carried out with three nitrogen addition levels on soil fungal diversity in degraded grassland with different slopes, which included low nitrogen (LN, 2 g·m

Background: Taiwan is a rapidly aging society. The elderly with mild cognitive impairment (MCI) have increased risk of dementia, and this is a population-based report using standard neuropsychological tests and expert consensus diagnosis to assess the MCI prevalence and its associated factors in Taiwan. Method: The Epidemiology of Mild Cognitive Impairment study in Taiwan (EMCIT) is a community-based, prospective cohort study. Independently-living individuals aged ≧60 years in a rural area (n = 122) and in an urban area (n = 348) of New Taipei City, Taiwan, completed detailed neuropsychological tests at the cohort baseline. Diagnosis of MCI was ascertained through expert consensus based on 2011 NIA-AA criteria. Results: Of 470 participants recruited between 2017 and 2019 (mean age 71.2 ± 5.4 years), the prevalence of MCI was higher in the rural area than in the urban area (25.1% vs. 10.8%, p

MiSeq sequencing technology was used to investigate the bacterial compositions and diversities of active patch, non-active patch, recovered patch, and healthy alpine meadows so as to understand the changes in soil bacterial community diversity during altitude change and alpine meadow degradation. The relationship between bacterial diversity and environmental factors was analyzed using redundancy analysis (RDA). The results showed that the dominant bacterial phyla in the soil included Proteobacteria, Actinobacteriota, and Acidobacteriota in the study areas. The dominant bacterial genera that were identified via the MiSeq were

Table S1: Pathomechanics of Joubert Syndrome Table S2: Pathomechanics of Bardet Biedl Syndrome Table S3: Pathomechanics of Neuromyelitis Optica Spectrum Disorder, Genome-wide association study; Phenome-wide association study; Genetic diagnosis; Molecular mechanisms; Cerebral visual impairment; Multiple sclerosis; Joubert syndrome; Mowat Wilson disease; Zellweger spectrum disorder; Neuromyelitis optica spectrum disorder

Wetland is an important carbon pool, and the degradation of wetlands causes the loss of organic carbon and total nitrogen. This study aims to explore how wetland degradation succession affects soil organic carbon (SOC) and total nitrogen (TN) contents in alpine wetland. A field survey of 180 soil-sampling profiles was conducted in an alpine wetland that has been classified into three degradation succession stages. The SOC and TN contents of soil layers from 0 to 200 cm depth were studied, including their distribution characteristics and the relationship between soil water content (SWC) and microtopography. The results showed that SOC and TN of different degradation succession gradients followed the ranked order of Non Degradation (ND) > Light Degradation (LD) > Heavy Degradation (HD). SWC was positively correlated with SOC and TN (p

Anopheles sinensis is widely distributed in Wanning County, it is necessary to understand the spatial distribution characteristics of Anopheles sinensis in order to maintain the elimination of malaria in Wanning. During May and October 2009, we sampled adult mosquitoes at 36 villages within Wanning County on Hainan island, and collected meteorological and geographical data at each sampling site. We used these data to analyze the spatial distribution of adult Anopheles sinensis mosquitoes, and logistic regression analysis was applied to explore the association of the spatial distribution of Anopheles sinensis with the geographical and meteorological factors. We found that the density of Anopheles sinensis showed a significant positive spatial correlation. From May to October, on the whole, the high-density area was located in the central part of Wanning County. But each month there was a relatively high-density cluster, and their location and range were not exactly the same. From east to west, the density of Anopheles sinensis increased initially and then decreased, but from south to north, there were different trends in the periods of May to August and September to October. Logistic regression analysis showed that the main environmental factors related with the distribution of Anopheles sinensis were land use type, soil type, distance to road, air pressure and relative humidity. These analysis results showed that the distribution of Anopheles sinensis had obvious spatial heterogeneity in Wanning County, which was related with geographical and meteorological factors. The mechanism of these environmental factors on the distribution of Anopheles sinensis needs to be further studied.

Owing to the different consumption habits of people, the market has rapidly changed, and customized demands have increased in recent years. This issue has led to the need for manufacturing industry to improve their production-process automation system control to become faster and more flexible. An intelligent automated production-line control system (IAPLCS) is proposed in this study, in which a graphic control system (GCS) is designed to integrate equipment communications in automated production. This system runs complex packaged programs for function blocks, which enable users to easily build function blocks in GCS. Users can plan the control flow of the system to control the machine operation. Not only is a web interface set in the IAPLCS, which makes it easier for users to operate and monitor, but also Internet-of-Things (IoT) sensors can be added for data collection and analysis based on the characteristics of the production line and equipment. Finally, the proposed control system was implemented in an actual production line to verify its feasibility.

MiSeq sequencing technology was used to analyze the microbial community diversity of soil in alpine wetlands to understand the degradation processes and environmental factors in these areas. The results showed that the severity of soil degradation changed the species diversity of soil microorganisms at the level of OTUs, and grass patches contained more species than frozen-thawing patches. The soil fungi species of OTUs changed significantly. The diversity indexes of bacteria (between the frozen-thawing patches and the grass patches) were higher than that of fungi. The dominant microbial species were consistent among different degradation stages. The dominant species of bacteria and fungi were Proteobacteria and RB41, and Ascomycota and

In this study, a metal enhanced fluorescence (MEF) approach using the homemade Ag nanowires for enzyme free and electrodeless detection of direct bilirubin (d-BLR) was successfully developed. The average diameter and length of the fabricated Ag nanowires were measured to be around 80 nm and 25 μm, respectively. Solvent effect experiments found that EtOH is more suitable as the solvent for d-BLR. The experimental results found that the linear detection range is from 1 to 10 μM, which can be used for detecting abnormal d-BLR concentration from 5 to 10 μM. The MEF approach not only enhanced the bilirubin fluorescence, but also improved the linearity of the standard curve. Furthermore, we also found that the fluorescence intensity of the chip-based MEF is much higher than that of the solution-based MEF. It is believed that the proposed enzyme free and electrodeless d-BLR detection platform is highly feasible for clinical applications.

The drying process of different grades of Angelicae Sinensis Radix under low temperature and resurgence conditions was simulated based on the Weibull distribution function,in order to clarify the low-temperature moisture regain drying characteristics of different grades of Angelicae Sinensis Radix,and explore the effect of grade and drying conditions on the drying process of Angelicae Sinensis Radix. Research results indicated that the Weibull function can be used to simulate different grades of Angelicae Sinensis Radix low-temperature moisture regain drying process,and the lower the drying temperature,the smaller the grade,and the better the simulation effect. The grade and drying temperature showed a significant effect on the low-temperature moisture regain drying process of Angelicae Sinensis Radix,and the effect of temperature on the relative moisture regain rate of Angelicae Sinensis Radix was greater than the grade. The relative moisture regain rate of different grades of Angelicae Sinensis Radix at 40 ℃ was higher than 55 ℃,and the relative moisture regain rate at 40 ℃ was first classsecond classthird class. After drying,the moisture ratio at 40 ℃ was lower than that at 55 ℃; the effect of the grade on the effective diffusion coefficient of dry water was greater than the temperature. Under different conditions of 40 ℃ and 55 ℃ moisture regain,the effective diffusion coefficient of water was between 2. 941 6×10

Angelicae sinensis Radix( ASR) is a commonly used medicinal material in Chinese medicine,widely used in clinical practice of Chinese medicine,Gansu province is the genuine production area of ASR. This paper studies the evolution law of drying method of ASR,the results showed that drying process was the key affection of the medicinal properties and quality of ASR,and it was an important reflection of the authentic properties of ASR. The drying history of ASR has gradually changed from the earliest shade drying to various drying methods. The Chinese Pharmacopoeia stipulates that the drying method of ASR is"fumigation drying",and the traditional drying method can not meet the processing needs of the origin. In recent years,the new drying methods and drying effects on the quality of ASR are more.

According to industry4.0, every different field not only factories but companies are achieving the goal of intelligence manufacturing and going to be transformation to promote their competition. Therefore, system provider firstly put forward upgrading automation production line. After this condition, it could achieve the goal on optimization and efficiency. In order to realize planning and designing of automation manufacturing, it established an automation checking with visualization and use robotic arms to glue and assemble on our workstation. In the end, we achieve the planning and designing of automation manufacturing unit. This working station could produce in automation process line.

Coal conversion including reforming of nascent tar over the char surface in a drop tube reactor (DTR) was studied both experimentally and numerically. Victorian brown coal and char prepared from the same coal were co-fed into an atmospheric DTR. The effects of reaction temperature (973–1173 K), solid hold-up (8.31 × 10− 6–2.50 × 10− 4), residence time (0–4.6 s for gas; 0–0.78 s for solid particles), and steam partial pressure (0–0.05 MPa) on the conversion characteristics were investigated. A 4-lump kinetic model consisting of tar, gases, char, and soot with 6 global reactions was developed based on the experimental results. The lumped kinetic model was integrated with a computational fluid dynamics (CFD) simulation using an Eulerian–Eulerian approach for mixed phase flow to simulate the coal conversion experiments in the DTR. The CFD results for product distribution during coal conversion in the DTR showed reasonable agreement with the experimental results. The CFD approach presented is suitable for use in designing and optimizing a pyrolyzer for a triple-bed combined circulating fluidized-bed coal gasifier, consisting of a downer (pyrolyzer), a bubbling fluidized bed (gasifier), and a riser (combustor).

Japanese encephalitis (JE) is the most common cause of viral encephalitis and an important public health concern in the Asia-Pacific region, particularly in China where 50% of global cases are notified. To explore the association between environmental factors and human JE cases and identify the high risk areas for JE transmission in China, we used annual notified data on JE cases at the center of administrative township and environmental variables with a pixel resolution of 1 km × 1 km from 2005 to 2011 to construct models using ecological niche modeling (ENM) approaches based on maximum entropy. These models were then validated by overlaying reported human JE case localities from 2006 to 2012 onto each prediction map. ENMs had good discriminatory ability with the area under the curve (AUC) of the receiver operating curve (ROC) of 0.82–0.91, and low extrinsic omission rate of 5.44–7.42%. Resulting maps showed JE being presented extensively throughout southwestern and central China, with local spatial variations in probability influenced by minimum temperatures, human population density, mean temperatures, and elevation, with contribution of 17.94%–38.37%, 15.47%–21.82%, 3.86%–21.22%, and 12.05%–16.02%, respectively. Approximately 60% of JE cases occurred in predicted high risk areas, which covered less than 6% of areas in mainland China. Our findings will help inform optimal geographical allocation of the limited resources available for JE prevention and control in China, find hidden high-risk areas, and increase the effectiveness of public health interventions against JE transmission. Keywords: Japanese encephalitis, Ecological niche model, MaxEnt, China

With the prevalence of Internet, eLearning provides a platform for education that enables students to take classes online. While eLearning provides a flexible learning environment, it also has drawbacks. This research investigated the potential benefit of the proposed method in an informal formative web-based assessment. The data were collected from college students in three separated groups. The statistical analyses showed mixed results. Some possible reasons were discussed along with other methods that could be further explored in the future.

Series sample were prepared with solvothermal method using ethylene-diomine as solvent, at 220°C for 24h. All samples are white powder and XRD proofs that all of them are single phases. Using the Laser granularity cryoscopy (rise 2008) to measure the samples size , and most samples sizes are from 150nm to 200nm. SEM photo shows that the Y2O2S:Eu3+morphologies are spherical but have some aggregation. And Y2O2S:Eu3+has a better a anti-decay property compared with Rhodamine B. The Cell toxicity test (MTT) shows that when concentration range in 20-80mg/ml, the cytotoxicity of sample is relatively small ,but as a good bio-marker materials in tumors diagnosis , its toxicity is still high.

Series samples ZnS: Cu2+ have been prepared by Liquid-phase method and the final productivity has a great improvement compared with traditional method. Different concentration thioglycolic acid (TGA) modified combining nanoparticle makes water soluble ability better. When precipitating agent water and ethanol volume ratio is 3:1, sample production rate is the highest. Under XRD theoretical calculation ,the size of the series of samples are about 16nm , and the sample size is 18 nm while using Laser Particle Size Analyzers（Rise - 2208）measured. Series sample shows strong absorption under 200 nm to 340 nm range. Through absorption spectrum calculating the forbidden band width is about 3.58 eV. Under 210 nm of excitation, the emission spectrum shows that the strongest peak locates in 425 nm which belongs to Cu2 + ions’ t2 transition.

The process of word form encoding was investigated in primed word naming and word typing with Chinese monosyllabic words. The target words shared or did not share the onset consonants with the prime words. The stimulus onset asynchrony (SOA) was 100ms or 300ms. Typing required the participants to enter the phonetic letters of the target word, which correspond roughly to the onset and the rhyme of the word's syllable. Regardless of SOAs, response times were shorter in the related condition than in the unrelated condition (an onset priming effect) for word typing, but were similar for word naming. The results suggest that naming and typing in Chinese may involve somewhat different word form encoding processes (syllable driven in naming, but segment driven in typing) even though both tasks require accessing the phonological codes. It appears, then, that the kind of outputs a production system is designed to produce can flexibly and adaptively alter the way the system is organized and operates.

The removal of B and P consumes most of heat energy in Si metallurgical purification process for solar-grade Si. Metal-liquating purification of metallurgical grade silicon (MG-Si), also called Si-recrystallization from metal liquid, was a potential energy-saving method for the removal of B and P efficiently, since Si could be melted at lower temperature by alloying with metal. The selection criteria of metal-liquating system was elaborated, and Al, Sn and In were selected out as the optimum metallic mediums. For Sn-Si system, the segregation coefficient of B decreased to 0.038 at 1 500 K, which was much less than 0.8 at the melting point of Si. The mass fraction of B was diminished from 15x10(-6) to 0.1x10(-6) as MG-Si was purified by twice, while that of most metallic elements could be decreased to 0.1x10(-6) by purifying just once. During the metal-liquating process, the formation of compounds between impurity elements and Si was also an important route of impurity removal. Finally, one low-temperature metallurgical process based on metal-liquating method was proposed.

Vibrio cholerae ATP-binding cassette transporter VcaM (V. cholerae ABC multidrug resistance pump) has previously been shown to confer resistance to a variety of medically important drugs. In this study, we set to analyse its properties both in vitro in detergent-solubilised state and in vivo to differentiate its dependency on auxiliary proteins for its function. We report the first detailed kinetic parameters of purified VcaM and the rate of phosphate (Pi) production. To determine the possible functional dependencies of VcaM on the tripartite efflux pumps we then utilized different E. coli strains lacking the principal secondary transporter AcrB (Acriflavine resistance protein), as well as cells lacking the outer membrane factor (OMF) TolC (Tolerance to colicins). Consistent with the ATPase function of VcaM we found it to be susceptible to sodium orthovanadate (NaOV), however, we also found a clear dependency of VcaM function on TolC. Inhibitors targeting secondary active transporters had no effects on either VcaM-conferred resistance or Hoechst 33342 accumulation, suggesting that VcaM might be capable of engaging with the TolC-channel without periplasmic mediation by additional transporters. Our findings are indicative of VcaM being capable of a one-step substrate translocation from cytosol to extracellular space utilising the TolC-channel, making it the only multidrug ABC-transporter outside of the MacB-family with demonstrable TolC-dependency.

From December 2012 to February 2013, two outbreaks of acute respiratory disease caused by HAdV-7 were reported in China. We investigated possible transmission links between these two seemingly unrelated outbreaks by integration of epidemiological and whole-genome sequencing (WGS) data. WGS analyses showed that the HAdV-7 isolates from the two outbreaks were genetically indistinguishable; however, a 12 bp deletion in the virus-associated RNA gene distinguished the outbreak isolates from other HAdV-7 isolates. Outbreak HAdV-7 isolates demonstrated increased viral replication compared to non-outbreak associated HAdV-7 isolate. Epidemiological data supported that the first outbreak was caused by introduction of the novel HAdV-7 virus by an infected recruit upon arrival at the training base. Nosocomial transmission by close contacts was the most likely source leading to onset of the second HAdV-7 outbreak, establishing the apparent transmission link between the outbreaks. Our findings imply that in-hospital contact investigations should be encouraged to reduce or interrupt further spread of infectious agents when treating outbreak cases and WGS can provide useful information guiding infection-control interventions.

Objective To investigate the epidemic characteristics of human cutaneous anthrax (CA) in China, detect the spatiotemporal clusters at the county level for preemptive public health interventions, and evaluate the differences in the epidemiological characteristics within and outside clusters. Methods CA cases reported during 2005–2012 from the national surveillance system were evaluated at the county level using space-time scan statistic. Comparative analysis of the epidemic characteristics within and outside identified clusters was performed using using the χ2 test or Kruskal-Wallis test. Results The group of 30–39 years had the highest incidence of CA, and the fatality rate increased with age, with persons ≥70 years showing a fatality rate of 4.04%. Seasonality analysis showed that most of CA cases occurred between May/June and September/October of each year. The primary spatiotemporal cluster contained 19 counties from June 2006 to May 2010, and it was mainly located straddling the borders of Sichuan, Gansu, and Qinghai provinces. In these high-risk areas, CA cases were predominantly found among younger, local, males, shepherds, who were living on agriculture and stockbreeding and characterized with high morbidity, low mortality and a shorter period from illness onset to diagnosis. Conclusion CA was geographically and persistently clustered in the Southwestern China during 2005–2012, with notable differences in the epidemic characteristics within and outside spatiotemporal clusters; this demonstrates the necessity for CA interventions such as enhanced surveillance, health education, mandatory and standard decontamination or disinfection procedures to be geographically targeted to the areas identified in this study.

Background Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease caused by many serotypes of hantaviruses. In China, HFRS has been recognized as a severe public health problem with 90% of the total reported cases in the world. This study describes the spatiotemporal dynamics of HFRS cases in China and identifies the regions, time, and populations at highest risk, which could help the planning and implementation of key preventative measures. Methods Data on all reported HFRS cases at the county level from January 2005 to December 2012 were collected from Chinese Center for Disease Control and Prevention. Geographic Information System-based spatiotemporal analyses including Local Indicators of Spatial Association and Kulldorff's space-time scan statistic were performed to detect local high-risk space-time clusters of HFRS in China. In addition, cases from high-risk and low-risk counties were compared to identify significant demographic differences. Results A total of 100,868 cases were reported during 2005–2012 in mainland China. There were significant variations in the spatiotemporal dynamics of HFRS. HFRS cases occurred most frequently in June, November, and December. There was a significant positive spatial autocorrelation of HFRS incidence during the study periods, with Moran's I values ranging from 0.46 to 0.56 (P, Author Summary Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne viral disease caused by many serotypes of hantaviruses. In China, HFRS has been recognized as a severe public health problem and accounts for 90% of the reported cases in the world. We examined the spatiotemporal dynamics of HFRS cases in China during 2005–2012 and compared characteristics between cases from high-risk and low-risk counties. Several distinct HFRS cluster areas were identified, concentrated in northeastern, central, and eastern of China. Compared with cases from low-risk areas, a higher proportion of cases were younger, non-farmer, and floating residents in high-risk counties. These findings suggest preventative strategies for HFRS should be focused on the identified clusters in order to achieve the most cost-effective outcomes.

Background Severe acute respiratory syndrome (SARS) is an emerging viral infectious disease. We report our experience in treating SARS patients. Methods From April 27 to May 24, 2003, a total of 36 patients with probable SARS were admitted and treated in a hospital rearranged as a special center for the management of SARS patients. Medical records for the patients were retrospectively reviewed. Univariate and multivariate analyses were performed to determine factors associated with respiratory failure and intubation. Results Of the 36 patients with probable SARS (median age, 37 years; range, 22-66 years), 9 were male and 27 were female. Thirty-two patients (88.9%) were infected in the hospital setting. All patients presented with fever, and 33 eventually developed lymphopenia during hospitalization. Chest radiography showed no unique pattern, but pleural effusion was not seen. All patients initially received empiric antibacterial therapy against common causative pathogens of atypical pneumonia. Ribavirin was given to all except 1 patient. Twenty-two patients received immunoglobulin therapy, and 32 were given corticosteroids. A total of 20 patients (55.6%) required supplemental oxygen, and 8 (22.2%) were intubated with mechanical ventilatory support. Two of these patients died. A higher body temperature at presentation (median 39.5 vs 38.6°C), and higher peak values of lactate dehydrogenase (410 vs 282 U/L) and C-reactive protein (10.2 vs 2.5 mg/dL), were associated with subsequent respiratory failure. Multivariate analysis showed that peak level of C-reactive protein was the only independent predictor of respiratory failure and intubation (odds ratio for every increment of 1 mg/dL = 1.45; 95% confidence interval=1.003, 2.097; p = 0.048). Conclusion All patients with probable SARS who were admitted to hospital presented with fever and lymphopenia. While the efficacy of different treatments could not be evaluated from this retrospective study, a higher value of C-reactive protein was associated with the development of respiratory failure and subsequent intubation.

Quarantine Methods and Secondary Outbreak Prevention, During the 2009 influenza (H1N1) pandemic, some countries used quarantine for containment or mitigation. Of 152 quarantined university students we studied, risk for illness was higher for students quarantined in a room with a person with a confirmed case; we found no difference between students quarantined in double or single rooms.

The purpose of this study was to quantify the relationship between climate variation and transmission of hemorrhagic fever with renal syndrome (HFRS) in Heilongjiang Province, a highly endemic area for HFRS in China. Monthly notified HFRS cases and climatic data for 2001-2009 in Heilongjiang Province were collected. Using a seasonal autoregressive integrated moving average model, we found that relative humidity with a one-month lag (β = -0.010, P = 0.003) and a three-month lag (β = 0.008, P = 0.003), maximum temperature with a two-month lag (β = 0.082, P = 0.028), and southern oscillation index with a two-month lag (β = -0.048, P = 0.019) were significantly associated with HFRS transmission. Our study also showed that predicted values expected under the seasonal autoregressive integrated moving average model were highly consistent with observed values (Adjusted R(2) = 83%, root mean squared error = 108). Thus, findings may help add to the knowledge gap of the role of climate factors in HFRS transmission in China and also assist national local health authorities in the development/refinement of a better strategy to prevent HFRS transmission.

To the Editor: Human infection with a novel low pathogenicity influenza A(H7N9) virus in eastern China has recently raised global public health concerns (1). The geographic sources of infection have yet to be fully clarified, and confirmed human cases from 1 province have not been linked to those from other provinces. While some studies have identified epidemiologic characteristics of subtype H7N9 cases and clinical differences between these cases and cases of highly pathogenic influenza A(H5N1), another avian influenza affecting parts of China (2–4), the spatial epidemiology of human infection with influenza subtypes H7N9 and H5N1 in China has yet to be elucidated. To test the hypothesis of co-distribution of high-risk clusters of both types of infection, we used all available data on human cases in mainland China and investigated the geospatial epidemiologic features. Data on individual confirmed human cases of influenza (H7N9) from February 19, 2013, through May 17, 2013, and of influenza (H5N1) from October 14, 2005, through May 17, 2013, were collected from the Chinese Center for Disease Control and Prevention. The definitions of these cases have been described (3,5). A total of 129 confirmed cases of influenza (H7N9) (male:female ratio 2.39:1) and 40 confirmed cases of influenza (H5N1) (male:female ratio 0.90:1) were included in the analysis. The median age of persons with influenza (H7N9) was higher than for persons with influenza (H5N1) (58 years vs. 27 years; z = −7.73; p2 family members with laboratory-confirmed cases, was found for influenza (H7N9) cases during March–April 2013 in Shanghai and Jiangsu Provinces and for influenza (H5N1) cases during December 2007 in Jiangsu Province. Family clustering may indicate person-to-person viral transmission or may reflect common exposure to infected poultry or their excrement in the household or in a contaminated environment (7). No evidence supports person-to-person viral transmission as the means of transmission in family clusters. In conclusion, we found compelling evidence that the high-risk areas for human infection with subtype H7N9 and H5N1 viruses are co-distributed in an area bordering the provinces of Anhui and Zhejiang, which suggests that this area might be a common ground for the transmission of emerging avian influenza viruses in China. We also found that visits to live poultry markets or exposure to contaminated environments are a pathway to infection with influenza (H7N9) virus, whereas infection with influenza (H5N1) is more tied to occupational hazards. These differences may reflect the differences in the pathogenicity of the viruses in poultry, which influences disease progression and identification of clinical signs further down the poultry market chain. Further empirical investigation into our findings could identify risk factors that might be involved in disease transmission to humans in high-risk areas and could help public health authorities develop targeted control and surveillance strategies to prevent disease transmission.

Severe fever with thrombocytopenia syndrome (SFTS), an emerging vector-borne disease, is caused by a novel bunyavirus belonging to the genus Phlebovirus [1, 2]. SFTS infections can be life-threatening and are characterized by sudden onset of fever, thrombocytopenia, gastrointestinal symptoms, and leukocytopenia. The tick Haemaphysalis longicornis is generally considered to be the vector of SFTS, which is widely distributed in China [2]. Person-to-person transmission through direct contact with contaminated blood has also been reported as a possible means of SFTS transmission [3–5]. Currently, there is no specific treatment other than supportive care [6]...