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To improve the accuracy of photovoltaic (PV) power prediction, this paper proposes a novel weather classification method. First, it distinguishs the clear days and cloudy days according to the total cloud cover. Then, it further classifies the cloudy days into three subtypes to investigate whether the sun is obscured by clouds. This method can effectively identify the characteristics of key meteorological environmental factors that affect PV output and form a new classification index sky condition factor (SCF) by weighted summation. This method has clear physical meanings, good discrimination, and easy quantification. The reasonable classification of weather types can eliminate the coupling relationship between many meteorological environmental factors and reduce the dimension of input variables, which makes it easy for statistical modeling. Based on the theoretical and the statistical approachs respectively, the modeling and verification are conducted and the results show that the method can effectively improve the accuracy of PV power prediction.

Background To study the association of beta-carotene intake from diet with anxiety in US midlife women. Methods Analyses were performed on the baseline data of the Study of Women's Health Across the Nation (SWAN), a multicenter and population-based study of the natural history of US midlife women aged from 42 to 52. Logistic regression and restricted cubic spline models were performed to examine the association of beta-carotene intake with anxiety. Results A total of 3051 midlife women were included in the present study. In early perimenopausal women, the odds ratios (ORs) of anxiety in the crude model indicated that beta-carotene intake was inversely associated with anxiety. After additional adjustment for age, race/ethnicity, education, income, financial strain, physical activity, BMI, vasomotor symptoms (VMS), chronic stress, use of antidepressant and total caloric intake in model 1, the results were similar to those of the crude model. This association remained statistically significant and changed little when additional controlling for estradiol, testosterone and sex hormone binding globulin (SHBG) in the fully adjusted model 2. The fully adjusted ORs and 95% confidence intervals (CIs) were 0.606 (0.408-0.901). However, in premenopausal women, no statistically significant difference was observed between beta-carotene intake and anxiety. Limitations This was a cross-sectional study, limiting causal inferences. Conclusion Dietary beta-carotene intake may be inversely associated with anxiety in early perimenopausal women, but not in premenopausal women.

The aim of the present study was to determine the changes of serum chromogranin A (CgA) levels upon depression by investigating the relationship between serum CgA levels and the depressive symptoms assessed by 24-item Hamilton Rating Scale for Depression (HRSD-24).Serum CgA levels were measured by enzyme-linked immunosorbent assay in 133 male patients with major depressive disorder (MDD) and were compared with those of 47 healthy controls. Then generalized linear regression, logistic regression and restricted cubic spline models were performed to examine the association between serum CgA levels and depressive symptoms.Serum CgA levels were lower in MDD patients than in controls (P 0.001) and were inversely associated with scores on HRSD-24 in unadjusted, age, smoking, alcohol consumption, traumatic life events and family history of depression-adjusted and fully adjusted linear regression model. The fully adjusted regression coefficient with 95% confidence intervals was -0.028 (-0.045, -0.010) for serum CgA levels and HRSD-24 score. Serum CgA levels were inversely associated with depressive symptoms (HRSD ≥20) in each logistic regression model.Serum CgA decrease was noted in male patients of MDD and may be inversely associated with depressive symptoms.

Background In December 2019, the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out in Wuhan. Epidemiological and clinical characteristics of patients with COVID-19 have been reported, but the relationships between laboratory features and viral load has not been comprehensively described. Methods Adult inpatients (≥18 years old) with COVID-19 who underwent multiple (≥5 times) nucleic acid tests with nasal and pharyngeal swabs were recruited from Renmin Hospital of Wuhan University, including general patients (n = 70), severe patients (n = 195), and critical patients (n = 43). Laboratory data, demographic data, and clinical data were extracted from electronic medical records. The fitted polynomial curve was used to explore the association between serial viral loads and illness severity. Results Viral load of SARS-CoV-2 peaked within the first few days (2–4 days) after admission, then decreased rapidly along with virus rebound under treatment. Critical patients had the highest viral loads, in contrast to the general patients showing the lowest viral loads. The viral loads were higher in sputum compared with nasal and pharyngeal swab (P = .026). The positive rate of respiratory tract samples was significantly higher than that of gastrointestinal tract samples (P < .001). The SARS-CoV-2 viral load was negatively correlated with portion parameters of blood routine and lymphocyte subsets and was positively associated with laboratory features of cardiovascular system. Conclusions The serial viral loads of patients revealed whole viral shedding during hospitalization and the resurgence of virus during the treatment, which could be used for early warning of illness severity, thus improve antiviral interventions.

In order to explore the diagnostic effect of the expert system in knee sports injury, a method of diagnostic value of expert system in sports knee sports injury is proposed. This paper mainly takes 200 professional football players in sports higher vocational colleges as the research object. There are 146 male athletes and 44 female athletes; we establish a football injury ontology knowledge base and use a reasoning engine to build an intelligent expert system diagnosis system, allowing users to quickly discover diseases, accurately diagnose injuries, and obtain the best means of rehabilitation. Through the investigation, it can be seen that the body parts caused by football injuries are more complex, and the types of injuries in each part are also different. Therefore, it is particularly important to establish an intelligent retrieval system with convenient query and clear diagnosis by the expert system. With the birth and development of computer and artificial intelligence technology, the development of artificial intelligence expert systems in the medical field has become a reality. The construction of this system will have theoretical and practical significance and application value.

Objectives This study is to explore the clinical significance of folate receptor‐positive circulating tumor cells (FR+CTC) in the early diagnosis and disease progress in patients with breast cancer. Methods Folate receptor‐positive circulating tumor cells was enriched from peripheral blood of the patients with immunomagnetic separation method and quantitated by folate receptor on the CTC with the ligand‐targeted PCR. Results The levels of FR+CTC were significantly higher in breast cancer patients compared with healthy controls. Detective rate of FR+CTC was decreased in 19 of 27 patients underwent the surgery in 2 weeks post‐operation compared with pre‐operation; statistical analysis showed the difference was significant. We also found that the combination of FR+CTC, CEA, CA125, and CA153 can significantly improve the diagnostic efficiency for breast cancer. Conclusions This study showed the detective rate of FR+CTC is significantly increased in the patients with breast cancer, and the detective level is associated with disease progress., In this paper, FR+CTC was detected in peripheral blood of the patients with breast cancer with the ligand‐targeted PCR. The levels of FR+CTC were significantly higher in breast cancer patients compared to healthy controls and the FR+CTC level were significantly higher in the distant metastasis and high TNM stage. The level of FR+CTC was decreased underwent the surgery in 2 weeks post‐operation compared to pre‐operation. The detection sensitivity and specificity of FR+CTC was higher diagnostic efficacy than other biomarkers, such as CEA, CA125, and CA153. This study showed that may be used as a potential biomarker for auxiliary diagnosis and early detection particularly combined with other biomarkers assay in breast cancer.

Background: We aimed to analyze clinical characteristics and find potential factors to predict poor prognosis in patients with coronavirus disease 2019 (COVID-19). Methods: We analyzed the clinical characteristics and laboratory tests of COVID-19 patients and detected SARS-CoV-2 RNA in urine sediments collected from 53 COVID-19 patients enrolled in Renmin Hospital of Wuhan University from 31 January 2020 to 18 February 2020 with qRT-PCR analysis. Then, we classified those patients based on clinical conditions (severe or non-severe syndrome) and urinary SARS-CoV-2 RNA (URNA− or URNA+). Results: We found that COVID-19 patients with severe syndrome (severe patients) showed significantly higher positive rate (11 of 23, 47.8%) of urinary SARS-CoV-2 RNA than non-severe patients (4 of 30, 13.3%, p = 0.006). URNA+ patients or severe URNA+ subgroup exhibited higher prevalence of inflammation and immune discord, cardiovascular diseases, liver damage and renal dysfunction, and higher risk of death than URNA− patients. To understand the potential mechanisms underlying the viral urine shedding, we performed renal histopathological analysis on postmortems of patients with COVID-19 and found severe renal vascular endothelium lesion characterized by an increase of the expression of thrombomodulin and von Willebrand factor, markers to assess the endothelium dysfunction. We proposed a theoretical and mathematic model to depict the potential factors that determine the urine shedding of SARS-CoV-2. Conclusions: This study indicated that urinary SARS-CoV-2 RNA detected in urine specimens can be used to predict the progression and prognosis of COVID-19 severity.

The purpose of the present study was to study the characteristics of epidemic growth factor receptor (EGFR) gene distribution in patients with non-small cell lung cancer (NSCLC), and to detect the mutation rate of EGFR gene by Sanger sequencing and amplification refractory mutation system (ARMS)-PCR. Paraffin-embedded sections of NSCLC tissues from 399 NSCLC patients diagnosed in Renmin Hospital of Wuhan University were collected, 103 of them were detected for exons 18-21 mutation of EGFR by Sanger sequencing method, 296 cases were detected for exons 18-21 mutation by ARMS-PCR method. DNA extraction of both groups was performed with Qiagen QLAamp DNA FFPE Tissue KIT. Comparisons of detection rates between the two methods were conducted by row X list chi-square test. The total mutation rate of EGFR gene detected by Sanger sequencing was 21.4%, exons 18-21 and combined mutation rates were 1.0%, 9.7%, 1.0%, 7.8% and 2.0%, respectively. And the proportions were 4.7%, 45.2%, 4.7%, 36.3% and 9.4% respectively. The total mutation rate detected by ARMS-PCR was 51.4%, exons 18-21 and combined mutation rates were 2.7%, 27%, 1.7%, 18.2% and 1.7%, respectively. The proportions were 5.3%, 52.6%, 3.3%, 35.5% and 3.3% respectively. Further analysis of mutation rate showed that there was significant difference between the two methods in detecting total mutation of EGFR gene (P

Background To study the association of trans fatty acid intake from diet with depressive symptoms in midlife women. Methods Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Linear regression, logistic regression and restricted cubic spline models were performed to examine the association trans fatty acid intake with depressive symptoms. Results A total of 3095 women aged 42–52 years were included in the present study. Trans fatty acid intake was positively associated with CES-D (Center for Epidemiological Studies-Depression) scores in unadjusted, age-, race/ethnicity-, total family income- and education-adjusted and fully adjusted linear regression model. The fully adjusted regression coefficient with 95% confidence intervals (CIs) of trans fatty acid intake were 0.146 (0.047-0.246) for CES-D score. Trans fatty acid intake was positively associated with depressive symptoms (CES-D score ≥16) in each logistic regression model. The fully adjusted odds ratios (ORs) with 95% CI of depressive symptoms were 1.410 (1.019-1.951) in quartile 4 compared with quartile 1 for trans fatty acid intake. Sensitivity analyses showed that the association between trans fatty acid and depressive symptoms were not affected by use of antidepressant. Stratified analysis showed that, in fully adjusted model, the trans fatty acid intake was not significantly associated with depressive symptoms in early perimenopausal women. Limitations This was a cross-sectional study, limiting causal inferences. Conclusion Trans fatty acid may be positively associated with depressive symptoms in premenopausal women, but not in early perimenopausal women.

Background The prenatal test of cell-free fetal DNA (cffDNA) is also known as noninvasive prenatal testing (NIPT) with high sensitivity and specificity. This study is to evaluate the performance of NIPT and its clinical relevance with various clinical indications. Methods A retrospective analysis was conducted on 14,316 pregnant women with prenatal indications, including advanced maternal age (≥35 years), maternal serum screening abnormalities, the thickened nuchal translucency (≥2.5 mm) and other ultrasound abnormalities, twin pregnancy/IVF-ET pregnancy, etc. The whole-genome sequencing (WGS) of maternal plasma cffDNA was employed in this study. Results A total of 189 (1.32%) positive NIPT cases were identified, and 113/189 (59.79%)cases were confirmed by invasive prenatal testing. Abnormal serological screening (53.14%) was the most common indication, followed by elderly pregnancy (23.02%). The positive prediction value for T21, T18, T13, sex chromosome abnormalities, other autosomal aneuploidy abnormalities, and CNV abnormalities were 91.84, 68.75,37.50, 66.67, 14.29, and 6.45%, respectively. The positive rate and the true positive rate of nuchal translucency (NT) thickening were the highest (4.17 and 3.33%), followed by the voluntary requirement group (3.49 and 1.90%) in the various prenatal screening indications. The cffDNA concentration was linearly correlated with gestational age (≥10 weeks) and the positive NIPT group’s Z-score values. Conclusions whole-genome sequencing of cffDNA has extremely high sensitivity and specificity for T21, high sensitivity for T18, sex chromosome abnormalities, and T13. It also provides evidence for other abnormal chromosomal karyotypes (CNV and non-21/18/13 autosomal aneuploidy abnormalities). The cffDNA concentration is closely related to the gestational age and determines the specificity of NIPT. Our results highlight NIPT’s clinical significance, which is an effective prenatal screening tool for high-quality care of pregnancy., Highlights The whole-genome sequencing of cell-free fetal DNA from maternal plasma is an effective prenatal screening tool for pregnancies with various prenatal indications.The concentration of cffDNA was linear with gestational age and the Z-score values of the positive NIPT group.NIPT has a significant positive predictive value for pregnancies with prenatal indications.

To study the association of Provitamin A (pro-A) carotenoid intake from diet with depressive symptoms in midlife women.Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Logistic regression and restricted cubic spline models were performed to examine the association pro-A carotenoid intake with depressive symptoms.A total of 3054 midlife women aged 42-52 years were included in the present study. In overall midlife women, pro-A carotenoid intake was inversely associated with depressive symptoms (CES-D score ≥16). In premenopausal women, pro-A carotenoid intake was inversely associated with depressive symptoms after adjustment for age, race/ethnicity, total family income, education, physical activity, BMI, use of antidepressant, dietary total caloric, protein, carbohydrate, fat, vitamin C, vitamin E and pro-A carotenes in model 1. In fully adjusted model, after additional adjustment for day of cycle, FSH and SHBG, this association remained statistically significant. The fully adjusted odds ratios (ORs) with 95 % CI of depressive symptoms were 0.685 (0.450-1.043) in quartile 4 compared with quartile 1 for pro-A carotenoid intake. However, in early perimenopausal women, no statistically significant difference was observed between pro-A carotenoid intake and depressive symptoms after adjustment for confounders.This was a cross-sectional study, limiting causal inferences. Assessment of CES-D was based on a self-report scale.Pro-A carotenoid intake may be inversely associated with depression symptoms in premenopausal women, but not in early perimenopausal women.

The outbreak and widely spread of coronavirus disease 2019 (COVID-19) has become a global public health concern. COVID-19 has caused an unprecedented and profound impact on the whole world, and the prevention and control of COVID-19 is a global public health challenge remains to be solved. The retrospective analysis of the large scale tests of SARS-CoV-2 RNA may indicate some important information of this pandemic. We selected 12400 SARS-CoV-2 tests detected in Wuhan in the first semester of 2020 and made a systematic analysis of them, in order to find some beneficial clue for the consistent prevention and control of COVID-19.SARS-CoV-2 RNA was detected in suspected COVID-19 patients with real-time fluorescence quantitative PCR (RT-qPCR). The patients' features including gender, age, type of specimen, source of patients, and the dynamic changes of the clinical symptoms were recorded and statistically analyzed. Quantitative and qualitive statistical analysis were carried out after laboratory detection.The positive rate of SARS-CoV-2 was 33.02% in 12,400 suspected patients' specimens in Wuhan at the first months of COVID-19 epidemics. SARS-CoV-2 RT-qPCR test of nasopharyngeal swabs might produce 4.79% (594/12400) presumptive results. The positive rate of SARS-CoV-2 RNA was significantly different between gender, age, type of specimen, source of patients, respectively (P < .05). The median window period from the occurrence of clinical symptom or close contact with COVID-19 patient to the first detection of positive PCR was 2 days (interquartile range, 1-4 days). The median interval time from the first SARS-CoV-2 positive to the turning negative was 14 days (interquartile range, 8-19.25 days).This study reveals the comprehensive characteristics of the SARS-CoV-2 RNA detection from multiple perspectives, and it provides important clues and may also supply useful suggestions for future work of the prevention and treatment of COVID-19.

The spread of COVID-19, the disease caused by SARS-CoV-2, has progressed into a global pandemic. To date, thousands of genetic variants have been identified across strains of SARS-CoV-2 isolated from worldwide patients. However, there is still little direct evidence linking viral variants and clinical features. Based on two tightly linked SNPs, we previously divided SARS-CoV-2 into two major lineages: the ancestral ‘S lineage’ (U8,782 and C28,144) and the derived ‘L lineage’ (C8,782 and U28,144). Here, we identified SARS-CoV-2 lineages from 271 COVID-19 patients during the early outbreak of this pandemic in Wuhan, including 73 S- and 198 L-lineage patients. The S-lineage patients exhibited significantly worse clinical severity than the L-lineage patients, even after excluding other risk factors. This study suggests that SARS-CoV-2 lineage may provide useful clinical information for the management of COVID-19 and support the argument that viral clades should be analyzed as a function of clinical severity.

Background: We aimed to analyse clinical characteristics and find potential factors predicting poor prognosis in patients with coronavirus disease 2019 (COVID-19). Methods: We analyzed the demographic and clinical data of COVID-19 patients and detected SARS-CoV-2 RNA in urine sediments collected from 53 COVID-19 patients enrolled in Renmin Hospital of Wuhan University from January 31, 2020 to February 18, 2020 with qRT-PCR analysis, and then classified those patients based on clinical conditions (severe or non-severe syndrome) and urinary SARS-CoV-2 RNA (URNA- or URNA+). Results: We found that COVID-19 patients with severe syndrome (severe patients) showed significantly higher positive rate (11 of 23, 47.8%) of urinary SARS-CoV-2 RNA than non-severe patients (4 of 30, 13.3%, p = 0.006). URNA+ patients or severe URNA+ subgroup exhibited higher prevalence of inflammation and immune discord, cardiovascular diseases, liver damage and renal disfunction, and higher risk of death than URNA- patients. To understand the potential mechanisms underlying the viral urine shedding, we performed renal histopathological analysis on postmortems of patients with COVID-19 and found that severe renal vascular endothelium lesion characterized by increase of the expression of thrombomodulin and von Willebrand factor, markers to assess the endothelium dysfunction. We proposed a theoretical and mathematic model to depict the potential factors determining the urine shedding of SARS-CoV-2. Conclusions: This study indicated that urinary SARS-CoV-2 RNA detected in urine specimens can be used to predict the progression and prognosis of COVID-19 severity.

Accurate test results depend on high-quality specimens. The collection of specimens plays a very important role in ensuring the accuracy of test results. Without qualified specimens, accurate results cannot be detected. Therefore, the first step in comprehensive quality control is to ensure high-quality specimens. In the quality control work before molecular diagnostic analysis, proper processing during specimen collection is the key to ensuring sample integrity, checking qualitative detection of nucleic acids, and accurate quantitative detection. Improper handling may result in degradation of the nucleic acid, or false negatives or low levels of detection (in quantitative testing). In addition, specimen collection must also comply with the requirements of the appropriate biosafety guidelines. This chapter focuses on pre-acquisition considerations and acquisition procedures for common types of specimens in clinical molecular diagnostics.

Background The SARS-CoV-2 RNA was detected positive again after discharged from hospital in some COVID-19 patients, with or without clinical symptoms such as fever or dry cough. Methods 1008 severe COVID-19 patients, with SARS-CoV-2 RNA positive detected with the mixed specimen of nasopharyngeal swab and oropharyngeal swab by real-time fluorescence quantitative PCR (RT-qPCR), were selected to monitor SARS-CoV-2 RNA with the 12 types of specimens by RT-qPCR during hospitalization. All of 20 discharged cases with COVID-19 were selected to detect SARS-CoV-2 RNA in isolation period with 7 types of specimens by RT-qPCR before releasing the isolation period. Results Of the enrolled 1008 severe patients, the nasopharyngeal swab specimens showed the highest positive rate of SARS-CoV-2 RNA (71.06%), followed by alveolar lavage fluid (66.67%), oropharyngeal swab (30.77%), sputum (28.53%), urine (16.30%), blood (12.5%), stool (12.21%), anal swab (11.22%) and corneal secretion (2.99%), and SARS-CoV-2 RNA couldn’t be detected in other types of specimen in this study. Of the 20 discharged cases during the isolation period, the positive rate of SARS-CoV-2 RNA was 30% (6/20): 2 cases were positive in sputum at the eighth and ninth day after discharge, respectively, 1 case was positive in nasopharynx swab at the sixth day after discharge, 1 case was positive in anal swab at the eighth day after discharge, and 1 case was positive in 3 specimens (nasopharynx swab, oropharynx swab and sputum) simultaneously at the fourth day after discharge, and no positive SARS-CoV-2 RNA was detected in other specimens including stool, urine and blood at the discharged patients. Conclusions SARS-CoV-2 RNA should be detected in multiple specimens, such as nasopharynx swab, oropharynx swab, sputum, and if necessary, stool and anal swab specimens should be performed simultaneously at discharge when the patients were considered for clinical cure and before releasing the isolation period.

In article number 2002169, Wu Wei, Yan Li, Tiangang Liu, and co‐workers develop a novel detection technology, nanopore targeted sequencing (NTS), for the accurate and comprehensive detection of SARS‐CoV‐2 and other respiratory viruses. This detection technology is suitable for the identification of suspected COVID‐19 cases and can also monitor mutations in the virus and the type of virus.

Background: The aging process is accompanied by the gradual development of chronic systemic inflammation (inflamm-aging). Growth differentiation factor-15 (GDF-15) is associated with inflammation and known to be a stress-induced factor. The present study aimed to explore the association of GDF-15 with aging.Methods: In this cross-sectional study, serum GDF-15, hematological parameters, and biomedical parameters were determined in 120 healthy individuals (23-83 years old, males). Three telomere related parameters, including telomere length, telomerase activity, and the expression of human telomerase reverse transcriptase (hTERT) mRNA were also quantified.Results: The older group has a higher levels of GDF-15 and lower expression of hTERT mRNA, and PBMC telomerase activity (ppr=0.664, pr=-0.434, pr=-0.231, p=0.012), and hTERT mRNA (r=-0.206, p=0.024). Furthermore, in multivariate regression analysis, GDF-15 levels showed a statistically significant linear and negative relationship with PBMC telomerase activity (β-coefficient=-0.583, 95% CI -1.044 to -0.122, p=0.014), telomere length (β-coefficient=-0.200, 95% CI -0.305 to -0.094, pβ-coefficient=-0.207, 95% CI -0.312 to -0.102, pConclusions: In conclusion, our results show that circulating GDF-15 is the potential biomarkers of aging that may influence the risk and progression of multiple aging conditions.

BackgroundThe outbreak of COVID-2019 is becoming a global public health emergency. Although its basic clinical features have been reported, the dynamic characteristics of immune system in COVID-2019 patients, especially those critical patients with refractory hypoxemia, are not yet well understood. We aim to describe the dynamic characteristics of immune system in 3 critical patients with refractory hypoxemia, and discuss the relationship between hypoxemia severity and immune cell levels, and the changes of gut microbes of COVID-2019 patient.MethodsThis is a retrospective study from 3 patients with 2019-nCoV infection admitted to Renmin Hospital of Wuhan University, a COVID-2019 designated hospital in Wuhan, from January 31 to February 6, 2020. All patients were diagnosed and classified based on the Diagnosis and Treatment of New Coronavirus Pneumonia (6th edition) published by the National Health Commission of China4. We recorded the epidemiological history, demographic features, clinical characteristics, symptoms and signs, treatment and clinical outcome in detail. Blood samples were collected and we determined the expression levels of immune cells (CD3+ T cells, CD4+ T cells, CD8+ T cells, CD19+ B cells, and CD16+56+ NK cells) in different time points. Nanopore Targeted Sequencing was used to determine the alterations of gut microbiota homeostasis.ResultsApart from the clinical features described previously4, we found that four patients had decreased immune cells and refractory hypoxemia during the hospitalization, and the severity of hypoxemia was strongly correlated to the expression levels of immune cells. Additionally, we found that the proportion of probiotics was significantly reduced, such as Bifidobacterium, Lactobacillus, and Eubacterium, and the proportion of conditioned pathogenic bacteria was significantly increased, such as Corynebacterium of Actinobacteria and Ruthenibacterium of Firmicutes. Notably, all patients died.ConclusionsWe discussed the dynamic characteristics of host immune system and the imbalance of gut microbiota in 3 critical patients with COVID-2019. Hypoxemia severity was closely related with host immune cell levels, and the vicious circle between immune disorder and gut microbiota imbalance may be a high risk of fatal pneumonia. To the best of our knowledge, this is the first study which revealing that immunodepletion with refractory hypoxemia is a potential high risk subtype of COVID-2019 and the vicious circle between immune disorder and gut dysbiosis may be a high risk of fatal pneumonia.

The ongoing novel coronavirus pneumonia COVID-19 outbreak in Wuhan, China, has engendered numerous cases of infection and death. COVID-19 diagnosis relies upon nucleic acid detection; however, current recommended methods exhibit high false-negative rates, low sensitivity, and cannot identify other respiratory virus infections, thereby resulting patient misdiagnosis and impeding epidemic containment. Combining the advantages of target amplification and long-read, real-time nanopore sequencing, we developed nanopore target sequencing (NTS) to detect SARS- CoV-2 and other respiratory viruses simultaneously within 6–10 h. Parallel testing with approved qPCR kits of SARS-CoV-2 and NTS using 61 nucleic acid samples from suspected COVID-19 cases confirmed that NTS identified more infected patients as positive, and could also monitor for mutated nucleic acid sequence or other respiratory virus infection in the test sample. NTS is thus suitable for contemporary COVID-19 diagnosis; moreover, this platform can be further extended for diagnosing other viruses or pathogens.

Protein phosphatase 2A (PP2A) was reported to play an important role in cancer development; however, the relationship between PP2A and cervical cancer development has yet to be fully understood. The present study aimed to explore the role of PP2A in the development of cervical cancer. Serum levels of PP2A were detected by ELISA in 23 patients with cervical cancer and 30 patients with benign cervical lesions. Furthermore, the PP2A activities and the mRNA and protein levels of PP2A were measured in cervical cancer (n=8) and chronic cervicitis (n=10) tissues. The results showed that the serum levels of PP2A were significantly reduced in patients with cervical cancer. Further studies showed that not only the activities of PP2A but also the mRNA and protein levels of PP2A were significantly decreased in cervical cancer tissues. Wound healing and Transwell assays demonstrated that pharmacological and genetic upregulation of PP2A could inhibit the migration of HeLa cells, but the downregulation of PP2A promoted cellular migration. The activation of PP2A also inhibited the remodeling of actin and the activity of mitogen-activated protein kinases (MAPKs) including p-JNK, p-p38 and p-ERK. Meanwhile, the activation of PP2A was found to downregulate MMP-9 levels, which further inhibited the migration and invasion of HeLa cells. In conclusion, our data suggest that the activity and expression of PP2A are significantly reduced in cervical cancer tissues, and the activation of PP2A may inhibit the migration of cervical cancer cells by inhibiting the phosphorylation of p-JNK, p-p38 and the p-ERK/MAPK signaling pathway as well as by downregulating MMP-9, implying that PP2A plays an important role in cervical cancer development.

Background To study the association of manganese intake from diet with depressive symptoms in midlife women. Methods Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Linear regression, logistic regression and restricted cubic spline models were performed to examine the association of manganese intake with depressive symptoms. Results A total of 2993 midlife women aged 42–52 years were included in the present study. In premenopausal women, manganese intake was inversely associated with CES-D score and after adjustment for total caloric intake, age, race/ethnicity, education, income, financial strain, physical activity, BMI, vasomotor symptoms, chronic stress and use of antidepressant, estradiol, testosterone and sex hormone binding globulin using linear regression. The fully adjusted regression coefficient 95% confidence intervals (CIs) were −0.533 (−0.993, −0.074). Similarly, manganese intake was inversely associated with depressive symptoms (CES-D scores≥16) using logistic regression adjusted same confounders. The fully adjusted odds ratios (ORs) with 95% CI of depressive symptoms were 0.512 (0.287–0.913) in quartile 4 compared with quartile 1 for manganese intake. However, in early perimenopausal women, no statistically significant difference was observed between manganese intake and depressive symptoms after adjustment for same confounders that adjusted in premenopausal women. Limitations This was a cross-sectional study, limiting causal inferences. Assessment of CES-D was based on a self-report scale. Conclusion Manganese intake may be inversely associated with depression symptoms in premenopausal women, but not in early perimenopausal women.

SummaryBackground2019-Novel coronavirus (2019-nCoV) outbreaks create challenges for hospital laboratories because thousands of samples must be evaluated each day. Sample types, interpretation methods, and corresponding laboratory standards must be established. The possibility of other infections should be assessed to provide a basis for clinical classification, isolation, and treatment. Accordingly, in the present study, we evaluated the testing methods for 2019-nCoV and co-infections.MethodsWe used a fluorescence-based quantitative PCR kit urgently distributed by the Chinese CDC to detect 8274 close contacts in the Wuhan region against two loci on the 2019-nCoV genome. We also analyzed 613 patients with fever who underwent multiple tests for 13 respiratory pathogens; 316 subjects were also tested for 2019-nCoV.FindingsAmong the 8274 subjects, 2745 (33.2%) had 2019-nCoV infection; 5277 (63.8%) subjects showed negative results in the 2019-nCoV nucleic acid test (non-2019-nCoV); and 252 cases (3.0%) because only one target was positive, the diagnosis was not definitive. Eleven patients who originally had only one positive target were re-examined a few days later; 9 patients (81.8%) were finally defined as 2019-nCoV-positive, and 2 (18.2%) were finally defined as negative. The positive rates of nCoV-NP and nCovORF1ab were 34.7% and 34.7%, respectively. nCoV-NP-positive only and nCovORF1ab-positive cases accounted for 1.5% and 1.5%, respectively. In the 316 patients with multiple respiratory pathogens, 104 were positive for 2019-nCov and 6/104 had co-infection with coronavirus (3/104), influenza A virus (2/104), rhinovirus (2/104), and influenza A H3N2 (1/104); the remaining 212 patients had influenza A virus (11/202), influenza A H3N2 (11/202), rhinovirus (10/202), respiratory syncytial virus (7/202), influenza B virus (6/202), metapneumovirus (4/202), and coronavirus (2/202).InterpretationClinical testing methods for 2019-nCoV require improvement. Importantly, 5.8% of 2019-nCoV infected and 18.4% of non-2019-nCoV-infected patients had other pathogen infections. It is important to treat combined infections and perform rapid screening to avoid cross-contamination of patients. A test that quickly and simultaneously screens as many pathogens as possible is needed.FundingNo founding was receivedResearch in contextEvidence before this studyWe searched PubMed for articles published up to January 31, 2020 using the keywords “2019 novel coronavirus” or “2019-nCoV”. No published study on the characteristics of 2019-nCoV tests or 2019-nCoV co-infections was found. We only noted recent laboratory findings for other tests of patients infected with 2019-nCoV.Added value of this studyPositive detection of nCoV-NP or nCovORF1ab is presented, and individuals with/without 2019-nCoV infections or with inconclusive results were identified. Patients with inconclusive results may be diagnosed with 2019-nCoV infection or found to be negative for the infection after resampling and retesting in the next few days. Approximately 5.8% of the subjects diagnosed with 2019-nCoV had co-infection.Implications of all the available evidenceManagement of the population showing inconclusive results should be given attention; additionally, such results can be minimized by improving the sampling, sample pretreatment, and testing methodologies. When diagnosing 2019-nCoV subjects, the possibility of co-infection should be considered. Finally, better clinical detection methods are needed to simultaneously screen as many pathogens as possible.

BackgroundThe emerging 2019 novel coronavirus (2019-nCoV) has pushed several countries into state of emergency all over the world. The possible transmission of 2019-nCoV by conjunctiva is controversial and has substantial public health implications.MethodsA retrospective cohort study was initiated to investigate the possible transmission of 2019-nCoV through aerosol contact with conjunctiva. We enrolled 67 cases of confirmed or suspected cases of novel coronavirus pneumonia (NCP) during 17–28 Jan 2020. Nasopharyngeal and conjunctival swabs were collected for real time RT-PCR analysis to detect 2019-nCoV.Results63 patients were identified as laboratory-confirmed NCP and the remaining four were suspected NCP. Conjunctival swab samples from one NCP patient yielded positive PCR results and two NCP patients yielded probable positive PCR results. None of the three patients had ocular symptoms. The only one NCP patient with conjunctivitis as the first symptom had negative conjunctival sac 2019-nCoV test. Conjunctival swab samples from the four suspected cases of NCIP were negative.Conclusion2019-nCoV can be detected in the conjunctival sac of patients with NCP. Through clinical analysis, viral transmission via the conjunctival route was not supported by the data. Good clinical protection can effectively cut off the transmission path.

Additional file 1 : Table S1. The primers for amplification and sequencing the exons of G6PD gene.

Background This prospective investigation examined relations between baseline dietary saturated fatty acid (SFA) intake of women at midlife and prevalence of depressive symptoms 4 years later. Methods Women enrolled in the Study of Women's Health Across the Nation (SWAN) had measures of CES-D depression scores 4 years later and SFA intake at baseline. Logistic regression models were used to study prospective associations between SFA intake and depressive symptoms. Results A total of 2400 women aged 42–52 years were included in the present study. The ORs of depressive symptoms in model 1 adjustment for baseline CES-D score indicated that baseline SFA intake was positively associated with depressive symptoms. After additional adjustment for age, race/ethnicity, education, financial strain, physical activity, smoking currently, BMI, menopausal status, VMS, chronic stress and use of antidepressant in model 2, the results were similar to those of the model 1. This association remained statistically significant and changed little when additional controlling for SHBG and FSH in fully adjusted model 3. The fully adjusted OR of depressive symptoms in model 3 was 2.423 (1.142–5.143) in quartile 4 (the highest) versus quartile 1 (the lowest) of the baseline SFA intake. Limitations Assessment of depression and SFA intake was based on a self-report scale. Conclusions Baseline SFA intake is a predictor for depressive symptoms assessed 4 years later in midlife women. This underlines the importance of targeting SFA intake in the prevention of major depression in midlife women.

Background: This study aimed to evaluate the performance of modified carbapenem inactivation method (mCIM) combined EDTA-carbapenem inactivation method (eCIM), and inhibitor-based combined disk test (CDT) in the detection and distinguishing of carbapenemase production in Enterobacteriaceae. Methods: A total of 101 nonrepetitive carbapenem insensitive Enterobacteriaceae [minimal inhibitory concentration (MIC) ≥2 µg/mL] were tested by mCIM, eCIM and CDT respectively, and the major carbapenemase genes including blaKPC, blaNDM, blaIMP, blaVIM and blaOXA-48-like genes were detected by polymerase chain reaction (PCR) as control. Results: Seventy-nine (78.2%) of isolates were found to harbour one or more carbapenemase genes by PCR, with blaKPC and blaNDM being the most common genes. OXA-48-like genes were undetectable. The coincidence rate of mCIM combined eCIM and CDT was 97.5% (77/79) and 96.2% (76/79) respectively, compared with gene detection. Both assays had a misclassification in two bla KPC+NDM -producing isolates of Klebsiella oxytoca . The sensitivity and specificity of two assays above were 100.0% vs . 95.0% and 98.4% vs . 98.4%, respectively in distinguishing serine-carbapenemase, while they were 95.1% vs . 97.6% and 100% vs . 100.0%, respectively in distinguishing metallo-carbapenemase. Conclusions: mCIM combined eCIM and the CDT are both useful tools for the reliable detection and distinguishing single serine-carbapenemase or metallo-carbapenemase, but not for mixed types.

Background: We conducted a comprehensive comparison in the sensitivity, specificity, dilution sensitivity, and precision between two immunoassay systems, Roche Elecsys Cobas e 601 and Sysmex HISCL 5000, for the detection of hepatitis B virus surface antigen (HBsAg), antibody to hepatitis C virus (anti-HCV), treponemal antibodies (anti-TP), and human immunodeficiency virus (HIV). Methods: One thousand unselected samples and 100 reserved weak reactive samples were tested by the two systems. Sensitivity and specificity were then calculated for each system. Seroconversion panels were used to assess the sensitivity in early stage detection. Dilution sensitivity was evaluated by dilution tests of several seroconversion panel samples. Evaluation of within-run and intermediate precision was conducted following EP-15A protocol. Results: The consistency rates of the two systems for the detection of four pathogens were all over 99% among unselected samples. Both Elecsys and HISCL were observed to have high sensitivity and specificity in unselected samples and weak reactive samples. Seroconversion panel tests showed that Elecsys could identify positive results earlier than HISCL in HBsAg (1 out of 4), anti-TP (1 out of 2) and HIV (1 out of 12) panels. The results of the anti-HCV panels were comparable. In dilution tests, Elecsys could detect lower concentrations than HISCL in two anti-HCV samples and one anti-TP sample. The two systems had similar performance in dilution tests of HBsAg and HIV samples. Both Elecsys and HISCL had qualified intra-assay and inter-assay precision. Conclusions: Both Elecsys and HISCL have good performance in the screening of four common bloodborne pathogens. The two systems are comparable and considered adequate for clinical use.

Background An inverse association between dietary fiber intake and depressive symptoms was reported in the general population, but this association is unstudied in midlife women. This study was designed to investigate the association of dietary fiber intake with depressive symptoms in midlife women. Methods Analyses for this cross-sectional study were performed on baseline assessment of the Study of Women's Health Across the Nation (SWAN). Linear regressions were used to examine the association of fiber intake with Center for Epidemiological Studies-Depression (CES-D) score. Logistic regression and restricted cubic spline analyses were used to examine the association between fiber intake and depressive symptoms (CES-D score ≥ 16). Results A total of 3054 midlife women in our study were stratified into premenopausal women and early perimenopausal women by menstrual bleeding patterns. In premenopausal women, dietary fiber intake was inversely associated with CES-D scores in unadjusted, age-, education-, race/ethnicity-, total family income-, BMI-, sport-, use of antidepressant-, dietary total caloric intake-, SHBG-, and FSH-adjusted linear regression model. The fully adjusted regression coefficient with 95% confidence intervals (CIs) of fiber intakes was -0.146 (-0.235, -0.058) for CES-D score. Fiber intake was inversely associated with depressive symptoms (CES-D score ≥ 16) in crude and fully adjusted logistic regression model. The fully adjusted odds ratios (ORs) with 95% CI of depressive symptoms was 0.483 (0.314-0.745) in quartile 4 compared with quartile 1 for fiber intake. However, in early perimenopausal women, dietary fiber intake was not statistically significantly associated with depressive symptoms. Conclusion Dietary fiber is inversely associated with depressive symptoms in premenopausal women, but not in early perimenopausal women.

Background : To study the association of n-3 polyunsaturated fatty acid (n-3 PUFA) intake from diet with depressive symptoms in midlife women. Methods : Data for this cross-sectional study were retrieved from baseline assessment of the Study of Women's Health Across the Nation (SWAN). Logistic regression and restricted cubic spline models were performed to examine the association n-3 PUFA intake with depressive symptoms. Results : A total of 3054 women aged 42–52 years were included in the present study. In overall midlife women, n-3 PUFA intake was not significantly associated with depressive symptoms (CES-D score ≥16) after adjustment for potential confounders. In early perimenopausal women, n-3 PUFA intake was inversely associated with depressive symptoms after adjustment for potential confounders. The fully adjusted OR with 95% CI of depressive symptoms were 0.062 (0.009–0.457) in the highest quartile (n-3 PUFAs intake was categorized by quartiles) compared with the lowest quartile for n-3 PUFA intake. Restricted cubic spline analyses showed that n-3 PUFA intake were dose–response inversely associated with depressive symptoms in early perimenopausal women. However, in premenopausal women, no significant association between depressive symptoms and n-3 PUFA intake was observed. Limitations : This was a cross-sectional study, limiting causal inferences. Conclusion : Dietary n-3 PUFA may be inversely associated with depressive symptoms in early perimenopausal women, but not in premenopausal women.

Objectives The aim of this study was to review the association of dietary intake of oleic and linoleic acids (OA and LA, respectively) with depressive symptoms in perimenopausal women. Methods This cross-sectional study used data from the Study of Women's Health Across the Nation (SWAN). Linear and logistic regressions and restricted cubic spline models were performed to examine the association of intake of OA and LA with depression. Results We included 2793 women 42 to 52 y of age in the present study. Intake of the two acids was positively associated with the Center for Epidemiologic Studies Depression Scale (CES-D) scores in unadjusted and age-, race/ethnicity-, total family income- and education-adjusted linear regression model. The fully adjusted regression coefficients were β = 0.089 and β = 0.145 for oleic and linoleic acid intake, respectively. OA and LA intake was positively associated with depressive symptoms (CES-D score ≥16) in unadjusted and age-, race/ethnicity-, total family income- and education-adjusted logistic regression model. The fully adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were 1.994 (1.298–3.063) and 1.592 (1.047–2.421) for the highest versus lowest quartile of intake of OA and LA, respectively. Conclusion Intake of OA and LA may be positively associated with depressive symptoms in perimenopausal women.

The ongoing global novel coronavirus pneumonia COVID‐19 outbreak has engendered numerous cases of infection and death. COVID‐19 diagnosis relies upon nucleic acid detection; however, currently recommended methods exhibit high false‐negative rates and are unable to identify other respiratory virus infections, thereby resulting in patient misdiagnosis and impeding epidemic containment. Combining the advantages of targeted amplification and long‐read, real‐time nanopore sequencing, herein, nanopore targeted sequencing (NTS) is developed to detect SARS‐CoV‐2 and other respiratory viruses simultaneously within 6–10 h, with a limit of detection of ten standard plasmid copies per reaction. Compared with its specificity for five common respiratory viruses, the specificity of NTS for SARS‐CoV‐2 reaches 100%. Parallel testing with approved real‐time reverse transcription‐polymerase chain reaction kits for SARS‐CoV‐2 and NTS using 61 nucleic acid samples from suspected COVID‐19 cases show that NTS identifies more infected patients (22/61) as positive, while also effectively monitoring for mutated nucleic acid sequences, categorizing types of SARS‐CoV‐2, and detecting other respiratory viruses in the test sample. NTS is thus suitable for COVID‐19 diagnosis; moreover, this platform can be further extended for diagnosing other viruses and pathogens., A detection technology, nanopore targeted sequencing (NTS), for the accurate and comprehensive detection of SARS‐CoV‐2 and other respiratory viruses within 6–10 h is developed, which is suitable for the identification of suspected cases and used as a supplementary technique for the SARS‐CoV‐2 test. NTS can also monitor mutations in the virus and the type of virus.

The ageing process is accompanied by the gradual development of chronic systemic inflammation (inflamm-ageing). Growth differentiation factor 15 (GDF15) is associated with inflammation and known to be a stress-induced factor. The present study aimed to explore the association of GDF15 with ageing. In this cross-sectional study, serum GDF15, hematological parameters, and biomedical parameters were determined in 120 healthy individuals (23-83 years old, males). Three telomere related parameters, including telomere length, telomerase activity, and the expression of human telomerase reverse transcriptase (hTERT) mRNA were also quantified. Our results showed that the older group has a higher levels of GDF15 and lower expression of hTERT mRNA, and PBMC telomerase activity (p 0.001). In individuals with high GDF15 levels, they were older, and presented with the lower level of hTERT mRNA and T/S ratio (p 0.01). Spearman correlation analysis shows that GDF15 positively correlated with age (r = 0.664, p 0.001), and negatively correlated with telomere length (r = -0.434, p 0.001), telomerase activity (r = -0.231, p = 0.012), and hTERT mRNA (r = -0.206, p = 0.024). Furthermore, in multivariate regression analysis, GDF15 levels showed a statistically significant linear and negative relationship with PBMC telomerase activity (β-coefficient = -0.583, 95% CI -1.044 to -0.122, p = 0.014), telomere length (β-coefficient = -0.200, 95% CI -0.305 to -0.094, p 0.001), and hTERT mRNA (β-coefficient = -0.207, 95% CI -0.312 to -0.102, p 0.001) after adjusting for confounders. These results support that circulating GDF15 is the potential biomarker of ageing that may influence the risk and progression of multiple ageing conditions.

The coronavirus disease 2019 (COVID-19) has already become a pandemic wherein the infection’s timely diagnosis has proven beneficial to patient treatment and disease control. Nucleic acid detection has been the primary laboratory diagnostic method for the detection of SARS-CoV-2. To ensure laboratory staff safety and quality nucleic acid testing, the Chinese Society of Laboratory Medicine formulated this consensus, based on the Chinese National Recommendations and previous literature for nucleic acid detection. A working group comprises 34 hospital professionals experience with real-time polymerase chain reactions (PCR) testing for SARS-CoV-2 drafted guidance statements during online discussions. A modified Delphi methodology was used in forming a consensus among a wider group of hospital professionals with SARS-CoV-2 detection experience. Guidance statements were developed for four categories: (I) specimen type, priority, collecting, transportation and receiving; (II) nucleic acid isolation and amplification; (III) quality control; (IV) biosafety management and decontamination. The modified Delphi voting process included a total of 29 guidance statements and final agreement. Consensus was reached after two rounds of voting. Recommendations were established for the detection of SARS-CoV-2 using real time PCR testing based on evidence and group consensus. The manuscript was evaluated against The Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II) and was developed to aid medical laboratory staff in the detection of the ribonucleic acid (RNA) of SARS-CoV-2.