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BackgroundThe estimates of several key epidemiological parameters of the COVID-19 pandemic are often based on small sample sizes or are inaccurate for various reasons. ObjectiveThe aim of this study is to obtain more robust estimates of the incubation period, serial interval, frequency of presymptomatic transmission, and basic reproduction number (R0) of COVID-19 based on a large case series. MethodsWe systematically retrieved and screened 20,658 reports of laboratory-confirmed COVID-19 cases released by the health authorities of China, Japan, and Singapore. In addition, 9942 publications were retrieved from PubMed and China National Knowledge Infrastructure (CNKI) through April 8, 2020. To be eligible, a report had to contain individual data that allowed for accurate estimation of at least one parameter. Widely used models such as gamma distributions were fitted to the data sets and the results with the best-fitting values were presented. ResultsIn total, 1591 cases were included for the final analysis. The mean incubation period (n=687) and mean serial interval (n=1015 pairs) were estimated to be 7.04 (SD 4.27) days and 6.49 (SD 4.90) days, respectively. In 40 cases (5.82%), the incubation period was longer than 14 days. In 32 infector-infectee pairs (3.15%), infectees’ symptom onsets occurred before those of infectors. Presymptomatic transmission occurred in 129 of 296 infector-infectee pairs (43.58%). R0 was estimated to be 1.85 (95% CI 1.37-2.60). ConclusionsThis study provides robust estimates of several epidemiological parameters of COVID-19. The findings support the current practice of 14-day quarantine of persons with potential exposure, but also suggest the need for additional measures. Presymptomatic transmission together with the asymptomatic transmission reported by previous studies highlight the importance of adequate testing, strict quarantine, and social distancing.

Objective To investigate the efficacy of cluster therapy in the treatment of severe intracranial infection. Methods The clinical data of 43 patients with severe intracranial infection in Shenzhen University General Hospital and Shenzhen Second People's Hospital from July 2020 to June 2023 were retrospectively analyzed. Patients with intracranial infection were treated with cluster therapy: systemic broad-spectrum antibiotics were used at first; cerebrospinal fluid was obtained by multiple drainage routes for routine and biochemical testing, and then cultured and undertook next - generation sequencing (NGS); head/chest CT and brain MRI plain and enhanced scan were performed; after the NGS results were reported, precisely adjust the drug treatment according to the infection pathogen; sequentially use different drainage protocols of infected cerebrospinal fluid. Patients with severe intraventricular inflammation were treated with ventriculoscope (flexible endoscope) irrigation and fistula; cerebrospinal fluid, microbial culture and whole blood test for infection indicators were regularly extracted for laboratory test, and the type and dosage of antibiotics were adjusted one week after the indicators returned to normal, and the treatment effect of patients was judged comprehensively according to blood, cerebrospinal fluid, imaging results and clinical signs of infection. Results Sixteen patients were administered a broad - spectrum antibiotic regimen consisting of meropenem and vancomycin. Cerebrospinal fluid analysis revealed that 12 cases (27.91%) were culture-positive for microbial organisms (bacteria, fungi, viruses), while 35 cases (81.40%) yielded positive results in NGS. Upon identification of the pathogen via NGS, 15 cases were switched to targeted, sensitive antibiotics, with 12 cases exhibiting notable improvements in symptoms, and 3 cases demonstrating no significant changes. A total of 27 patients (62.79%) underwent surgical intervention, including 7 patients (16.28%) who underwent abscess puncture drainage, 6 patients (13.95%) who received Ommaya sac implantation, 11 patients (25.58%) who underwent external ventricular drainage (8 of whom also underwent ventriculoscopic irrigation and ventriculostomy), and 3 patients (6.98%) who were treated with lumbocisterna drainage. The length of hospitalization was 30 (19, 57) d. The 37 cases (86.05%) were successfully cured, while 6 cases (13.95%) died. Conclusions The cure rate of patients with severe intracranial infection was significantly improved after cluster therapy, and early initiation of cluster therapy can significantly improve the prognosis of patients, which is worthy of clinical application.

Abstract Background This multicenter, double-blinded, randomized controlled trial (RCT) aims to assess the impact of an artificial intelligence (AI)-based model on the efficacy of intracranial aneurysm detection in CT angiography (CTA) and its influence on patients’ short-term and long-term outcomes. Methods Study design: Prospective, multicenter, double-blinded RCT. Settings: The model was designed for the automatic detection of intracranial aneurysms from original CTA images. Participants: Adult inpatients and outpatients who are scheduled for head CTA scanning. Randomization groups: (1) Experimental Group: Head CTA interpreted by radiologists with the assistance of the True-AI-integrated intracranial aneurysm diagnosis strategy (True-AI arm). (2) Control Group: Head CTA interpreted by radiologists with the assistance of the Sham-AI-integrated intracranial aneurysm diagnosis strategy (Sham-AI arm). Randomization: Block randomization, stratified by center, gender, and age group. Primary outcomes: Coprimary outcomes of superiority in patient-level sensitivity and noninferiority in specificity for the True-AI arm to the Sham-AI arm in intracranial aneurysms. Secondary outcomes: Diagnostic performance for other intracranial lesions, detection rates, workload of CTA interpretation, resource utilization, treatment-related clinical events, aneurysm-related events, quality of life, and cost-effectiveness analysis. Blinding: Study participants and participating radiologists will be blinded to the intervention. Sample size: Based on our pilot study, the patient-level sensitivity is assumed to be 0.65 for the Sham-AI arm and 0.75 for the True-AI arm, with specificities of 0.90 and 0.88, respectively. The prevalence of intracranial aneurysms for patients undergoing head CTA in the hospital is approximately 12%. To establish superiority in sensitivity and noninferiority in specificity with a margin of 5% using a one-sided α = 0.025 to ensure that the power of coprimary endpoint testing reached 0.80 and a 5% attrition rate, the sample size was determined to be 6450 in a 1:1 allocation to True-AI or Sham-AI arm. Discussion The study will determine the precise impact of the AI system on the detection performance for intracranial aneurysms in a double-blinded design and following the real-world effects on patients’ short-term and long-term outcomes. Trial registration This trial has been registered with the NIH, U.S. National Library of Medicine at ClinicalTrials.gov, ID: NCT06118840 . Registered 11 November 2023.

Stroke has emerged as the primary cause of disability and death globally in recent years. Intracerebral hemorrhage (ICH), a particularly severe kind of stroke, is occurring in an increasing number of people. The two main clinical treatments for ICH now in use are conservative pharmaceutical therapy and surgical intervention, both of which have risks and drawbacks. Consequently, it is crucial to look into the pathophysiology of ICH and consider cutting-edge therapeutic approaches. Recent research has revealed that pyroptosis is a newly identified type of cell death distinguished by the break of the cell membrane and the discharge of pro-inflammatory substances through different routes. Following ICH, glial cells experience pyroptosis, which worsens neuroinflammation. Hence, the onset and progression of ICH are strongly linked to pyroptosis, which is facilitated by different inflammasomes. It is essential to conduct a comprehensive investigation of ICH damage processes and uncover new targets for treatment. The impact and function of pyroptosis in ICH, as well as the activation and regulation of inflammasomes and their mediated pyroptosis pathways will be fully discussed in this review.

Rapid industrial development has resulted in serious pollutants to the urban transitional areas. But less is known on the spatial distribution and ecological risk of heavy metals (HMs) caused by regional industrialization. In present study, soils, bedrocks and plant tissues were collected in the industrial transitional areas of Chang-Zhu-Tan Urban Agglomeration (CUA) of China. Results indicated that HMs contamination in the CUA was closely connected to the distribution of regional industries, and the pollution of HMs mainly focused on the exceed of cadmium (Cd: 48.2 %), mercury (Hg: 10.8 %) and lead (Pb: 11.5 %), which presented a diffusion trend towards the surrounding environment with the industrial center as the starting point. Additionally, the structural equation model (SEM) demonstrated that the other pollutants accompanied by metals discharge might further exacerbate the ecological risk of HMs. In the detected soil properties, Soil total organic carbon (TOC) content was the key factor affecting the Hg and Pb migration, while the distribution of Cd was more affected by the soil pH. Despite HMs contamination in the intersection area of CUA was relatively light. Taking the industrial distribution in the CUA into consideration, residents in the industrial central areas of Xiangtan (XT) and Zhuzhou (ZZ) cities might have a significant higher risk of HMs exposure. Fortunately, the application of organic fertilizers may have an effective limiting effect on the current Cd migration in the CUA region.

Hong Kong controlled the spread of COVID-19 caused by the SARS-CoV-2 Delta variant with stringent border control, effective contact tracing, and social distancing measures; only a small number of local [...]

Abstract Purpose To investigate the health-related quality of life (HRQoL) and subjective well-being (SWB) of children aged 9–12 years in eastern China, and examine concordance within child self-reported and parent proxy-assessed. Methods Data was collected from 9 to 12 years old children (including their parents) in Shandong Province in 2018. Participants self-completed a hard-copy questionnaire including Child Health Utility 9D (CHU9D), Pediatric Quality of Life Inventory (PedsQL)™ 4.0 Short Form 15 Generic Core Scales (hereafter the PedsQL™), Student’s Life Satisfaction Scale (SLSS), as well as information on socio-demographic characteristics and self-report health status. Spearman’s correlation coefficients and the difference between sub-groups were conducted to assess and compare the agreement on HRQoL and SWB instruments. Exploratory factor analysis (EFA) was used to ascertain the number of unique underlying latent factors that were associated with the items covered by the two generic HRQoL and the SWB instruments. The concordance of child self-reported and parent proxy-assessed was analyzed using weighted kappa coefficient and Bland-Altman plots. Results A total of 810 children and 810 parents were invited to participate in the survey. A valid sample of 799 (98.6%) children and 643 (79.4%) parents completed the questionnaire. The child self-reported mean scores were CHU9D = 0.87, PedsQL™ = 83.47, and SLSS = 30.90, respectively. The parent proxy-assessed mean scores were PedsQL™ = 68.61 and SLSS = 31.23, respectively. The child self-reported PedsQL™ was moderately correlated with the CHU9D (r = 0.52). There was a weak correlation between CHU9D and SLSS (r = 0.27). The EFA result found 3 factors whilst seven SLSS items grouped into a standalone factor (factor 3), and the nine dimensions of CHU9D shared two common factors with the PedsQL™ (factor 1 and factor 2). A low level of concordance was observed across all comparisons and in all domains (weighted kappa

Since its inception by Dr. Kabat-Zinn, Mindfulness-Based Stress Reduction (MBSR) has led to various mindfulness interventions and gained positive feedback in many fields. This paper extracts the shared mindfulness mechanisms emphasized by Kabat-Zinn’s MBSR and the Buddhist “Four Foundations of Mindfulness,” assesses their applicability to mindfulness education, and compares their differences in objectives and skills, serving as a reference for the future development of mindfulness education in Taiwan. The study finds that mindfulness education in Taiwan mainly follows Kabat-Zinn’s guidance, focusing on basic practices of “body, feelings, and mind,” with less involvement in higher-level psychological insights. In the aspect of “dharmas,” Kabat-Zinn incorporated Zen concepts, a practice that has seen limited attention and utilization in Taiwan, which also rarely addresses goal-oriented elements. This paper suggests that mindfulness education in Taiwan should emphasize the guidance of “impermanence and non-self” and the systematic thinking of “dharmas,” striving to present these concepts in accessible language to mitigate concerns over religiosity. To enhance mindfulness education in Taiwan, two key areas should be addressed: first, the scope of mindfulness research and practice should expand to include “higher-level psychological qualities”; second, government authorities should consolidate resources to establish a mindfulness research and teacher training center, aiming to develop a comprehensive and practical pedagogical framework. Only with solid academic research and institutional support can mindfulness education in Taiwan be truly strengthened, thereby enhancing public well-being and promoting holistic development.

We propose and demonstrate a silicon photonic optical phased array (OPA) with ultra-low sidelobe level. The arbitrary ratio power splitters (ARPSs) are introduced to manipulate the amplitude distribution between different channels and suppress the sidelobe level. A 32-channel OPA has been designed and demonstrated with the amplitude distribution determined by preferred Chebyshev method. The experimental results indicate that the sidelobe suppression ratio (SLSR) can be up to 25.3 dB. The measured field of view (FOV) is 84° × 13° with divergence of 2.8° × 1.7°. Furthermore, the frequency-modulated continuous-wave (FMCW) based ranging has been also demonstrated experimentally by utilizing the OPA as the transmitter.

This paper proposes a new method for service restoration of distribution network with the support of transportable power sources (TPSs) and repair crews (RCs). Firstly, a coupling model of distribution networks and vehicle routing of TPSs and RCs is proposed, where the TPSs serve as emergency power supply sources, and the RCs are used to repair the faulted lines. Considering the uncertainty of traffic congestion, the probability distribution of the travel time spent on each road is derived based on the Nesterov user equilibrium model, and a two-stage stochastic program is formulated to determine the optimal routings of TPSs and RCs. To efficiently solve the proposed stochastic mixed-integer linear program (MILP), a two-phase scenario reduction method is then developed to scale down the problem size, and an adaptive progressive hedging algorithm is used for an efficient solution. The effectiveness of the proposed methods and algorithms has been illustrated in a modified IEEE 33-bus system.

An optical phased array (OPA) with 2-D circular sparse array aperture has been proposed and demonstrated in the silicon integrated photonic platform. The sparse distribution of the antenna array can realize no grating lobes in 2-D full field of view (FOV). To achieve fast and accurate phase calibration for OPA, an improved rotating element electric field vector algorithm based on golden section search method (GSS-REV) has also been proposed and verified. The 32-element antenna sparse distribution of the proposed OPA is designed and fabricated. A far-field beam steering measurement across 20° × 20° range features the side lobe suppression ratio (SLSR) of larger than 4.81 dB and a full width at half-maximum (FWHM) of approximately 0.63° × 0.59°. The resolvable points are derived to be ∼1076. The OPA chip has also been demonstrated on range measurement with frequency-modulated continuous-wave (FMCW) system.