Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were based on information from the general population. Limited data are available for pregnant women ...with COVID-19 pneumonia. This study aimed to evaluate the clinical characteristics of COVID-19 in pregnancy and the intrauterine vertical transmission potential of COVID-19 infection.
Clinical records, laboratory results, and chest CT scans were retrospectively reviewed for nine pregnant women with laboratory-confirmed COVID-19 pneumonia (ie, with maternal throat swab samples that were positive for severe acute respiratory syndrome coronavirus 2 SARS-CoV-2) who were admitted to Zhongnan Hospital of Wuhan University, Wuhan, China, from Jan 20 to Jan 31, 2020. Evidence of intrauterine vertical transmission was assessed by testing for the presence of SARS-CoV-2 in amniotic fluid, cord blood, and neonatal throat swab samples. Breastmilk samples were also collected and tested from patients after the first lactation.
All nine patients had a caesarean section in their third trimester. Seven patients presented with a fever. Other symptoms, including cough (in four of nine patients), myalgia (in three), sore throat (in two), and malaise (in two), were also observed. Fetal distress was monitored in two cases. Five of nine patients had lymphopenia (<1·0 × 10⁹ cells per L). Three patients had increased aminotransferase concentrations. None of the patients developed severe COVID-19 pneumonia or died, as of Feb 4, 2020. Nine livebirths were recorded. No neonatal asphyxia was observed in newborn babies. All nine livebirths had a 1-min Apgar score of 8–9 and a 5-min Apgar score of 9–10. Amniotic fluid, cord blood, neonatal throat swab, and breastmilk samples from six patients were tested for SARS-CoV-2, and all samples tested negative for the virus.
The clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for non-pregnant adult patients who developed COVID-19 pneumonia. Findings from this small group of cases suggest that there is currently no evidence for intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia in late pregnancy.
Hubei Science and Technology Plan, Wuhan University Medical Development Plan.
Purpose
Using a multi-level perspective, the purpose of this paper is to investigate impact of transformational leadership on employees’ creative process engagement and mediating roles of intrinsic ...motivation, task complexity and innovation support in the process of influence.
Design/methodology/approach
This study follows a quantitative method. Using a multi-item survey instrument, a total of 400 questionnaires were distributed among employees of small and medium enterprises registered with the Chittagong Chamber of Commerce and Industry in Bangladesh. Collected data were analyzed using structural equation model as well as factor analysis and path analysis to test the hypotheses and to assess the moderating and mediating effects of the variables.
Findings
The findings reveal that transformational leadership has a significant impact on employees’ creative process engagement. The study further shows that task complexity and support for innovation moderate the relationship between transformational leadership and employees’ creative process engagement.
Research limitations/implications
Based on the premises of interactionist perspectives on creativity, this study integrates multi-level variables to investigate leaders’ influences on followers’ creative process engagement. This study contributes to the existing literature by providing empirical evidence on influence of transformational leadership on employees’ creative process engagement as well as the impact of both individual- and organizational-level variables.
Originality/value
The study adopts a distinct model comprising five different variables to investigate creative process engagement from a multi-level perspective, i.e., creative process engagement and intrinsic motivation at the individual level, task complexity at the unit level, and support for innovation and leadership at the organizational level. This integrated model of using predictors from multiple levels supports the theoretical assumptions that creative process engagement results from the interaction of individual-, group- and organizational-level factors.
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•The CoFe2O4/porous carbon materials were first fabricated from waste paper.•The bimetallic FeCo-MOFs were in-situ grown on CoFe2O4/porous carbon skeleton.•The magnetic carbon-based ...FeCo-MOF composite exhibited maximum capture capacity of 909 mg g−1 for tetracycline.•The in-situ shaping strategy of FeCo-MOF can be applied to biomass-derived magnetic carbon carrier.•The tetracycline-adsorbed FeCo-MOF/porous carbon can be used for fruit preservation.
Magnetic carbon materials as the fascinating scavenger have been used for the purification of antibiotic wastewater. However, a majority of the reported magnetic carbon adsorbents suffer from the poor adsorption capacity and costly preparation costs. Herein, we report an in-situ growth of bimetallic FeCo-metal organic frameworks (MOFs) on waste paper-derived CoFe2O4/porous carbon via a hydrothermal strategy for reinforced clearance of tetracycline. The adsorption properties and mechanisms were systematically explored. Results revealed that the adsorption isotherms obeyed the Langmuir model, and the pseudo-second-order kinetics model could be well used to describe the current adsorption behavior. The maximum Langmuir adsorption capacity of FeCo-MOF@CoFe2O4/porous carbon toward tetracycline was calculated as 909 mg g−1, which was significantly higher than that of other reported adsorbents. The ascendant capture property of the current adsorbent was presented under a wide pH range (5.0–12.0) and had excellent resistance to humic acid. In addition, the proposed coating method can also be applied to in-situ grow FeCo-MOF on biomass-derived magnetic porous carbon to enhance removal of tetracycline. Interestingly, the tetracycline adsorbed FeCo-MOF@CoFe2O4/porous carbon as a sustainable additive was further proved to be used for fruit preservation. Overall, this work provided a new research direction for in-situ architecture of magnetic carbon-based bimetallic MOF materials to treat antibiotic sewage and fruit preservation.
The risk associated with container shipping has been a major concern in recent decades. This study presents three major risk frameworks to systematically and inclusively explore and validate ...container operational risk scales based on risk factors derived from the extant literature. The three risk frameworks identified are risks related to information flow, risks related to physical flow, and risks related to payment flow. Each risk factor is grouped into sub-factors (dimensions), three factors for information flow, two factors for physical flow, and two factors for payment flow. The study uses Ethiopia as a case study and employed both qualitative and quantitative research methods. An interview survey was conducted to explore additional risk factors and validate the identified risk factors in container shipping, and a questionnaire survey was then accompanied to collect the relevant data. A pairwise comparison chart (PCC) was employed to rank the risk dimensions. The results showed that the container operational risk model is satisfactory by employing exploratory and confirmatory factor analysis. Furthermore, the PCC result indicates that risk of loss or damage of goods/assets, payment delay, and decrease in or total loss of payment were ranked first, second, and third, respectively, and consequently the most significant dimensions of the risk factors. This study provides a reliable and valid scale for measuring container operational risk in container shipping companies. It also unlocks future works for using the identified risk factors as guidelines for researchers and experts to design and develop container operational risk dimensions.
This study investigates the impact of supervisor support on research innovation pursuit among international doctoral students in China. A total of 120 international doctoral students’ responses were ...employed through random sampling from the three business schools of Chinese public universities. The data were analyzed using the partial least squares technique, a second-generation statistical software package for structural equation modeling. The results revealed that supervisor support significantly affects students’ research innovation endeavors. The study also suggests that supportive supervision is necessary for fostering citizenship behavior, creativity and innovation pursuit among international doctoral students. The findings of this pioneering study will help higher education administrators, and policymakers revisit existing doctoral program management and deliveries processes and encourage academic supervisors to modify guidance and mentoring procedures for doctoral students.
In reinforcement learning, a promising direction to avoid online trial-and-error costs is learning from an offline dataset. Current offline reinforcement learning methods commonly learn in the policy ...space constrained to in-support regions by the offline dataset, in order to ensure the robustness of the outcome policies. Such constraints, however, also limit the potential of the outcome policies. In this paper, to release the potential of offline policy learning, we investigate the decision-making problems in out-of-support regions directly and propose offline Model-based Adaptable Policy LEarning (MAPLE). By this approach, instead of learning in in-support regions, we learn an adaptable policy that can adapt its behavior in out-of-support regions when deployed. We give a practical implementation of MAPLE via meta-learning techniques and ensemble model learning techniques. We conduct experiments on MuJoCo locomotion tasks with offline datasets. The results show that the proposed method can make robust decisions in out-of-support regions and achieve better performance than SOTA algorithms.
Abstract
Aim
To compare the safety and effects of unrestricted visiting policies (UVPs) and restricted visiting policies (RVPs) in intensive care units (ICUs) with respect to outcomes related to ...delirium, infection, and mortality.
Methods
MEDLINE, Cochrane Library, Embase, Web of Science, CINAHL, CBMdisc, CNKI, Wanfang, and VIP database records generated from their inception to 22 January 2022 were searched. Randomized controlled trials and quasi-experimental studies were included. The main outcomes investigated were delirium, ICU-acquired infection, ICU mortality, and length of ICU stay. Two reviewers independently screened studies, extracted data, and assessed risks of bias. Random‑effects and fixed-effects meta‑analyses were conducted to obtain pooled estimates, due to heterogeneity. Meta-analyses were performed using RevMan 5.3 software. The results were analyzed using odds ratios (ORs), 95% confidence intervals (CIs), and standardized mean differences (SMDs).
Results
Eleven studies including a total of 3741 patients that compared UVPs and RVPs in ICUs were included in the analyses. Random effects modeling indicated that UVPs were associated with a reduced incidence of delirium (OR = 0.4, 95% CI 0.25–0.63,
I
2
= 71%,
p
= 0.0005). Fixed-effects modeling indicated that UVPs did not increase the incidences of ICU-acquired infections, including ventilator-associated pneumonia (OR = 0.96, 95% CI 0.71–1.30,
I
2
= 0%,
p
= 0.49), catheter-associated urinary tract infection (OR 0.97, 95% CI 0.52–1.80,
I
2
= 0%,
p
= 0.55), and catheter-related blood stream infection (OR = 1.15, 95% CI 0.72–1.84,
I
2
= 0%,
p
= 0.66), or ICU mortality (OR = 1.03, 95% CI 0.83–1.28,
I
2
= 49%,
p
= 0.12). Forest plotting indicated that UVPs could reduce the lengths of ICU stays (SMD = − 0.97, 95% CI − 1.61 to 0.32,
p
= 0.003).
Conclusion
The current meta-analysis indicates that adopting a UVP may significantly reduce the incidence of delirium in ICU patients, without increasing the risks of ICU-acquired infection or mortality. Further large-scale, multicenter studies are needed to confirm these indications.
Imitation learning aims at recovering expert policies from limited demonstration data. Generative Adversarial Imitation Learning (GAIL) employs the generative adversarial learning framework for ...imitation learning and has shown great potentials. GAIL and its variants, however, are found highly sensitive to hyperparameters and hard to converge well in practice. One key issue is that the supervised learning discriminator has a much faster learning speed than the reinforcement learning generator, making the generator gradient vanishing. Although GAIL is formulated as a zero-sum adversarial game, the ultimate goal of GAIL is to learn the generator, thus the discriminator should play the role more like a teacher rather than a real opponent. Therefore, the learning of the discriminator should consider how the generator could learn. In this paper, we disclose that enhancing the gradient of the generator training is equivalent to increase the variance of the fake reward provided by the discriminator output. We thus propose an improved version of GAIL, GAIL-VR, in which the discriminator also learns to avoid generator gradient vanishing through regularization of the fake rewards variance. Experiments in various tasks, including locomotion tasks and Atari games, indicate that GAIL-VR can improve the training stability and imitation scores.
Bortezomib is a frequently used chemotherapeutic drug for the treatment of multiple myeloma and other nonsolid malignancies. Accumulating evidence has demonstrated that bortezomib-induced persistent ...pain serves as the most frequent reason for treatment discontinuation.
The von Frey test was performed to evaluate neuropathic pain behavior, and real-time quantitative reverse transcription polymerase chain reaction, chromatin immunoprecipitation, western blot, immunohistochemistry, and small interfering RNA were performed to explore the molecular mechanisms in adult male Sprague-Dawley rats.
We found that application of bortezomib significantly increased the expression of NALP1 protein and mRNA levels in spinal dorsal horn neurons, and intrathecal application of NALP1 siRNA attenuated the bortezomib-induced mechanical allodynia. In addition, bortezomib also decreased the SIRT1 expression, and treatment with SIRT1 activator resveratrol ameliorated the NALP1 upregulation and mechanical allodynia induced by bortezomib. Meanwhile, knockdown of SIRT1 using the SIRT1 siRNA induced the NALP1 upregulation in dorsal horn and mechanical allodynia in normal animal. These results suggested that reduction of SIRT1 induced the NALP1 upregulation in dorsal horn neurons, and participated in bortezomib-induced mechanical allodynia. Importantly, we found that the binding of SIRT1 and NALP1 promoter region did not change before and after bortezomib treatment, but SIRT1 downregulation increased p-STAT3 expression. Furthermore, the activation of STAT3 enhanced the recruitment of p-STAT3 to the Nalp1 gene promoter, which increased the acetylation of histone H3 and H4 in NALP1 promoter regions and epigenetically upregulated NALP1 expression in the rodents with bortezomib treatment.
These findings suggested a new epigenetic mechanism for NALP1 upregulation involving SIRT1 reduction and subsequent STAT3-mediated histone hyperacetylation in NALP1 promoter region in dorsal horn neurons, which contributed to the bortezomib-induced mechanical allodynia.
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