Since December 2019, the 2019 coronavirus disease (COVID-19) has expanded to cause a worldwide outbreak that more than 600,000 people infected and tens of thousands died. To date, the clinical ...characteristics of COVID-19 patients in the non-Wuhan areas of Hubei Province in China have not been described.
We retrospectively analyzed the clinical characteristics and treatment progress of 91 patients diagnosed with COVID-19 in Jingzhou Central Hospital.
Of the 91 patients diagnosed with COVID-19, 30 cases (33.0%) were severe and two patients (2.2%) died. The severe disease group tended to be older (50.5 vs. 42.0 years; p = 0.049) and have more chronic disease (40% vs. 14.8%; p = 0.009) relative to mild disease group. Only 73.6% of the patients were quantitative polymerase chain reaction (qPCR)-positive on their first tests, while typical chest computed tomography images were obtained for each patient. The most common complaints were cough (n = 75; 82.4%), fever (n = 59; 64.8%), fatigue (n = 35; 38.5%), and diarrhea (n = 14; 15.4%). Non-respiratory injury was identified by elevated levels of aspartate aminotransferase (n = 18; 19.8%), creatinine (n = 5; 5.5%), and creatine kinase (n = 14; 15.4%) in laboratory tests. Twenty-eight cases (30.8%) suffered non-respiratory injury, including 50% of the critically ill patients and 21.3% of the mild patients.
Overall, the mortality rate of patients in Jingzhou was lower than that of Wuhan. Importantly, we found liver, kidney, digestive tract, and heart injuries in COVID-19 cases besides respiratory problems. Combining chest computed tomography images with the qPCR analysis of throat swab samples can improve the accuracy of COVID-19 diagnosis.
Emergency situations often demand high-quality decision-making results because a wrong decision may cause incalculable losses. Therefore, in such cases, the views of all decision makers should be ...fully considered, especially minority opinions, and the interests of all parties should be well balanced. Additionally, an emergency decision often has to be made within a short period of time, which may require the rational treatment of non-cooperative behaviors. Classical consensus models mainly focus on group decision-making problems where a small number of decision makers participate. However, an emergency decision often involves many stakeholders, and thus requires the participation of larger number of decision makers. In this paper, an improved consensus model is proposed for large-group emergency decision making, and an approach to managing minority opinions and non-cooperative behaviors is described. By simulating the consensus reaching process, a method is presented to determine two important parameters: the minimum group consensus threshold and the maximum number of iterations. Finally, an illustrative example proves that the proposed consensus model is feasible and effective, and a detailed discussion highlights the advantages of this model for managing large-group emergency decision-making problems.
•A consensus model for large-group emergency decision making is developed.•The model is designed to manage minority opinions and non-cooperative behaviors.•A method is presented for getting the two required parameters.•We put forward the concept of comprehensive adjustment coefficient.•A discussion is conducted to show the advantage of the proposed consensus model.
Horizontal transfer of transposable elements (HTT) is an important process shaping eukaryote genomes, yet very few studies have quantified this phenomenon on a large scale or have evaluated the ...selective constraints acting on transposable elements (TEs) during vertical and horizontal transmission. Here we screen 307 vertebrate genomes and infer a minimum of 975 independent HTT events between lineages that diverged more than 120 million years ago. HTT distribution greatly differs from null expectations, with 93.7% of these transfers involving ray-finned fishes and less than 3% involving mammals and birds. HTT incurs purifying selection (conserved protein evolution) on all TEs, confirming that producing functional transposition proteins is required for a TE to invade new genomes. In the absence of HTT, DNA transposons appear to evolve neutrally within genomes, unlike most retrotransposons, which evolve under purifying selection. This selection regime indicates that proteins of most retrotransposon families tend to process their own encoding RNA (cis-preference), which helps retrotransposons to persist within host lineages over long time periods.
•A novel mechanism of addressing non-cooperative behaviors is presented.•A confidence consensus-based model for large-scale group decision making is built.•We conclude the advantages and ...disadvantages of different consensus measures.•Analysis of the impact of thresholds on consensus reaching processes is presented.•Detailed comparative analysis is presented to further explain the proposed model.
Because of the complexity of real-world problems, large-scale group decision making has become a research topic of great interest in the field of decision science. Differences of opinion in a large group are highly likely. Sometimes, decision makers are unwilling to adjust their opinions to promote consensus. It is hence necessary to establish a consensus model for the effective management of opinion differences and non-cooperative behaviors. More importantly, the credibility of the adjustment information must be ensured. In this paper, we present a confidence consensus-based model for large-scale group decision making that provides a novel approach to addressing non-cooperative behaviors. First, some new concepts are proposed, including the collective adjustment suggestion and rationality degree. Then, we combine the rationality and non-cooperation of the adjustment information to construct the concept of a confidence level. This confidence level measures the impartiality and objectivity of the adjustment information and is the basis for managing non-cooperative behaviors. We then establish a mechanism for addressing non-cooperative behaviors. Finally, we present a case study that illustrates that the proposed model is feasible and effective. A comparative analysis reveals the features and advantages of this model for managing large-scale group decision making.
The synthesis of steroid hormones produces wastewater that is difficult to manage and characterize due to its complex components and high levels of toxicity and bio-refractory compounds. In this ...work, interior micro-electrolysis (IME) and Fenton oxidation–coagulation (FOC) were investigated as wastewater pretreatment processes in combination with biological treatments using a hydrolysis acidification unit (HA) and two-stage biological contact oxidation (BCO) in laboratory and field experiments. In laboratory experiments with an average initial COD load of about 15,000 mg/L, pH of 4, Fe–C/water (V/V) ratio of 1:1, air/water ratio of 10, and reaction time of 180 min, IME achieved a COD removal efficiency of 31.8% and a 1.7-fold increase in the BOD5/COD (B/C) ratio of wastewater. The Fe2+ concentration of 458.5 mg/L in the IME effluent meets the requirements of the Fenton oxidation (FO) process. FOC further reduced the COD with an efficiency of 30.1%, and the B/C ratio of the wastewater reached 0.59. Excitation-emission matrix (EEM) analysis showed that complex higher molecular weight organic compounds in the wastewater were degraded after the pretreatment process. In addition, a field experiment with a continuous flow of 96 m3/d was conducted for over 90 d. The combined process system operated steadily, though the Fe–C fillings should be soaked in a sulfuric acid solution (5‰) for 12 h to recover activity every two weeks. The COD and BOD5 concentrations in the final effluent were less than 90 mg/L and 15 mg/L, respectively.
•IME–FO lab-scale tests and IME–FOC–biological treatment full-scale experiments were conducted.•Optimal parameters were obtained and the BOD5/COD of wastewater improved 2.8 times after pretreatment.•IME effluent with appropriate pH and high Fe2+ concentration was suitable for the FO process.•The combined system had a high pollutant removal efficiency and good operating stability.
This study compares the electrocatalytic activity of nitrogen-doped carbon nanotubes (NCNTs) with multiwalled carbon nanotubes (MWCNTs). Results indicate that NCNTs possess a marked electrocatalytic ...activity toward oxygen reduction reaction (ORR) by an efficient four-electron process in the alkaline condition, while the process of MWCNTs is through a two-electron pathway. Meanwhile, NCNTs show a very attractive electrochemical performance for the redox reaction of hydrogen peroxide (H2O2) and could be employed as a H2O2 sensor at a low potential of +0.3 V. The sensitivity of the NCNT-based biosensor reaches 24.5 microA/mM, more than 87 times that of the MWCNT-based one. Moreover, NCNTs exhibit striking analytical stability and reproducibility, which enables a reliable and sensitive determination of glucose by monitoring H2O2 produced by an enzymatic reaction between glucose oxidase/glucose or choline oxidase/choline at +0.3 V without the help of the electron mediator. The NCNT-based glucose biosensor has a linear range from 2 to 140 microM with an extremely high sensitivity of 14.9 microA/mM, and the detection limit is estimated to be 1.2 microM at a signal-to-noise ratio of 3. The results indicate that the NCNTs are good nanostructured materials for potential application in biosensors.
Significant dysbiosis occurs in the gut microbiome of stroke patients. Condensing these broad, complex changes into one index would greatly facilitate the clinical usage of gut microbiome data. Here, ...we formulated a gut microbiota index in patients with acute ischemic stroke based on their gut microbiota dysbiosis patterns and tested whether the index was correlated with brain injury and early outcome.
A total of 104 patients with acute ischemic stroke and 90 healthy individuals were recruited, and their gut microbiotas were compared and to model a Stroke Dysbiosis Index (SDI), which representing stroke-associated dysbiosis patterns overall. Another 83 patients and 70 controls were recruited for validation. The association of SDI with stroke severity (National Institutes of Health Stroke Scale NIHSS score) and outcome (modified Rankin scale mRS score: favorable, 0-2; unfavorable, >2) at discharge was also assessed. A middle cerebral artery occlusion (MCAO) model was used in human flora-associated (HFA) animals to explore the causal relationship between gut dysbiosis and stroke outcome.
Eighteen genera were significantly different between stroke patients and healthy individuals. The SDI formula was devised based on these microbiome differences; SDI was significantly higher in stroke patients than in healthy controls. SDI alone discriminated stroke patients from controls with AUCs of 74.9% in the training cohort and 84.3% in the validation cohort. SDI was significantly and positively correlated with NIHSS score on admission and mRS score at discharge. Logistic regression analysis showed that SDI was an independent predictor of severe stroke (NIHSS ≥8) and early unfavorable outcome (mRS >2). Mice receiving fecal transplants from high-SDI patients developed severe brain injury with elevated IL-17
γδ T cells in gut compared to mice receiving transplants from low-SDI patients (all
< 0.05).
We developed an index to measure gut microbiota dysbiosis in stroke patients; this index was significantly correlated with patients' outcome and was causally related to outcome in a mouse model of stroke. Our model facilitates the potential clinical application of gut microbiota data in stroke and adds quantitative evidence linking the gut microbiota to stroke.
•Four punishment approaches to addressing noncooperative behavior are summarized.•An independent consensus-reaching model considering noncooperative behavior is built.•A mixed consensus-reaching ...model considering noncooperative behavior is proposed.•A novel weighting method is developed to calculate the weights of the clusters.
Large-scale group decision-making (LSGDM) has been widely studied to address increasingly complex decision-making problems. The consensus-reaching process is usually designed to reduce differences between decision-makers and achieve high-consensus decision results. Opinion adjustment is a good solution for promoting consensus, but there are always some decision-makers who refuse to adjust or make small compromises. Many noncooperative behaviors may exist in the consensus-reaching process. Traditional consensus-reaching models dealing with noncooperative behaviors focus on situations where only one decision-maker modifies his or her opinion in each consensus iteration. However, some, or even all, decision-makers may adjust their opinions in one iteration, especially at the beginning. In this study, a mixed consensus-reaching model for managing noncooperative behaviors is proposed. We first develop a novel method to calculate the weights of decision-makers in LSGDM environments. An independent consensus-reaching model is then put forward to address situations where multiple decision-makers modify their opinions in each iteration. By combining this independent consensus model with traditional consensus models, a mixed consensus model is constructed. Finally, a case study is used to show the feasibility and applicability of the proposed model, and a comparative analysis illustrates its advantages for managing noncooperative behaviors in LSGDM situations.
Efficient biosynthesis of microbial bioactive natural products (NPs) is beneficial for the survival of producers, while self‐protection is necessary to avoid self‐harm resulting from ...over‐accumulation of NPs. The underlying mechanisms for the effective but tolerable production of bioactive NPs are not well understood. Herein, in the biosynthesis of two fungal polyketide mycotoxins aurovertin E (1) and asteltoxin, we show that the cyclases in the gene clusters promote the release of the polyketide backbone, and reveal that a signal peptide is crucial for their subcellular localization and full activity. Meanwhile, the fungus adopts enzymatic acetylation as the major detoxification pathway of 1. If intermediates are over‐produced, the non‐enzymatic shunt pathways work as salvage pathways to avoid excessive accumulation of the toxic metabolites for self‐protection. These findings provided new insight into the interplay of efficient backbone release and multiple detoxification strategies for the production of fungal bioactive NPs.
The biosynthesis of aurovertins involves a coordinated strategy for the tolerable production of fungal mycotoxins. A cyclase promotes the release of the polyketide backbone, while enzymatic acetylation functions as the major detoxification pathway, and non‐enzymatic shunt pathways function as salvage routes to avoid excessive accumulation of the toxic metabolites.
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