Role of 5G-powered remote robotic ultrasound during the COVID-19 outbreak: insights from two cases

The 2019 Novel Coronavirus disease (COVID-19) broke out in Wuhan, China in December 2019 and spread throughout the world. Early screening and early diagnosis play key roles in prevention and management of the epidemic. Attention should also be paid to the infection of health workers and shortage of medical resources in high-risk areas. Here, we report two cases of patients diagnosed with COVID-19 and evaluated by robotic ultrasound based on 5G-powered technology 700 km east of Wuhan. We here show the advantages of this kind of remote ultrasound scan, which could become a method for the diagnosis and assessment of COVID-19.

[Clinicopathological characteristics of NTRK-rearranged mesenchymal tumors in childhood]

Objective: To investigate the clinical and pathological features of pediatric NTRK-rearranged tumors. Methods: Four NTRK-rearranged soft tissue tumors and one renal tumor at Shanghai Children's Medical Center, Shanghai Jiaotong University and Singapore KK Women's and Children's Hospital from January 2017 to September 2019 were identified. Pan-TRK immunohistochemistry, and the ALK and ETV6 gene break-apart fluorescence in situ hybridizations (FISH) were performed. NTRK gene rearrangement was detected using sequencing-based methods. Results: There were 3 males and 2 females in this study. The patients were between 3 months and 13 years of age. Histologically, the tumors were infiltrative spindle cell tumors with variable accompanying inflammatory cells. Immunohistochemistry showed positive reactivity for pan-TRK in all tumors, with nuclear staining for NTRK3 fusion, and cytoplasmic staining for NTRK1 fusion. The molecular testing revealed NTRK gene fusions (one each of TPM3-NTRK1, ETV6-NTRK3 and DCTN1-NTRK1, and two cases of LMNA-NTRK1). Two patients were receiving larotrectinib. The others were are well without disease, with follow-up durations of 9 to 29 months. Conclusions: NTRK-rearranged mesenchymal tumors from soft tissue sites and kidney are identified. A novel DCTN1-NTRK1 fusion is described. Pan-TRK immunohistochemistry is useful for diagnosis. NTRK-targeted therapy may be an option for unresectable, recurrent or metastatic cases.

Elevated salinity deteriorated enhanced biological phosphorus removal in an aerobic granular sludge sequencing batch reactor performing simultaneous nitrification, denitrification and phosphorus removal

Hypersaline wastewater may pose threats to biological wastewater treatment processes. An aerobic granular sludge-based sequencing batch reactor (SBR) performing simultaneous nitrification, denitrification and phosphorus removal (SNDPR) was evaluated with increased salinity from 1 to 2 % (w/v). Nitrogen removal performance was unaffected by salinity up to 20 g/L in terms of reliable and efficient nitrification and denitrification. Enhanced biological phosphorus removal (EBPR) process was completely deteriorated at salinity up to 2 %, in contrast to excellent phosphorus removal at 1 %. Profiles of phosphorus over one cycle demonstrated that higher salinity not only inhibited anaerobic phosphorus release but also impeded aerobic/anoxic phosphorus uptake. Illumina MiSeq sequencing revealed multiple halophilic and non-halophilic bacteria within aerobic granules with family Anaerolineaceae being the predominant potential salt adapter. Besides, ammonia oxidizing bacteria (AOB), glycogen accumulating organisms (GAOs) were more tolerant to salt than nitrite oxidizing bacteria (NOB) and phosphorus accumulating organisms (PAOs) and denitrifying PAOs (DNPAOs). These results deciphered the resilience of aerobic granular sludge-based biological nitrogen and phosphorus removal processes to hypersaline stress.

[Preliminary study of the relationship between novel coronavirus pneumonia and liver function damage: a multicenter study]

Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. Results: 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34 ~ 21.15) μmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31 ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) μmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) μmol/L, respectively. Conclusion: The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

[A cross-sectional study on the prevalence and related factors of dyslipidemia among adults in Anhui province, in 2015]

Objective: Based on the data of chronic diseases and nutrition surveillance among Chinese adults in 2015, dyslipidemia and related factors were analyzed. Methods: Multi-stage stratified cluster random sampling was used to select participants who were aged 18 and over, with questionnaire survey and related measurements conducted. Prevalence rates of dyslipidemia among participants by different characteristics and influencing factors were analyzed, using the method of complex weighting and post-weighted stratification. Results: In all, 7 404 participants were included. The overall prevalence of dyslipidemia was 30.5% among the adults. The overall prevalence of dyslipidemia were 36.5% in males and 24.4% in females (P<0.05). The prevalence rates of hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C were 3.7%, 12.2%, 5.3%, and 19.4%, respectively. Results from the multivariate logistic regression model analysis showed that age (OR=1.009, 95%CI: 1.000-1.018), female (OR=0.501, 95%CI: 0.397-0.632), College degree or above (OR=1.728, 95%CI: 1.257-2.374), alcohol consumption 3 (OR=0.711, 95%CI: 0.536-0.943), central obesity (OR=1.868, 95%CI: 1.547-2.257), BMI (OR=1.141, 95%CI: 1.098-1.186), hypertension (OR=1.259, 95%CI: 1.077-1.473) and diabetes (OR=2.025, 95%CI: 1.446-2.835) were influencing factors on dyslipidemia. Conclusions: The prevalence of dyslipidemia seemed high among adults in Anhui. Risk factors should be closely monitored and under control, including those people with unhealthy lifestyles or being overweight, obesity, hypertensive and diabetic.

The dietary combination of essential oils and organic acids reduces Salmonella enteritidis in challenged chicks

This study was conducted to determine the effects of essential oils and organic acids (EOA) on Salmonella Enteritidis (S. Enteritidis) challenged chickens. One-day-old specific pathogen-free (SPF) chicks (250) were randomly assigned to 5 groups, with 50 birds in each group. The treatment groups were as follows: 1) basal diet, negative control group (NC); 2) basal diet + S. Enteritidis, positive control group (PC); 3) PC + 4,000 g/t of enrofloxacin (5%), antibiotic group (ENR); 4) PC + 800 g/t of EOA1, thymol-benzoic acid group (TBA); and 5) PC + 800 g/t of EOA2, cinnamylaldehyde-caproic acid group (CCA). At 7 D of age, each bird, except those in NC, was orally gavaged with 0.4 mL of a suspension of 4.4 × 10⁹ cfu S. Enteritidis/mL. Results revealed that ENR reduced bacterial counts in the liver and spleen on days 3, 5, and 7 post-challenge more (P < 0.05) than any other treatments. However, bacterial counts in cecal contents among ENR, TBA, and CCA were similar at 5 and 7 D post-challenge but lower than those of PC. Additionally, the bacterial counts in liver, spleen, and cecum contents in TBA were lower (P < 0.05) than in PC at 3, 5, and 7 D post-challenge; the bacterial counts in spleen contents in TBA were lower (P < 0.05) than in CCA at 7 D post-challenge. Tumor necrosis factor-α contents in TBA and CCA were lower (P < 0.05) than those in PC. Also, the ratio of villus height to crypt depth in the ileum of CCA was higher (P < 0.05) than that of PC and ENR; however, there was no difference in the secretory IgA content of the jejunum among the groups. In conclusion, EOA had a bacteriostatic effect on S. Enteritidis, and the effect of the thymol-benzoic acid complex surpassed that of the cinnamaldehyde-caproic acid complex. Therefore, EOA may act as an effective antibiotic substitute for animals in the prevention and treatment of Salmonella.

Zeffiro User Interface for Electromagnetic Brain Imaging: a GPU Accelerated FEM Tool for Forward and Inverse Computations in Matlab

This article introduces the Zeffiro interface (ZI) version 2.2 for brain imaging. ZI aims to provide a simple, accessible and multimodal open source platform for finite element method (FEM) based and graphics processing unit (GPU) accelerated forward and inverse computations in the Matlab environment. It allows one to (1) generate a given multi-compartment head model, (2) to evaluate a lead field matrix as well as (3) to invert and analyze a given set of measurements. GPU acceleration is applied in each of the processing stages (1)-(3). In its current configuration, ZI includes forward solvers for electro-/magnetoencephalography (EEG) and linearized electrical impedance tomography (EIT) as well as a set of inverse solvers based on the hierarchical Bayesian model (HBM). We report the results of EEG and EIT inversion tests performed with real and synthetic data, respectively, and demonstrate numerically how the inversion parameters affect the EEG inversion outcome in HBM. The GPU acceleration was found to be essential in the generation of the FE mesh and the LF matrix in order to achieve a reasonable computing time. The code package can be extended in the future based on the directions given in this article.

Investigation on saturable absorbers based on nonlinear Kerr beam cleanup effect

We experimentally investigate characteristics of saturable absorbers (SAs) based on nonlinear Kerr beam cleanup effect (NL-KBC). The SAs are formed by a long graded-index multimode fiber (GRIN MMF) with a short single-mode fiber served as a diaphragm. We studied the evolution of output spectrum and beam profiles from the GRIN MMF in order to investigate the mechanism of these SAs. We further performed saturable absorption measurements to evaluate their modulation depths and saturation intensities. We experimentally observed and first theoretically analyzed the "relaxation oscillation" behavior of the optical transmittance with increasing input intensity. We also studied their nonlinear polarization dynamics and observed the repolarized effect in NL-KBC regime. Our results confirm the optical properties of the SAs based on NL-KBC, and these SAs can find applications in Q-switched and mode-locked lasers.

Quantitative method for estimating stain density in electron microscopy of conventionally prepared biological specimens

Stain density is an important parameter for optimising the quality of ultrastructural data obtained from several types of 3D electron microscopy techniques, including serial block-face electron microscopy (SBEM), and focused ion beam scanning electron microscopy (FIB-SEM). Here, we show how some straightforward measurements in the TEM can be used to determine the stain density based on a simple expression that we derive. Numbers of stain atoms per unit volume are determined from the measured ratio of the bright-field intensities from regions of the specimen that contain both pure embedding material and the embedded biological structures of interest. The determination only requires knowledge of the section thickness, which can either be estimated from the microtome setting, or from low-dose electron tomography, and the elastic scattering cross section for the heavy atoms used to stain the specimen. The method is tested on specimens of embedded blood platelets, brain tissue and liver tissue.

Novel pectin based composite hydrogel derived from grapefruit peel for enhanced Cu(II) removal

Novel biochar/pectin/alginate hydrogel beads (BPA) derived from grapefruit peel were synthesized and used for Cu(II) removal from aqueous solution. FTIR, SEM-EDS, XRD, TGA and XPS, etc. were applied for characterization analysis. The synergistic reinforcing effect of polymer matrix and biochar fillers improved the adsorptive, mechanical and thermostabilized performance of BPA. Factors like component contents of biochar and pectin, pH, contact time, Cu(II) concentration and coexisting inorganic salts or organic ligands were systematically investigated in batch mode. The adsorption isotherms were fitted well by the Freundlich model and the experimental maximum adsorption capacity of optimized BPA-9 beads (mass ratio of pectin to alginate = 10:1) with 0.25% biochar, was ∼80.6 mg/g at pH 6. Kinetic process was well described by the pseudo-second-order model and film diffusion primarily governed the overall adsorption rate, followed by intraparticle diffusion. Thermodynamics analysis suggested spontaneous feasibility and endothermic nature of adsorption behavior. Moreover, BPA also showed better environmental adaptability in the presence of NaCl, MgCl₂, CaCl₂, EDTA-2Na and CA as well as good adsorption potential for other heavy metal [e.g. Pb(III)]. Crucially, the BPA beads showed good regeneration ability after five cycles. All these results indicated the potential of BPA for removing heavy metal from water.

Robustness of an aerobic granular sludge sequencing batch reactor for low strength and salinity wastewater treatment at ambient to winter temperatures

Acclimation performances and characteristics of aerobic granular sludge to salt and temperature were investigated in a sequencing batch reactor (SBR) performing simultaneous nitrification, denitrification and phosphorus removal (SNDPR). The aerobic granular SNDPR system was firstly subjected to low salinity (0.5%, w/v) at moderate temperature (> 15 ℃) and subsequent low temperature (< 15 ℃). The shock loading of salinity temporarily deteriorated biological phosphorus removal, while dual stresses of salinity and low temperature induced temporary inhibition on both nitrogen and phosphorus removal. Both salinity and low temperature stimulated the settleability of aerobic granules, accompanied with decreased ratios of protein to polysaccharide (PN/PS). Illumina MiSeq sequencing revealed that salinity rarely affected bacterial richness, but significantly decreased the diversity. Whereas low temperature strengthened both bacterial richness and diversity. Phyla Proteobacteria, Chloroflexi and their sub-groups acted as the main halophilic bacteria while Proteobacteria was also psychrophilic. The functional bacteria such as nitrifiers, denitrifiers, and phosphorus removal bacteria exhibited greater tolerance to salt and low temperature than glycogen accumulating organisms (GAOs). Overall, the present study demonstrated the resilience and robustness of aerobic granular sludge toward salinity and low temperature, which could aid the knowledge of saline wastewater treatment by aerobic granular sludge.

Enhanced simultaneous nitrification, denitrification and phosphorus removal through mixed carbon source by aerobic granular sludge

Aerobic granular sludge-based simultaneous nitrification, denitrification and phosphorus removal (SNDPR) systems were configured for the treatment of low-strength municipal wastewater. Granular characteristics, process performance, and the corresponding microbial ecology dynamics were comprehensively explored with sodium acetate and succinate as mixed carbon source. Results revealed that aerobic granules kept structural and functional resilience, while mixed carbon source largely altered and balanced the growth and competition of phosphorus/glycogen accumulating organisms (PAOs/GAOs). Appropriate ratio of mixed carbon source was vital for superb physiochemical behaviors and reliable removal performance by aerobic granules. Therefore, the aerobic granular SNDPR system could achieve deep-level nutrients removal through enhancing the anaerobic carbon uptake rate and strengthening the carbon usage efficiency. The present work could add some guiding sight into the application of aerobic granular SNDPR system for wastewater treatment.

Chinese farmers' attitude towards the improvement of animal welfare in their facilities

This study sought to investigate Chinese farmers' attitude towards animal welfare by using the Theory of Planned Behaviour (TPB). According to the TPB, an individual's intention to behave in a certain way is determined by his/her attitude towards the behaviour (specific attitude — importance — and general attitudes), the perceived behavioural control (easiness), and the supposed opinion of the people who are important to him/her (subjective norms). A total of 253 questionnaires are used, which included the three main animal productions in chena (swine, poultry and cattle). Chinese farmers have perceived the improvement of animal welfare as two abstracts: general attitudes (reward-seeking, and empathic farmer); and four specific categories of actions (favourable environment, animal health, humane treatment of animals and farmers' well-being). Our analysis revealted that general and specific attitudes were the strongest predictors of farmers' intentions to improve animal welfare in the questionnaire study. In fact, Chinese farmers considered it fairly important to improve the animal welfare meaures considered in the survey. In contrast, the same animal welfare measures were considered difficult to improve by the farmers as indicated by the lack of association between the easiness of improving animal welfare and the intentions. In addition, veterinarians, agricultural advisers, and scientific experts were considered to be relatively influential subjective norms as regards the activities of the farmers. This is the first study to provide an insight into the underlying meanings and values of Chinese farmers views on improvements to animal welfare.

Lymph node characteristics of 6279 N1 differentiated thyroid cancer patients

PURPOSE

This study examined the clinicopathological characteristics of 6279 N1 differentiated thyroid cancer (DTC) patients who underwent operations in our center.

METHODS

This was a retrospective longitudinal analysis. We categorized the DTC on the basis of various lymph node (LN) characteristics. Logistic regression models and multiple linear regression models were used for the correlation analysis.

RESULTS

A total of 3693 (58.8%) N1a patients and 2586 (41.1%) N1b patients were included. Patients with N1b disease had larger metastatic foci (0.5 vs. 0.15 cm), a greater number of metastatic LNs (5 vs. 2), a greater number of dissected LNs (25 vs. 7), and a smaller lymph node ratio (NR, number of positive LNs / number of sampled LNs) (23.1% vs. 28.6%) than patients in stage N1a. Comparing the clinicopathological features, we found that male, increased tumor size, multifocality, and thyroiditis increased the risk of stage N1b disease (P<0.05). Sex, multifocality, capsular infiltration, and tumor size were associated with the size of the metastatic LNs (P<0.05). Sex, capsular infiltration, and nodular goiter were associated with the NR (P<0.05). Male sex, tumor located in inferior lobe, maximal tumor diameter (MTD) <1cm, and nodular goiter were independent predictors for skip metastases (P<0.05). MTD <1cm, central neck metastasis and advanced age were independent predictors for bilateral lateral neck metastasis (BLNM) (P<0.05).

CONCLUSION

The LN characteristics of stage N1a and N1b disease were associated with significantly different features, such as sex, tumor size, multifocality, capsular infiltration, and nodular goiter.

A pilot-scale study on the treatment of landfill leachate by a composite biological system under low dissolved oxygen conditions: Performance and microbial community

In this work, a pilot-scale low dissolved oxygen (DO) composite biological system (LDOCBS) composed of an anoxic rotating biological contactor (RBC) and four aeration tanks with gradient aeration was used to treat landfill leachate for 88 d. The maximum removals of 85.65%, 99.92% and 84.06% for chemical oxygen demand (COD), ammonia (NH₄⁺-N) and total nitrogen (TN) were achieved, respectively. The three-dimensional exaction and emission matrix (3D-EEM) fluorescence spectroscopy revealed that the biodegradability of leachate was significantly improved by the LDOCBS. Mass balance calculations showed that the COD removal and denitrification process mainly occurred in RBC while 1# contributed primarily to nitrification. High-throughput sequencing analysis indicated that denitrifying bacteria with highly relative abundances of 46.45%-53.81% played key roles in organic degradation and nitrogen removal. This work could add some guiding insights into the cost-efficient treatment of landfill leachate by the composite biological system.

Research on the aerobic granular sludge under alkalinity in sequencing batch reactors: Removal efficiency, metagenomic and key microbes

Effects of additional alkalinity on the performance of aerobic granular sludge (AGS) in sequencing batch reactors (SBR) performing simultaneous nitrification, denitrification, and phosphorus removal (SNDPR) were evaluated. Results showed that COD and ammonia-N (NH₄⁺-N) were slightly stimulated and remained high and stable with the increase of alkalinity up to 750 mg/L, while denitrification was boosted and total inorganic nitrogen (TIN) removal efficiency increased from 60.46% to 98.62% with an additional alkalinity of 750 mg/L. However, total phosphorus (TP) removal stayed unaffected and efficient. Illumina MiSeq sequencing revealed that microbial diversity and richness shifted mostly with 500 mg/L exterior alkalinity addition. Additional alkalinity altered the bacterial compositions within aerobic granules at various levels and the enrichment of Thiothrix and Acinetobacter was accounted for the promotion of COD and TIN removal.

A comprehensive comparison between non-bulking and bulking aerobic granular sludge in microbial communities

Filamentous sludge bulking poses great threats to operational stability of aerobic granular sludge. Exploration of the microbial community aids knowledge of the causative factors to sludge bulking and guides directions for corresponding actions for prevention and controlling. Detailed changes of bacterial community within the non-bulking and bulking were performed and compared with a non-specific method through 1‰ (v/v) hydrogen peroxide (H₂O₂) addition. Results revealed that non-bulking/bulking granules maintained effective carbon and nitrogen removal, while bulking completely deteriorated enhanced biological phosphorus removal (EBPR). Excess extracellular polymeric substances (EPS) especially polysaccharide (PS) were directly linked with sludge bulking and abundant PS contributed to subsequent granular re-stability. Filamentous bulking dramatically altered the bacterial populations and 1‰ H₂O₂ effectively controlled bulking by eliminating causative filaments Singulisphaera and Thiothrix. Together, this study provides new insights into the non-bulking/bulking granules and could direct the prevention and control of filamentous bulking in aerobic granules.