Clinical features and “early” corticosteroid treatment outcome of pediatric mycoplasma pneumoniae pneumonia

BackgroundMany children with mycoplasma pneumoniae (MP) pneumonia (MPP) developed sequelae such as bronchiolitis/bronchitis obliterans (BO). Early corticosteroid therapy might prevent disease progression. This study aimed to use “early” corticosteroid and observe the treatment outcome in patients with MPP.MethodsPatients who had pulmonary infiltrations on chest imaging within 5 days of the disease course and were suspected of having MP infection on admission were enrolled. Among them, patients whose disease course was within 10 days on admission were ultimately enrolled. We analyzed their data including the clinical features, the starting time and dose of corticosteroid therapy, and the treatment outcome. According to chest imaging, we divided patients into two groups (Group A: bronchiolitis-associated lesions or ground-glass opacities; Group B: pulmonary segmental/lobar consolidation).ResultsA total of 210 patients with confirmed MPP were ultimately enrolled. There were 59 patients in Group A and 151 patients in Group B. Patients in Group A were more prone to have allergy histories, hypoxemia, wheezing sound, and wet rales on auscultation than those in Group B. Corticosteroid treatment was initiated between 5 and 10 days of disease onset in all patients and 6–7 days in most patients. Methylprednisolone was prescribed in all patients within 10 days of disease onset, and the highest prescribed dose was at least 2 mg/kg/day. In Group A, methylprednisolone >2 mg/kg/day was prescribed in 22 patients, and among them, 8 patients with diffuse bronchiolitis-associated lesions received high-dose methylprednisolone therapy. After 3 months, lung CT revealed slightly segmental ground-glass opacity in three patients. In Group B, methylprednisolone >2 mg/kg/day was prescribed in 76 patients, and among them, 20 patients with pulmonary lobar consolidation received high-dose methylprednisolone therapy. After 3 months, chest imaging revealed incomplete absorption of pulmonary lesions in seven patients. Among them, five patients with consolidation in more than one pulmonary lobe ultimately had slight BO.ConclusionIn hospitalized patients with MPP, particularly severe MPP, the ideal starting time of corticosteroid treatment might be 5–10 days, preferably 6–7 days, after disease onset. The initial dosage of corticosteroid therapy should be decided according to the severity of the disease. MPP patients with diffuse bronchiolitis-associated lesions/whole lobar consolidation on imaging might require high-dose corticosteroid therapy

Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders

ObjectiveArteriovenous fistulas (AVFs) in the craniocervical junction (CCJ) region are a rare occurrence with special clinical manifestations. This study retrospectively reviewed patients with CCJ AVFs treated at our neurosurgical center, aiming to enhance the understanding of CCJ AVFs.MethodsA total of 113 patients with CCJ AVFs treated at our neurosurgical center between January 2013 and December 2020 were enrolled. They were grouped as patients with CCJ AVFs with spinal arterial feeders (n = 20) and patients with CCJ AVF without spinal arterial feeders (n = 93). Clinical presentation, angiographic characteristics, intraoperative findings, and treatment outcomes were analyzed.ResultsThe patients’ median age was 55 years (IQR 47.5–62 years). The proportion of males in the group without spinal arterial feeders was significantly higher (p = 0.001). Subarachnoid hemorrhage (SAH) was the most common clinical presentation, especially in the group with spinal arterial feeders (p < 0.001). There were significant differences in AVF type, fistula location, and direction of the venous drainage between the two groups (p < 0.001). Intervention embolization combined with microsurgery was more common in treating AVFs with spinal arterial feeders (p = 0.006). Spinal arterial feeders did not affect the outcome (p = 0.275).ConclusionsSAH was the most common presentation of CCJ AVFs in this study. Microsurgery and interventional embolization were optional treatment strategies. The angioarchitecture of CCJ AVFs was essential for selecting treatment strategies

Near Net Forming Research for Fin-Typed LED Radiator

Pure aluminum radiator is the best choice for heat dissipation of various LED products at present. Its forming methods include common extrusion, die casting, forging, etc. Compared with other forming technologies, the LED radiator formed by cold forging has good heat dissipation performance, but there are some disadvantages in the forming process, such as uneven deformation, large material consumption and low die life. The cold forging process of pure aluminum fin-typed LED radiator is analyzed by the finite element method. The calculation results show that equal fillet structure of concave die is improper, leading to serious uneven flow velocity distribution during aluminum forging, inconsistent fin length, and warpage tendency. The gradient fillet structure of concave die is adopted. Numerical simulation and production test show that the gradient fillet structure design can significantly reduce the uneven metal flow. The extruded fins have a uniform length, which is conducive to reducing subsequent machining and production cost

Genomic prediction of rice mesocotyl length indicative of directing seeding suitability using a half-sib hybrid population.

Direct seeding has been widely adopted as an economical and labor-saving technique in rice production, though problems such as low seedling emergence rate, emergence irregularity and poor lodging resistance are existing. These problems are currently partially overcome by increasing seeding rate, however it is not acceptable for hybrid rice due to the high seed cost. Improving direct seeding by breeding is seen as the ultimate solution to these problems. For hybrid breeding, identifying superior hybrids among a massive number of hybrids from crossings between male and female parental populations by phenotypic evaluation is tedious and costly. Contrastingly, genomic selection/prediction (GS/GP) could efficiently detect the superior hybrids capitalizing on genomic data, which holds a great potential in plant hybrids breeding. In this study, we utilized 402 rice inbred varieties and 401 hybrids to investigate the effectiveness of GS on rice mesocotyl length, a representative indicative trait of direct seeding suitability. Several GP methods and training set designs were studied to seek the optimal scenario of hybrid prediction. It was shown that using half-sib hybrids as training set with the phenotypes of all parental lines being fitted as a covariate could optimally predict mesocotyl length. Partitioning the molecular markers into trait-associated and -unassociated groups based on genome-wide association study using all parental lines and hybrids could further improve the prediction accuracy. This study indicates that GS could be an effective and efficient method for hybrid breeding for rice direct seeding

Reducing noisy annotations for depression estimation from facial images

| openaire: EC/H2020/101016775/EU//INTERVENE Funding Information: This work is supported by the Shaanxi Provincial Social Science Foundation (grant 2021K015), the Shaanxi Provincial Natural Science Foundation (grant 2021JQ-824), the Shaanxi Provincial Natural Science Foundation (grant 2022JM-380), the Special Construction Fund for Key Disciplines of Shaanxi Provincial Higher Education, the Scientific Research Program Funded by Shaanxi Provincial Education Department (Program No. 19JS028), and the Scientific Research Program Funded by Shaanxi Provincial Education Department (Program No. 20JG030). This work was also supported by the Academy of Finland (grants 336033, 315896), Business Finland (grant 884/31/2018), and EUH2020 (grant 101016775). Publisher Copyright: © 2022 The Author(s)Depression has been considered the most dominant mental disorder over the past few years. To help clinicians effectively and efficiently estimate the severity scale of depression, various automated systems based on deep learning have been proposed. To estimate the severity of depression, i.e., the depression severity score (Beck Depression Inventory-II), various deep architectures have been designed to perform regression using the Euclidean loss. However, they do not consider the label distribution, and they do not learn the relationships between the facial images and BDI-II scores, which can be resulting in the noisy labeling for automatic depression estimation (ADE). To mitigate this problem, we propose an automated deep architecture, namely the self-adaptation network (SAN), to improve this uncertain labeling for ADE. Specifically, the architecture consists of four modules: (1) ResNet-18 and ResNet-50 are adopted in the deep feature extraction module (DFEM) to extract informative deep features; (2) a self-attention module (SAM) is adopted to learn the weights from the mini-batch; (3) a square ranking regularization module (SRRM) to create high partitions and low partitions is proposed; and (4) a re-label module (RM) is used to re-label the uncertain annotations for ADE in the low partitions. We conduct extensive experiments on depression databases (i.e., AVEC2013 and AVEC2014) and obtain a performance comparable to the performances of other ADE methods in assessing the severity of depression. More importantly, the proposed method can learn valuable depression patterns from facial videos and obtain a performance comparable to the performances of other methods for depression recognition.Peer reviewe

Application of Brillouin optical time domain reflectometry to dynamic monitoring of overburden deformation and failure caused by underground mining

Brillouin optical time domain reflectometry (BOTDR), a fully-distributed optical fiber sensing technology, was applied to monitoring the deformation behavior of overlying strata during underground mining. Three types of optical cables, Metal kieso sensing optical cable (MKS), Glass fiber reinforced sensing optical cable (GFRS) and 10 m interval fixed-point sensing optical cable (10 m IFS), were embedded vertically into two boreholes that are located 582 m and 1746 m from the open-off cut, respectively. The strain distribution characteristics of the cables and variations of the mechanical and hydraulic properties in the overburden were analyzed with consideration of the lithology and mining positions. The results show that MKS cable has better performance in strength and accuracy than the GFRS and 10 m IFS cables. The strata in front of the panel provided front bearing loads and were compressed in the vertical direction. As the panel passed the cables to approximately 90 m, the tensile stress increased, and the peak value moved up gradually. With the occurrence and development of the caved zone, the strains of the lower optical drill were negative and in the compression state. Throughout the monitoring process, the upper cable showed a process from compression to tension, while the lower cable showed a process from compression through tension to compression. In addition, the strain distribution of the cables corresponded well with the strata. The vertical compression of the strata appears to be inversely proportional to their Young\u27s modulus. Tensile failure dominates in the overlying strata during the mining process. With the advancing of the panel, the tensile failure zone moved upward episodically, and the height of the fractured zone reached the maximum where the distance between the face and cable was approximately 90 or 100 m. Compared with the traditional monitoring methods, BOTDR monitoring provided more accurate data on the dynamic height of the fractured zone. The research results are of practical significance for monitoring overburden deformation under mining, and they are helpful to prevent or mitigate water inrush and surface ecological geological disasters

First report of macrolide-resistant and -susceptible Mycoplasma pneumoniae clinical strains isolated from a single case

Objectives: The aim of this study was to investigate the biological characteristics and effect of antibiotic treatment for different Mycoplasma pneumoniae isolates co-infecting the same patient. Methods: Two throat swab specimens from a single patient, on the day of admission (Sp01) and discharge (Sp13), were liquid cultured and subcultured on agar medium to obtain M. pneumoniae monoclones. The 23S rRNA gene of 50 monoclones from specimens Sp01 and Sp13 were analysed. Real-time PCR assay was used for detection of mutations and genotyping. Two typical monoclones were isolated for antimicrobial susceptibility testing. Results: Genotype 1 monoclones accounted for 70.8% (34/48) in Sp01 and 95.7% (44/46) in Sp13. All genotype 1 monoclones were of the 4-5-7-2 multilocus variable-number tandem-repeat analysis (MLVA) type, while all genotype 2 monoclones were 3-5-6-2 MLVA type. The genotype 1 monoclone, which harboured the A2063G mutation in 23S rRNA gene, was resistant to erythromycin and azithromycin in vitro, whilst genotype 2, which did not carry the mutation, was susceptible to macrolides. The proportion of macrolide-resistant M. pneumoniae monoclones in the specimen cultures collected rose from 70.8% to 95.7% at the time of discharge. Conclusion: This is the first report on the isolation of macrolide-resistant and -susceptible strains of M. pneumoniae from the same patient. After treatment, the proportion of macrolide-resistant M. pneumoniae increased, but the patient still carried viable macrolide-susceptible strains, meaning that the macrolide-susceptible strains did not disappear completely

Culture-Independent Detection and Genotyping of Mycoplasma pneumoniae in Clinical Specimens from Beijing, China.

A duplex real-time PCR assay was designed for simultaneous detection and genotyping of Mycoplasma pneumoniae (M. pneumoniae). The detection/typing performance of this duplex PCR method, targeting specific genes for M. pneumoniae type 1 (mpn 459) and type 2 (mpna 5864), was compared to that of the previously published MpP1 real-time PCR assay and the genotyping method for the adhesin P1 gene (mpn 141). A total of 1,344 throat swab specimens collected from patients in Beijing, China were tested for M. pneumoniae by bacterial culture, MpP1 real-time PCR assay, and our duplex PCR assay, and positive detection rates of 26.9%, 34.4%, and 33.7%, respectively, were obtained. The duplex PCR method demonstrated high sensitivity and accuracy for detecting and genotyping M. pneumoniae, and significant differences in genotyping ability were observed when compared to the conventional P1 gene-based method. M. pneumoniae type 1 was the predominate genotype from 2008 to 2012 in Beijing, and a shift from type 1 to type 2 began to occur in 2013. To our knowledge, this is the first reported incidence of a type shift phenomenon of M. pneumoniae clinical isolates in China. These genotyping results provide important information for understanding recent changes in epidemiological characteristics of M. pneumoniae in Beijing