Patient delay in a coronavirus disease 2019 (COVID-19) outbreak in Tianjin, China from January to February 2020.

BACKGROUND: Patient delay of COVID-19 patients occurs frequently, which poses a challenge to the overall epidemic situation. In this study, we aimed to evaluate the extent of patient delay, explore its factors, and investigate the effects of patient interval on epidemic situation. METHODS: A retrospective cohort study was conducted with 136 COVID-19 patients in Tianjin, China. Factors associated with patient delay were explored using logistic regression models. The relationship was investigated by spearman correlation analysis and mean absolute error between patient interval of lagging days and epidemic situation. RESULTS: The factors associated with patient delay of COVID-19 patients were mainly the imported cases, the first presentation to a tertiary hospital, close contacts and spatial accessibility to fever clinic. The longer the patient intervals of lagging days, the greater the number of new-onset and confirmed cases in 3-4 and 5-7 days after the first day symptoms, respectively. CONCLUSION: Identification and quarantine of close contacts, promoting the spatial accessibility to fever clinics and creating public awareness are crucial to shortening patient delays to flat the curve for COVID-19.

qMrdd2, a novel quantitative resistance locus for maize rough dwarf disease.

BACKGROUND: Maize rough dwarf disease (MRDD), a widespread disease caused by four pathogenic viruses, severely reduces maize yield and grain quality. Resistance against MRDD is a complex trait that controlled by many quantitative trait loci (QTL) and easily influenced by environmental conditions. So far, many studies have reported numbers of resistant QTL, however, only one QTL have been cloned, so it is especially important to map and clone more genes that confer resistance to MRDD. RESULTS: In the study, a major quantitative trait locus (QTL) qMrdd2, which confers resistance to MRDD, was identified and fine mapped. qMrdd2, located on chromosome 2, was consistently identified in a 15-Mb interval between the simple sequence repeat (SSR) markers D184 and D1600 by using a recombinant inbred line (RIL) population derived from a cross between resistant ("80007") and susceptible ("80044") inbred lines. Using a recombinant-derived progeny test strategy, qMrdd2 was delineated to an interval of 577 kb flanked by markers N31 and N42. We further demonstrated that qMrdd2 is an incompletely dominant resistance locus for MRDD that reduced the disease severity index by 20.4%. CONCLUSIONS: A major resistance QTL (qMrdd2) have been identified and successfully refined into 577 kb region. This locus will be valuable for improving maize variety resistance to MRDD via marker-assisted selection (MAS).

PPR647 Protein Is Required for Chloroplast RNA Editing, Splicing and Chloroplast Development in Maize.

Chloroplasts play an essential role in plant growth and development. Any factors affecting chloroplast development will lead to abnormal plant growth. Here, we characterized a new maize mutant, albino seedling mutant 81647 (as-81647), which exhibits an entirely albino phenotype in leaves and eventually died before the three-leaf stage. Transmission electron microscopy (TEM) demonstrated that the chloroplast thylakoid membrane was impaired and the granum lamellae significantly decreased in as-81647. Map-based cloning and transgenic analysis confirmed that PPR647 encodes a new chloroplast protein consisting of 11 pentratricopeptide repeat domains. Quantitative real-time PCR (qRT-PCR) assays and transcriptome analysis (RNA-seq) showed that the PPR647 mutation significantly disrupted the expression of PEP-dependent plastid genes. In addition, RNA splicing and RNA editing of multiple chloroplast genes showed severe defects in as-81647. These results indicated that PPR647 is crucial for RNA editing, RNA splicing of chloroplast genes, and plays an essential role in chloroplast development.

Genome-wide identification and analysis of heterotic loci in three maize hybrids.

Heterosis, or hybrid vigour, is a predominant phenomenon in plant genetics, serving as the basis of crop hybrid breeding, but the causative loci and genes underlying heterosis remain unclear in many crops. Here, we present a large-scale genetic analysis using 5360 offsprings from three elite maize hybrids, which identifies 628 loci underlying 19 yield-related traits with relatively high mapping resolutions. Heterotic pattern investigations of the 628 loci show that numerous loci, mostly with complete-incomplete dominance (the major one) or overdominance effects (the secondary one) for heterozygous genotypes and nearly equal proportion of advantageous alleles from both parental lines, are the major causes of strong heterosis in these hybrids. Follow-up studies for 17 heterotic loci in an independent experiment using 2225 F2 individuals suggest most heterotic effects are roughly stable between environments with a small variation. Candidate gene analysis for one major heterotic locus (ub3) in maize implies that there may exist some common genes contributing to crop heterosis. These results provide a community resource for genetics studies in maize and new implications for heterosis in plants.

Synthesis and in vitro activity of asymmetric indole-based bisamidine compounds against Gram-positive and Gram-negative pathogens.

A series of new asymmetric bisamidine was designed, synthesized, and tested for their in-vitro antibacterial activity using a range of Gram-positive and Gram-negative pathogens. Most compounds demonstrated powerful antibacterial activity, and interestingly, some displayed better activity against several Gram-negative strains than the lead compound 1. The most potent bisamidine 8l exhibited 4-fold more potent activity against E. coli, K. pneumonia, P. aeruginosa, and C. freundii than compound 1. Especially 8l exhibited a powerful activity against K. pneumonia secreting NDM-1 enzyme with a minimum inhibitory concentration (MIC) of 2 µg/mL, while levofloxacin and vancomycin displayed resistance, with MICs > 128 µg/mL.

Genome-wide comparative analysis of digital gene expression tag profiles during maize ear development.

The present study profiled and analyzed gene expression of the maize ear at four key developmental stages. Based on genome-wide profile analysis, we detected differential mRNA of maize genes. Some of the differentially expressed genes (DEGs) were predicted to be potential candidates of maize ear development. Several well-known genes were found with reported mutant analyses, such as, compact plant2 (ct2), zea AGAMOUS homolog1 (zag1), bearded ear (bde), and silky1 (si1). MicroRNAs such as microRNA156 were predicted to target genes involved in maize ear development. Antisense transcripts were widespread throughout all the four stages, and are suspected to play important roles in maize ear development. Thus, identification and characterization of important genes and regulators at all the four developmental stages will contribute to an improved understanding of the molecular mechanisms responsible for maize ear development.

The development dynamics of the maize root transcriptome responsive to heavy metal Pb pollution.

Lead (Pb), as a heavy metal element, has become the most important metal pollutant of the environment. With allocating a relatively higher proportion of its biomass in roots, maize could be a potential important model to study the phytoremediation of Pb-contaminated soil. Here we analyzed the maize root transcriptome of inbred lines 9782 under heavy metal lead (Pb) pollution, which was identified as a non-hyperaccumulator for Pb in roots. In the present study, more than 98 millions reads were mapped to define gene structure and detect polymorphism, thereby to qualify transcript abundance along roots development under Pb treatment. A total of 17,707, 17,440, 16,998 and 16,586 genes were identified in maize roots at four developmental stages (0, 12 h, 24 h and 48 h) respectively and 2,825, 2,626, 2161 and 2260 stage-specifically expressed genes were also identified respectively. In addition, based on our RNA-Seq data, transcriptomic changes during maize root development responsive to Pb were investigated. A total of 384 differentially expressed genes (DEGs) (log2Ratio ≥ 1, FDR ≤ 0.001) were identified, of which, 36 genes with significant alteration in expression were detected in four developmental stages; 12 DEGs were randomly selected and successful validated by qRT-PCR. Additionally, many transcription factor families might act as the important regulators at different developmental stages, such as bZIP, ERF and GARP et al. These results will expand our understanding of the complex molecular and cellular events in maize root development and provide a foundation for future study on root development in maize under heavy metal pollution and other cereal crops.

Genetic and agronomic assessment of cob traits in corn under low and normal nitrogen management conditions.

KEY MESSAGE: Exploring and understanding the genetic basis of cob biomass in relation to grain yield under varying nitrogen management regimes will help breeders to develop dual-purpose maize. With rising energy demands and costs for fossil fuels, alternative energy from renewable sources such as maize cobs will become competitive. Maize cobs have beneficial characteristics for utilization as feedstock including compact tissue, high cellulose content, and low ash and nitrogen content. Nitrogen is quantitatively the most important nutrient for plant growth. However, the influence of nitrogen fertilization on maize cob production is unclear. In this study, quantitative trait loci (QTL) have been analyzed for cob morphological traits such as cob weight, volume, length, diameter and cob tissue density, and grain yield under normal and low nitrogen regimes. 213 doubled-haploid lines of the intermated B73 × Mo17 (IBM) Syn10 population have been resequenced for 8575 bins, based on SNP markers. A total of 138 QTL were found for six traits across six trials using composite interval mapping with ten cofactors and empirical comparison-wise thresholds (P = 0.001). Despite moderate to high repeatabilities across trials, few QTL were consistent across trials and overall levels of explained phenotypic variance were lower than expected some of the cob trait × trial combinations (R (2) = 7.3-43.1 %). Variation for cob traits was less affected by nitrogen conditions than by grain yield. Thus, the economics of cob usage under low nitrogen regimes is promising.

Analyses of the Disease Spectrum of Children After the Lushan Earthquake.

UNLABELLED: : An earthquake with a magnitude of 7.0 struck Lushan in Sichuan Province in China on April 20, 2013. Uniformed pediatricians visited the area where the epicenter was located to provide emergency relief care for children 10 days after the earthquake. OBJECTIVES: The aims of the study were to analyze the features of the disease spectrum of children in Baoxing at early time after Lushan earthquake and to provide basis information, which will be useful for the arrangement of the medical resources of pediatrics in the medical relief after Lushan earthquake in similar situation in the future. METHODS: A total of 220 case files were classified and analyzed. These files provided information regarding pediatric patients whose conditions were diagnosed and treated in the mobile hospital established by the Affiliated Hospital of Logistical University of Chinese People's Armed Police Forces in Baoxing from April 20, 2013 to April 30, 2013. The demographic data of all these patients were collected and the disease spectrum was analyzed. RESULTS: Children's ages differed. A total of 59 patients were neonates, infants, and toddlers (27%); 111 were school-aged children (50%) and 50 were adolescents (23%). Common diseases and injuries include respiratory tract infection, dermatosis, and trauma, which were observed 10 days after the earthquake. Trauma was mainly accidental injury. The morbidity rate of infectious diseases was low. CONCLUSIONS: Pediatricians have an important role in the early treatment and subsequent control of infectious diseases during earthquakes.

Microstructure and Mechanical Properties of Al-Li Alloys with Different Li Contents Prepared by Selective Laser Melting.

Research on the development of new lightweight Al-Li alloys using a selective laser melting process has great potential for industrial applications. This paper reports on the development of novel aluminum-lithium alloys using selective laser melting technology. Al-Cu-Li-Mg-Ag-Sc-Zr pre-alloyed powders with lithium contents of 1 wt.%, 2 wt.% and 3 wt.%, respectively, were prepared by inert gas atomization. After SLM process optimization, the microstructure and mechanical properties of the as-printed specimens were investigated. The densifications of the three newly developed alloys were 99.51%, 98.96% and 92.01%, respectively. They all had good formability, with the lithium loss rate at about 15%. The as-printed alloy with 1% Li content presented good comprehensive properties, with a yield strength of 413 ± 16 MPa, an ultimate tensile strength of 461 ± 12 MPa, and an elongation of 14 ± 1%. The three alloys exhibited a layered molten pool stacking morphology and had a typical heterostructure. The columnar crystals and equiaxed fine grains were alternately arranged, and most of the precipitated phases were enriched at the grain boundaries. The change in Li content mainly affected the precipitation of the Cu-containing phase. When the Li content was 1 wt.%, the following occured: θ phase, T1 phase and TB phase. When Li increased to 2 wt.%, T1 and T2 phases precipitated together. When Li reaches 3 wt.%, δ' phase precipitated with T2 phase. This study provides useful guidance for the future SLM forming of new crack-free and high-strength Al-Li alloys.

Acoustic emission characteristics of micro-discharges in initial pulsed PEO process on 60% SiCp/Al composite.

The initial discharge process of pulsed plasma electrolytic oxidation (PEO) on the 60% SiCp/2009 aluminum metal matrix composite (Al MMC) in silicate solution was monitored by acoustic emission (AE) technique. Parameters and correlations of AE signals on the Al MMC sample and under water were analyzed, and their generation mechanism was discussed. It was found that the peak amplitudes of AE signals and AE hits during the pulse time quickly increased with the increase of micro-discharge intensity, and the absolute energy of AE signals improved several orders of magnitude. Moreover, different from the peak amplitude, duration and rise time, the duration and count had a strong correlation. Elastic stress waves resulted from the microjet of plasma bubble collapse, the inner-surface friction inside discharge channel, the expansion-shrinkage process of plasma bubbles and micro-crack propagation during rapid solidification of melt are sources of AE signals on the Al MMC sample during the pulse time. However, the expansion-shrinkage process of plasma bubbles plays a key role in the generation of underwater AE signals. In the pause time of one pulse period, the bursting and moving of vapor bubbles result in weak AE signals. It is demonstrated that the AE technique can effectively characterize the features of micro-discharges within a pulse period.

Fine mapping and functional validation of the maize nicosulfuron-resistance gene CYP81A9.

Nicosulfuron, a widely utilized herbicide, is detrimental to some maize varieties due to their sensitivity. Developing tolerant varieties with resistance genes is an economical and effective way to alleviate phytotoxicity. In this study, map-based cloning revealed that the maize resistance gene to nicosulfuron is Zm00001eb214410 (CYP81A9), which encodes a cytochrome P450 monooxygenase. qRT- PCR results showed that CYP81A9 expression in the susceptible line JS188 was significantly reduced compared to the resistant line B73 during 0-192 hours following 80 mg/L nicosulfuron spraying. Meanwhile, a CYP81A9 overexpression line exhibited normal growth under a 20-fold nicosulfuron concentration (1600 mg/L), while the transgenic acceptor background material Zong31 did not survive. Correspondingly, silencing CYP81A9 through CRISPR/Cas9 mutagenesis and premature transcription termination mutant EMS4-06e182 resulted in the loss of nicosulfuron resistance in maize. Acetolactate Synthase (ALS), the target enzyme of nicosulfuron, exhibited significantly reduced activity in the roots, stems, and leaves of susceptible maize post-nicosulfuron spraying. The CYP81A9 expression in the susceptible material was positively correlated with ALS activity in vivo. Therefore, this study identified CYP81A9 as the key gene regulating nicosulfuron resistance in maize and discovered three distinct haplotypes of CYP81A9, thereby laying a solid foundation for further exploration of the underlying resistance mechanisms.

Genome expression profile analysis reveals important transcripts in maize roots responding to the stress of heavy metal Pb.

Lead (Pb) has become one of the most abundant heavy metal pollutants of the environment. With its large biomass, maize could be an important object for studying the phytoremediation of Pb-contaminated soil. In our previous research, we screened 19 inbred lines of maize for Pb concentration, and line 178 was identified to be a hyperaccumulator for Pb in both the roots and aboveground parts. To identify important genes and metabolic pathways related to Pb accumulation and tolerance, line 178 was underwent genome expression profile under Pb stress and a control (CK). A total of approximately 11 million cDNA tags were sequenced and 4 665 539 and 4 936 038 clean tags were obtained from the libraries of the test and CK, respectively. In comparison to CK, 2379 and 1832 genes were identified up- or downregulated, respectively, more than fivefolds under Pb stress. Interestingly, all the genes were related to cellular processes and signaling, information storage and processing or metabolism functions. Particularly, the genes involved in posttranslational modification, protein turnover and chaperones; signal transduction, carbohydrate transport and metabolism; and lipid transport and metabolism significantly changed under the treatment. In addition, seven pathways including ribosome, photosynthesis, and carbon fixation were affected significantly, with 118, 12, 34, 21, 18, 72 and 43 differentially expressed genes involved. The significant upregulation of the ribosome pathway may reveal an important secret for Pb tolerance of line 178. And the sharp increase of laccase transcripts and metal ion transporters were suggested to account in part for Pb hyperaccumulation in the line.

Transcriptional responses of maize seedling root to phosphorus starvation.

Maize (Zea mays) is the most widely cultivated crop around the world, however, it is commonly affected by phosphate (Pi) deficiency and the underlying molecular basis of responses mechanism is still unknown. In this study, the transcriptional response of maize roots to Pi starvation at 3 days after the onset of Pi deprivation was assessed. The investigation revealed a total of 283 Pi-responsive genes, of which 199 and 84 genes were found to be either up- or down-regulated respectively, by 2-fold or more. Pi-responsive genes were found to be involved in sugar and nitrogen metabolic pathways, ion transport, signal transduction, transcriptional regulation, and other processes related to growth and development. In addition, the expression patterns of maize inorganic phosphorus transporters, acid phosphatase, phytase, 2-deoxymugineic acid synthase1, POD and MYB transcription factor were validated in 178 roots response to low phosphorus stress. of which, two genes encoding phytase and acid phosphatase were significantly induced by Pi deficiency and may play a pivotal role in the process of absorption and re-utilization of Pi in Maize. These results not only enhance our knowledge about molecular processes associated with Pi deficiency, but also facilitate the identification of key molecular determinants for improving Pi use in maize. Moreover, this work sets a framework to produce Pi-specific maize microarrays to study the changes in global gene expression between Pi-efficient and Pi-inefficient maize genotypes.

An automated method for the assessment of the rice grain germination rate.

The germination rate of rice grain is recognized as one of the most significant indicators of seed quality assessment. Currently, grain germination rate is generally determined manually by experienced researchers, which is time-consuming and labor-intensive. In this paper, a new method is proposed for counting the number of grains and germinated grains. In the coarse segmentation process, the k-means clustering algorithm is applied to obtain rough grain-connected regions. We further refine the segmentation results obtained by the k-means algorithm using a one-dimensional Gaussian filter and a fifth-degree polynomial. Next, the optimal single grain area is determined based on the area distribution curve. Accordingly, the number of grains contained in the connected region is equal to the area of the connected region divided by the optimal single grain area. Finally, a novel algorithm is proposed for counting germinated grains. This algorithm is based on the idea that the length of the intersection between the germ and the grain is less than the circumference of the germ. The experimental results show that the mean absolute error of the proposed method for germination rate is 2.7%. And the performance of the proposed method is robust to changes in grain number, grain varieties, scale, illumination, and rotation.

Research on In-Plane Deformation Performance of Rotating Honeycomb Structures.

Most natural materials have rotational and hierarchical properties, so they can show excellent mechanical properties such as shear resistance and impact resistance. In order to further improve the energy absorption characteristics of vibration absorbing structures, a new type of honeycomb structure with integral rotation and group rotation is designed and characterized. The effects of the geometrical parameters of rotation Angle on the impact deformation mode, stress response curve and energy absorption characteristics of the honeycomb structure are studied through numerical simulation and experimental design. The results show that the overall honeycomb performance of 15° is better than that of 0°, the specific energy absorption is the results show that the overall honeycomb performance of 15° is better than that of 0°, the specific energy absorption is increased by 6%, the bearing capacity is increased by 320 N, and the crushing force efficiency is increased by 2%. Compared with the whole cell and the group cell, the specific absorption energy increased by 35%, 73% and 71%. The results of this paper provide a new insight into the impact performance of monolithic and grouped rotating honeycomb structures, which is helpful for the results of this paper provide a new insight into the impact performance of monolithic and grouped rotating honeycomb structures, which is helpful for the optimization of crashworthiness structural design.

Microstructure, Mechanical Properties and Fracture Behavior of Micron-Sized TiB2/AlZnMgCu(Sc,Zr) Composites Fabricated by Selective Laser Melting.

In this paper, micron-sized TiB2/AlZnMgCu(Sc,Zr) composites were fabricated by selective laser melting (SLM) using directly mixed powder. Nearly fully dense (over 99.5%) and crack-free SLM-fabricated TiB2/AlZnMgCu(Sc,Zr) composite samples were obtained and its microstructure and mechanical properties were investigated. It is found that the laser absorption rate of powder is improved by introducing micron-sizedTiB2 particles, then the energy density required for SLM forming can be reduced, and the densification can finally be improved. Some crystalline TiB2 formed a coherent relationship with the matrix, while some broken TiB2 particles did not, however, MgZn2 and Al3(Sc,Zr) can perform as intermediate phases to connect these non-coherent surfaces to aluminum matrix. All these factors lead to an increase in strength of the composite. The SLM-fabricated micron-sized TiB2/AlZnMgCu(Sc,Zr) composite finally shows a very high ultimate tensile strength of ~646 MPa and yield strength of ~623 MPa, which are higher than many other aluminum composites fabricated by SLM, while maintaining a relatively good ductility of ~4.5%. The fracture of TiB2/AlZnMgCu(Sc,Zr) composite is occurred along the TiB2 particles and the bottom of the molten pool. This is due to the concentration of stress from the sharp tip of TiB2 particles and the coarse precipitated phase at the bottom of the molten pool. The results show that TiB2 plays a positive role in AlZnMgCu alloys fabricated by SLM, but finer TiB2 particles should be studied.

Knowledge, attitudes, and practices associated with bioterrorism preparedness in healthcare workers: a systematic review.

Introduction: Bioterrorism is an important issue in the field of biosecurity, and effectively dealing with bioterrorism has become an urgent task worldwide. Healthcare workers are considered bioterrorism first responders, who shoulder essential responsibilities and must be equipped to deal with bioterrorism. This study aims to extract and summarize the main research components of the bioterrorism knowledge, attitude, and practice dimensions among healthcare workers. Method: This study utilized a systematic review research design based on the PRISMA 2020 guidelines. A literature search was conducted in the PubMed, Web of Science, and Scopus databases for peer-reviewed literature, and the Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the quality of the literature. Result: A total of 16 studies were included in the final selection. Through the analysis and summary of the included studies, three main aspects and 14 subaspects of the knowledge dimension, three main aspects and 10 subaspects of the attitude dimension, and two main aspects and six subaspects of the practice dimension were extracted. Conclusion: This study conducted a literature review on bioterrorism knowledge, attitudes, and practices for healthcare workers based on the PRISMA 2020 guidelines. The findings can guide improvements in health literacy and provide beneficial information to professional organizations that need to respond effectively to bioterrorism.

Composition Design and Tensile Properties of Additive Manufactured Low Density Hf-Nb-Ta-Ti-Zr High Entropy Alloys Based on Atomic Simulations.

High-entropy alloy (HEA) is a new type of multi-principal alloy material and the Hf-Nb-Ta-Ti-Zr HEAs have attracted more and more attention from researchers due to their high melting point, special plasticity, and excellent corrosion resistance. In this paper, in order to reduce the density of the alloy and maintain the strength of the Hf-Nb-Ta-Ti-Zr HEAs, the effects of high-density elements Hf and Ta on the properties of HEAs were explored for the first time based on molecular dynamics simulations. A low-density and high-strength Hf0.25NbTa0.25TiZr HEA suitable for laser melting deposition was designed and formed. Studies have shown that the decrease in the proportion of Ta element reduces the strength of HEA, while the decrease in Hf element increases the strength of HEA. The simultaneous decrease in the ratio of Hf and Ta elements reduces the elastic modulus and strength of HEA and leads to the coarsening of the alloy microstructure. The application of laser melting deposition (LMD) technology refines the grains and effectively solves the coarsening problem. Compared with the as-cast state, the as-deposited Hf0.25NbTa0.25TiZr HEA obtained by LMD forming has obvious grain refinement (from 300 µm to 20-80 µm). At the same time, compared with the as-cast Hf0.25NbTa0.25TiZr HEA (σs = 730 ± 23 MPa), the as-deposited Hf0.25NbTa0.25TiZr HEA has higher strength (σs = 925 ± 9 MPa), which is similar to the as-cast equiatomic ratio HfNbTaTiZr HEA (σs = 970 ± 15 MPa).

Triage Algorithms for Mass-Casualty Bioterrorism: A Systematic Review.

OBJECTIVES: To understand existing triage algorithms, propose improvement measures through comparison to better deal with mass-casualty incidents caused by bioterrorism. STUDY DESIGN: Systematic review. METHODS: Medline, Scopus and Web of Science were searched up to January 2022. The studies investigating triage algorithms for mass-casualty bioterrorism. Quality assessment was performed using the International Narrative Systematic Assessment tool. Data extractions were performed by four reviewers. RESULTS: Of the 475 titles identified in the search, 10 studies were included. There were four studies on triage algorithms for most bioterrorism events, four studies on triage algorithms for anthrax and two studies on triage algorithms for mental or psychosocial problems caused by bioterrorism events. We introduced and compared 10 triage algorithms used for different bioterrorism situations. CONCLUSION: For triage algorithms for most bioterrorism events, it is necessary to determine the time and place of the attack as soon as possible, control the number of exposed and potentially exposed people, prevent infection and determine the type of biological agents used. Research on the effects of decontamination on bioterrorism attacks needs to continue. For anthrax triage, future research should improve the distinction between inhalational anthrax symptoms and common disease symptoms and improve the efficiency of triage measures. More attention should be paid to triage algorithms for mental or psychosocial problems caused by bioterrorism events.