Joint transcriptomic and metabolomic analysis provides new insights into drought resistance in watermelon (Citrullus lanatus).

Introduction: Watermelon is an annual vine of the family Cucurbitaceae. Watermelon plants produce a fruit that people love and have important nutritional and economic value. With global warming and deterioration of the ecological environment, abiotic stresses, including drought, have become important factors that impact the yield and quality of watermelon plants. Previous research on watermelon drought resistance has included analyzing homologous genes based on known drought-responsive genes and pathways in other species. Methods: However, identifying key pathways and genes involved in watermelon drought resistance through high-throughput omics methods is particularly important. In this study, RNA-seq and metabolomic analysis were performed on watermelon plants at five time points (0 h, 1 h, 6 h, 12 h and 24 h) before and after drought stress. Results: Transcriptomic analysis revealed 7829 differentially expressed genes (DEGs) at the five time points. The DEGs were grouped into five clusters using the k-means clustering algorithm. The functional category for each cluster was annotated based on the Kyoto Encyclopedia of Genes and Genomes (KEGG) database; different clusters were associated with different time points after stress. A total of 949 metabolites were divided into 10 categories, with lipids and lipid-like molecules accounting for the most metabolites. Differential expression analysis revealed 22 differentially regulated metabolites (DRMs) among the five time points. Through joint analysis of RNA-seq and metabolome data, the 6-h period was identified as the critical period for watermelon drought resistance, and the starch and sucrose metabolism, plant hormone signal transduction and photosynthesis pathways were identified as important regulatory pathways involved in watermelon drought resistance. In addition, 15 candidate genes associated with watermelon drought resistance were identified through joint RNA-seq and metabolome analysis combined with weighted correlation network analysis (WGCNA). Four of these genes encode transcription factors, including bHLH (Cla97C03G068160), MYB (Cla97C01G002440), HSP (Cla97C02G033390) and GRF (Cla97C02G042620), one key gene in the ABA pathway, SnRK2-4 (Cla97C10G186750), and the GP-2 gene (Cla97C05G105810), which is involved in the starch and sucrose metabolism pathway. Discussion: In summary, our study provides a theoretical basis for elucidating the molecular mechanisms underlying drought resistance in watermelon plants and provides new genetic resources for the study of drought resistance in this crop.

Ultra-Broadband Flexible Thin-Film Sensor for Sound Monitoring and Ultrasonic Diagnosis.

Small-scale and flexible acoustic probes are more desirable for exquisite objects like human bodies and complex-shaped components than conventional rigid ones. Herein, a thin-film flexible acoustic sensor (FA-TES) that can detect ultra-broadband acoustic signals in multiple applications is proposed. The device consists of two thin copper-coated polyvinyl chloride films, which are stimulated by acoustic waves and contact each other to generate the triboelectric signal. Interlocking nanocolumn arrays fabricated on the friction surfaces are regarded as a highly adaptive spacer enabling this device to respond to ultra-broadband acoustic signals (100 Hz-4 MHz) and enhance sensor sensitivity for film weak vibration. Benefiting from the characteristics of high shape adaptability and ultrawide response range, the FA-TES can precisely sense human physiological sounds and voice (≤10 kHz) for laryngeal health monitoring and interaction in real-time. Moreover, the FA-TES flexibly arranged on a 3D-printed vertebra model can effectively and accurately diagnose the inner defect by ultrasonic testing (≥1 MHz). It envisions that this work can provide new ideas for flexible acoustic sensor designs and optimize real-time acoustic detections of human bodies and complex components.

A Soft Bioelectronic Patch for Simultaneous Respiratory and Cardiovascular Monitoring.

Sleep is critical to maintaining physical and mental health. Measuring physiological parameters to quantify sleep quality without uncomfortable user experience remains highly desired but a challenge. Here, this work develops a soft bioelectronic patch to perform simultaneous respiration and cardiovascular monitoring during sleep in a wearable and non-invasive manner. The soft bioelectronic patch system is mainly composed of a pressure sensor, a flexible printed circuit for signal processing, and a soft thermoplastic urethane mold for assembling different functional modules. The soft bioelectronic patch holds a sensitivity of >0.12 V kPa-1 and a remarkable low-frequency response from 0.5 to 15 Hz. It is demonstrated to continuously monitor respiration and heartbeat during the whole night, which could be harnessed for sleep monitoring and obstructive sleep apnea-hypopnea syndrome diagnosis. The reported soft bioelectronic patch represents a simple and convenient platform technology for sleep study.

Echo Frequency Estimation Technology for Passive Surface Acoustic Wave Resonant Sensors Based on a Genetic Algorithm.

Passive wireless surface acoustic wave (SAW) resonant sensors are widely used in measuring pressure, temperature, and torque, typically detecting sensing parameters by measuring the echo signal frequency of SAW resonators. Therefore, the accuracy of echo signal frequency estimation directly affects the performance index of the sensor. Due to the exponential attenuation trend of the echo signal, the duration is generally approximately 10 µs, with conventional frequency domain analysis methods limited by the sampling frequency and data points. Thus, the resolution of frequency estimation is limited. Here, signal time-domain fitting combined with a genetic algorithm is used to estimate SAW echo signal frequency. To address the problem of slow estimation speed and poor timeliness caused by a conventional genetic algorithm, which needs to simultaneously estimate multiple parameters, such as signal amplitude, phase, frequency, and envelope, the Hilbert transform is proposed to remove the signal envelope and estimate its amplitude, and the fast Fourier transform subsection method is used to analyze the initial phase of the signal. The genetic algorithm is thereby optimized to realize the frequency estimation of SAW echo signals under a single parameter. The developed digital signal processing frequency detection system was monitored in real time to estimate the frequency of an SAW echo signal lasting 10 µs and found to have only 100 sampling points. The proposed method has a frequency estimation error within 3 kHz and a frequency estimation time of less than 1 s, which is eight times faster than the conventional genetic algorithm.

Nasal nitric oxide in healthy Chinese children aged 6-18 years.

Objectives: To obtain the normal values of fractional concentration of nasal nitric oxide in Chinese children aged 6-18 years, so as to provide reference for clinical diagnosis. Methods: 2,580 out of 3,200 children (1,359 males and 1,221 females), whom were included from 12 centers around China were taken tests, their height and weight were also recorded. Data were used to analyze the normal range and influencing factors of fractional concentration of nasal nitric oxide values. Measurements: Data was measured using the Nano Coulomb Breath Analyzer (Sunvou-CA2122, Wuxi, China), according to the American Thoracic Society/European Respiratory Society (ATS/ERS) recommendations. Main Results: We calculated the normal range and prediction equation of fractional concentration of nasal nitric oxide values in Chinese children aged 6-18 years. The mean FnNO values of Chinese aged 6-18 yrs was 454.5 ± 176.2 ppb, and 95% of them were in the range of 134.5-844.0 ppb. The prediction rule of FnNO values for Chinese children aged 6-11 yrs was: FnNO = 298.881 + 17.974 × age. And for children aged 12-18 yrs was: FnNO = 579.222-30.332 × (male = 0, female = 1)-5.503 × age. Conclusions: Sex and age were two significant predictors of FnNO values for Chinese children(aged 12-18 yrs). Hopefully this study can provide some reference value for clinical diagnosis in children.

Effect Analysis of Different Environmental Disinfection Methods on Reducing Contamination of Surfaces by the Omicron BA.2.2 Variant of SARS-CoV-2 and the Characteristics of Fomite Contamination in the Fever Clinic in the Out-Broken of Shanghai.

This study aimed to investigate the effect of different environmental disinfection methods on reducing contaminated surfaces (CSs) by the Omicron BA.2.2 variant of SARS-CoV-2 in the fever clinic between March 20 and May 30, 2022, and to analyze the influences and related factors of CSs. This study includes survey data from 389 positive patients (SPPs) and 204 CSs in the fever clinic, including the CS type, disinfection method, length of time spent in the clinic, cycle threshold (CT) value, name, age, weight, mask type, mask-wearing compliance, hand-mouth touch frequency and sex. Associations between study variables and specified outcomes were explored using univariate regression analyses. Mask-wearing compliance had a significant negative correlation with CSs (r = - 0.446, P = 0.037). Among the 389 SPPs, 22 SPPs (CRP, 5.66%) caused CSs in the separate isolation room. A total of 219 SPPs (56.30%) were male. The mean age of SPPs was 4.34 ± 3.92 years old, and the mean CT value was 12.44 ± 5.11. In total, 9952 samples with exposure history were taken, including 204 (2.05%) CSs. Among the CSs, the positive rate of flat surfaces was the highest in public areas (2.52%) and separate isolation rooms (4.75%). Disinfection methods of ultraviolet radiation + chemical irradiation significantly reduced the CSs in both the public area (0% vs. 4.56%) and the separate isolation room (0.76% vs. 2.64%) compared with the chemical method alone (P < 0.05). Compared with ordinary SPPs, CRPs were older (6.04 year vs. 4.23 year), and the male proportion was higher (72.73% vs. 55.31%). In particular, it was found that SPPs contaminated their surroundings and therefore imposed risks on other people. Environmental disinfection with ultraviolet radiation + chemical treatment should be emphasized. The findings may be useful to guide infection control practices for the Omicron BA.2.2 variant of SARS-CoV-2.

Evolutionary Analysis of the Melon (Cucumis melo L.) GH3 Gene Family and Identification of GH3 Genes Related to Fruit Growth and Development.

The indole-3-acetic acid (IAA) auxin is an important endogenous hormone that plays a key role in the regulation of plant growth and development. In recent years, with the progression of auxin-related research, the function of the Gretchen Hagen 3 (GH3) gene has become a prominent research topic. However, studies focusing on the characteristics and functions of melon GH3 family genes are still lacking. This study presents a systematic identification of melon GH3 gene family members based on genomic data. The evolution of melon GH3 family genes was systematically analyzed by means of bioinformatics, and the expression patterns of the GH3 family genes in different melon tissues during different fruit developmental stages and with various levels of 1-naphthaleneacetic acid (NAA) induction were analyzed with transcriptomics and RT-qPCR. The melon genome contains 10 GH3 genes distributed across seven chromosomes, and most of these genes are expressed in the plasma membrane. According to evolutionary analysis and the number of GH3 family genes, these genes can be divided into three subgroups, and they have been conserved throughout the evolution of melon. The melon GH3 gene has a wide range of expression patterns across distinct tissue types, with expression generally being higher in flowers and fruit. Through promoter analysis, we found that most cis-acting elements contained light- and IAA-responsive elements. Based on the RNA-seq and RT-qPCR analyses, it can be speculated that CmGH3-5, CmGH3-6 and CmGH3-7 may be involved in the process of melon fruit development. In conclusion, our findings suggest that the GH3 gene family plays an important role in the development of melon fruit. This study provides an important theoretical basis for further research on the function of the GH3 gene family and the molecular mechanism underlying the development of melon fruit.

Capacitive Sensors with Hybrid Dielectric Structures and High Sensitivity over a Wide Pressure Range for Monitoring Biosignals.

Various dielectrics with porous structures or high dielectric constants have been designed to improve the sensitivity of capacitive pressure sensors (CPSs), but this strategy has only been effective for the low-pressure range. Here, a hierarchical gradient hybrid dielectric, composed of low-permittivity (low-k) polydimethylsiloxane (PDMS) foam with low Young's modulus (low-E) and high-permittivity (high-k) MWCNT/PDMS foam with high Young's modulus (high-E), is designed to develop a CPS for monitoring biosignals over a wide force range. The foam-like structure with hybrid permittivity (low-k + high-k) is facilitated to improve the sensitivity, while the hierarchical structure with gradient Young's modulus (low-E + high-E) contributes to broadening the pressure sensing range. With the hierarchical gradient hybrid structure, the flexible pressure sensor achieves an enhanced sensitivity of 2.155 kPa-1, a wide pressure range (up to 500 kPa), a minimum detection limit (50 Pa), and an excellent durability (>2500 cycles). As a demonstration, a venous thrombosis simulation and smart insole system are established to monitor venous blood clots and plantar pressures, respectively, which reveal potential applications in wearable medicine, sports health prediction, athlete training, and sports equipment design.

Clinical characteristics of pediatric cases infected with the SARS-CoV-2 Omicron variant in a tertiary children's medical center in Shanghai, China.

BACKGROUND: The number of pediatric cases of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has increased. Here, we describe the clinical characteristics of children in a tertiary children's medical center in Shanghai. METHODS: A total of 676 pediatric coronavirus disease 2019 (COVID-19) cases caused by the Omicron variant who were admitted to the Shanghai Children's Medical Center from March 28 to April 30, 2022 were enrolled in this single-center, prospective, observational real-world study. Patient demographics and clinical characteristics, especially COVID-19 vaccine status, were assessed. RESULTS: Children of all ages appeared susceptible to the SARS-CoV-2 Omicron variant, with no significant difference between sexes. A high SARS-CoV-2 viral load upon admission was associated with leukocytopenia, neutropenia, and thrombocytopenia (P = 0.003, P = 0.021, and P = 0.017, respectively) but not with physical symptoms or radiographic chest abnormalities. Univariable linear regression models indicated that comorbidities (P = 0.001) were associated with a longer time until viral clearance, and increasing age (P < 0.001) and two doses of COVID-19 vaccine (P = 0.001) were associated with a shorter time to viral clearance. Multivariable analysis revealed an independent effect of comorbidities (P < 0.001) and age (P = 0.003). The interaction effect between age and comorbidity showed that the negative association between age and time to virus clearance remained significant only in patients without underlying diseases (P < 0.001). CONCLUSION: This study describes the clinical characteristics of children infected with the Omicron variant of SARS-CoV-2 and calls for additional studies to evaluate the effectiveness and safety of vaccination against COVID-19 in children.

A Smart Pen Based on Triboelectric Effects for Handwriting Pattern Tracking and Biometric Identification.

The rapid development of artificial intelligence places high demands on human-machine interfaces. Various types of huma-machine interfaces have been implemented, including smart keyboards, electronic skins, and wearable motion sensors. Handwriting behavior has a high degree of interaction freedom, and handwriting characteristics offer high-security standards for human-machine systems. Herein, we propose a portable smart pen integrated with triboelectric displacement vector sensors to trace handwriting trajectories for human-machine interactions and biometric identification. A triboelectric pressure sensor array is evenly distributed along the pen case to sense displacement vectors, and an additional triboelectric sensor is placed on top of the pen to detect vertical force. By leveraging the resin pen refill as a tribopositive material and a nanowired polyethylene tribonegative layer attached to a Cu electrode, triboelectric signals are generated during the writing/moving process. The calculation and analysis of the sensor signals enable the recognition of handwritten patterns, including Latin letters and Arabic numerals. Moreover, the smart pen can be used to authenticate users based on their unique handwriting patterns, which can help take human-machine interfaces and cyber security to the next level. Furthermore, a custom smart pen operation mode that enables the control of a slide presentation demonstrates the smart pen's potential for various human-machine interface applications.

Lung involvement in children with newly diagnosed rheumatic diseases: characteristics and associations.

BACKGROUND: Pulmonary complications of rheumatic diseases may cause functional impairment and increase mortality. However, reports regarding detection of lung involvement in children with treatment-naive, newly diagnosed rheumatic diseases are scarce. Herein, we aimed to describe the characteristics of such patients and explore the association between lung involvement and rheumatic disease. METHODS: From January 2019 to June 2021, 48 pediatric patients with treatment-naive, newly diagnosed rheumatic diseases at Department of Rheumatology and Immunology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University were included with pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT) findings, and 51 age-matched healthy controls were examined based on PFTs. Univariate and multivariable logistic regression analyses were used to investigate the clinical characters and laboratory parameters associated with lung involvement in these patients. RESULTS: Asymptomatic patients had a faster respiratory rate and a higher ratio of forced expiratory volume in 1 s/forced vital capacity than the controls (P < 0.05). More patients than controls were observed to have a decreased DLCO below the lower limit of normal (18 of 45 [40.0%] vs. 6 of 36, respectively; P = 0.041). Among the 48 patients, 8 (16.7%) had abnormal HRCT findings and 27 (56.3%) had abnormal PFT results. Thirty-one (64.6%) patients had lung involvement. Logistic regression revealed that increases in the erythrocyte sedimentation rate (ESR) and CD4/CD8 ratio were associated with increased odds ratio of lung involvement (1.037, 95% CI: 1.003-1.072; 9.875, 95% CI: 1.296-75.243, respectively). CONCLUSIONS: Pediatric patients with treatment-naive, newly diagnosed rheumatic diseases are prone to pulmonary involvement. Increased ESR and CD4/CD8 are associated with elevated odds of lung involvement in patients. We recommend routine pulmonary evaluation in such patients, especially in high-risk patients, even in the absence of respiratory symptoms, once they are diagnosed with rheumatic disease.

Mycoplasma pneumoniae among Chinese Outpatient Children with Mild Respiratory Tract Infections during the Coronavirus Disease 2019 Pandemic.

Mycoplasma pneumoniae is a common pathogen causing respiratory disease in children. We sought to investigate the epidemiology of M. pneumoniae among outpatient children with mild respiratory tract infections (RTIs) during the coronavirus disease 2019 (COVID-19) pandemic. Eligible patients were prospectively enrolled from January 2020 to June 2021. Throat swabs were tested for M. pneumoniae RNA. M. pneumoniae IgM was tested by a colloidal gold assay. Macrolide resistance and the effect of the COVID-19 countermeasures on M. pneumoniae prevalence were assessed. Symptom scores, treatments, and outcomes were evaluated. Eight hundred sixty-two eligible children at 15 centers in China were enrolled. M. pneumoniae was detected in 78 (9.0%) patients. Seasonally, M. pneumoniae peaked in the first spring and dropped dramatically to extremely low levels over time until the next summer. Decreases in COVID-19 prevalence were significantly associated with decreases in M. pneumoniae prevalence (r = 0.76, P = 0.001). The macrolide resistance rate was 7.7%. The overall sensitivity and specificity of the colloidal gold assay used in determining M. pneumoniae infection were 32.1% and 77.9%, respectively. No more benefits for improving the severity of symptoms and outcomes were observed in M. pneumoniae-infected patients treated with a macrolide than in those not treated with a macrolide during follow-up. The prevalences of M. pneumoniae and macrolide resistance in outpatient children with mild RTIs were at low levels in the early stage of the COVID-19 pandemic but may have rebounded recently. The colloidal gold assay for M. pneumoniae IgM may be not appropriate for diagnosis of M. pneumoniae infection. Macrolides should be used with caution among outpatients with mild RTIs. IMPORTANCE This is the first and largest prospective, multicenter, active, population-based surveillance study of the epidemiology of Mycoplasma pneumoniae among outpatient children with mild respiratory tract infections (RTIs) during the COVID-19 pandemic. Nationwide measures like strict face mask wearing and restrictions on population movement implemented to prevent the spread of COVID-19 might also effectively prevent the spread of M. pneumoniae. The prevalence of M. pneumoniae and the proportion of drug-resistant M. pneumoniae isolates in outpatient children with mild RTIs were at low levels in the early stage of the COVID-19 pandemic but may have rebounded recently. The colloidal gold assay for M. pneumoniae IgM may be not appropriate for screening and diagnosis of M. pneumoniae infection. Macrolides should be used with caution among outpatients with mild RTIs.

A Flexible Pressure Sensor with a Mesh Structure Formed by Lost Hair for Human Epidermal Pulse Wave Monitoring.

Flexible pressure sensors with the capability of monitoring human vital signs show broad application prospects in personalized healthcare. In this work, a hair-based flexible pressure sensor (HBPS) consisting of lost hair and polymer films was proposed for the continuous monitoring of the human epidermal arterial pulse waveform. A macroscale mesh structure formed by lost hair provides a simplified spacer that endows the triboelectric-based flexible pressure sensor with sufficient contact-separation space. Based on this mesh structure design, the hair-based flexible pressure sensor can respond to the slight pressure change caused by an object with 5 mg weight and hold a stable output voltage under 1-30 Hz external pressure excitation. Additionally, the hair-based flexible pressure sensor showed great sensitivity (0.9 V/kPa) and decent stability after 4500 cycles of operation. Given these compelling features, the HBPS can successfully measure the human epidermal arterial pulses with obvious details at different arteries. The proposed HBPS can also be used to monitor the pulse signals of different subjects. Furthermore, the three different pulse wave transmission time (PTT) values (PTT-foot, PTT-middle, and PTT-peak) can be obtained by simultaneously monitoring human pulse and electrocardiogram signals, which has enormous application potential for assessing cardiovascular system health.

Associations between Upper Extremity Motor Function and Aphasia after Stroke: A Multicenter Cross-Sectional Study.

METHODS: Patients with stroke were compared and correlated from overall and three periods (1-3 months, 4-6 months, and >6 months). Fugl-Meyer assessment for the upper extremity (FMA-UE) and action research and arm test (ARAT) were used to compare the UE motor status between patients with PSA and without PSA through a cross-sectional study among 435 patients. Then, the correlations between the evaluation scale scores of UE motor status and language function of patients with PSA were analyzed in various dimensions, and the language subfunction most closely related to UE motor function was analyzed by multiple linear regression analysis. RESULTS: We found that the scores of FMA-UE and ARAT in patients with PSA were 14 points ((CI) 10 to 18, p < 0.001) and 11 points lower ((CI) 8 to 13, p < 0.001), respectively, than those without PSA. Their FMA-UE (r = 0.70, p < 0.001) and ARAT (r = 0.62, p < 0.001) scores were positively correlated with language function. Regression analysis demonstrated that spontaneous speech ability may account for UE motor function (R 2 = 0.51, p < 0.001; R 2 = 0.42, p < 0.001). Consistent results were also obtained from the analyses within the three time subgroups. CONCLUSION: Stroke patients with PSA have worse UE motor performance. UE motor status and language function showed positive correlations, in which spontaneous speech ability significantly accounts for the associations.

Graded Microstructured Flexible Pressure Sensors with High Sensitivity and an Ultrabroad Pressure Range for Epidermal Pulse Monitoring.

Precisely detecting epidermal pulse waves with pressure sensors is crucial for pulse-based personalized health-monitoring technologies. However, developing a pressure sensor that simultaneously demonstrates high sensitivity and an ultrabroad pressure range and a convenient fabrication process for large-scale production is a considerable challenge. Herein, by utilizing a commercial conductive fabric (CF) and a silica gel film, we develop a high-performance pressure sensor (HPPS) for the monitoring of human physiological signals. Based on convenient turnover formwork technology, the silica gel film was fabricated by replicating the microstructure of the sandpaper surface. This microstructure and the plain weave structure on the CF surface together provide a sharp increase in the contact-separation area and structural compressibility, which are beneficial for the enhancement of output performance. Made of these two materials, the graded microstructured HPPS holds high sensitivity (4.5 mV/Pa), an ultrabroad pressure range (0-30 kPa), a wide working frequency bandwidth (up to 35 Hz), decent stability (>50,000 cycles), and a simple fabrication process that is suitable for large-scale production. Given these noticeable features, the developed HPPS not only succeeds in precisely detecting subtle pulse waves on various positions of different people but can also objectively capture changes in cardiovascular parameters caused by exercise training at different intensities in real time. These findings exhibit the enormous potential application of HPPS in tracking an individual's health status and comprehensively evaluating exercise intensity.

Allergic Rhinitis Improvement in Asthmatic Children After Using Acaricidal Bait: A Randomized, Double-Blind, Cross-Placebo Study.

Objective: This study aimed to evaluate the effects of acaricidal bait use on the house dust mite (HDM) allergen concentration and occurrence of allergic rhinitis (AR) and asthma symptoms in children sensitized to HDMs. Study Design: Sixty-six children (3-12 years old) with AR and asthma sensitized to HDMs were randomly assigned to receive an acaricidal bait intervention for 8 weeks and a placebo intervention for 8 weeks separated by a 4-week washout period. The visual analog scale (VAS) score, rhinitis control assessment test (RCAT) score, rhinoconjunctivitis quality of life questionnaire (RQLQ) score, asthma control questionnaire-5 (ACQ-5) score and HDM allergen levels were monitored. Results: HDM allergen levels were significantly decreased after 8 weeks (Δder p2+f2 2.282 (3.516) µg/g vs. 0.147 (0.25) µg/g, P < 0.05) in the acaricidal bait group compared with the placebo group. The VAS, RCAT and RQLQ scores in the acaricidal bait group were also significantly improved (ΔVAS 7.5 (16) vs. 3 (18), P < 0.05; ΔRCAT-3 (5) vs. 0 (7), P < 0.05; ΔRQLQ 4.5 (8) vs. 1 (8), P < 0.05), but the ACQ-5 score did not improve (ΔACQ-5 0.2 (0.4) vs. 0 (0.65), P > 0.05). Conclusion: Acaricidal bait reduced HDM exposure and improved rhinitis symptoms. This trial is registered at www.chictr.org.cn.

Real-World Verification of Artificial Intelligence Algorithm-Assisted Auscultation of Breath Sounds in Children.

Objective: Lung auscultation plays an important role in the diagnosis of pulmonary diseases in children. The objective of this study was to evaluate the use of an artificial intelligence (AI) algorithm for the detection of breath sounds in a real clinical environment among children with pulmonary diseases. Method: The auscultations of breath sounds were collected in the respiratory department of Shanghai Children's Medical Center (SCMC) by using an electronic stethoscope. The discrimination results for all chest locations with respect to a gold standard (GS) established by 2 experienced pediatric pulmonologists from SCMC and 6 general pediatricians were recorded. The accuracy, sensitivity, specificity, precision, and F1-score of the AI algorithm and general pediatricians with respect to the GS were evaluated. Meanwhile, the performance of the AI algorithm for different patient ages and recording locations was evaluated. Result: A total of 112 hospitalized children with pulmonary diseases were recruited for the study from May to December 2019. A total of 672 breath sounds were collected, and 627 (93.3%) breath sounds, including 159 crackles (23.1%), 264 wheeze (38.4%), and 264 normal breath sounds (38.4%), were fully analyzed by the AI algorithm. The accuracy of the detection of adventitious breath sounds by the AI algorithm and general pediatricians with respect to the GS were 77.7% and 59.9% (p < 0.001), respectively. The sensitivity, specificity, and F1-score in the detection of crackles and wheeze from the AI algorithm were higher than those from the general pediatricians (crackles 81.1 vs. 47.8%, 94.1 vs. 77.1%, and 80.9 vs. 42.74%, respectively; wheeze 86.4 vs. 82.2%, 83.0 vs. 72.1%, and 80.9 vs. 72.5%, respectively; p < 0.001). Performance varied according to the age of the patient, with patients younger than 12 months yielding the highest accuracy (81.3%, p < 0.001) among the age groups. Conclusion: In a real clinical environment, children's breath sounds were collected and transmitted remotely by an electronic stethoscope; these breath sounds could be recognized by both pediatricians and an AI algorithm. The ability of the AI algorithm to analyze adventitious breath sounds was better than that of the general pediatricians.

Comparison of different detection methods for Mycoplasma pneumoniae infection in children with community-acquired pneumonia.

BACKGROUND: Due to the lack of a sensitive, specific and rapid detection method, aetiological diagnosis of pneumonia caused by Mycoplasma pneumoniae (M. pneumoniae, MP) is a constantly challenging issue. This retrospective study aimed to compare the diagnostic methods for Mycoplasma pneumoniae in children and evaluate their values. METHODS: From November 2018 to June 2019, 830 children with community-acquired pneumonia were selected from the Department of Respiratory Medicine, Shanghai Children's Medical Center. On the first day of hospitalization, sputum, throat swab and venous blood samples were collected to analyse MP-IgM (particle agglutination, PA), MP-IgM (immune colloidal gold technique, GICT), MP-DNA, MP-RNA (simultaneous amplification and testing, SAT) and MP-DNA (real-time polymerase chain reaction, RT-PCR). RESULTS: Among these 830 children, RT-PCR showed that the positive rate was 36.6% (304/830), in which the positive rate of macrolide resistance (A2063G mutation) accounted for 86.2% of cases (262/304). Using RT-PCR as the standard, MP-RNA (SAT) had the highest specificity (97.5%), and MP-IgM (PA) had the highest sensitivity (74.0%) and Youden index (53.7%). If MP-RNA (SAT) was combined with MP-IgM (PA), its Kappa value (0.602), sensitivity (84.2%), specificity (78.7%) and Youden index (62.9%) were higher than those of single M. pneumoniae detection. CONCLUSIONS: Our research indicated that a combination of MP-RNA (SAT) plus MP-IgM (PA) might lead to reliable results as an early diagnostic method for children with clinical manifestations of Mycoplasma pneumoniae pneumonia.

iTRAQ and RNA-Seq analyses revealed the effects of grafting on fruit development and ripening of oriental melon (Cucumis melo L. var. makuwa).

Rootstocks are among the primary factors that influence fruit yield and quality as well as melon development. To understand the differences in the molecular mechanisms and gene expression networks of fruit development between grafted and nongrafted plants in oriental melon, we performed a comprehensive analysis of the transcriptome and proteome dynamic gene/protein expression profiles during fruit development in oriental melon (Cucumis melo L. var. makuwa). Using pairwise comparisons between grafted and nongrafted samples by transcriptome analysis, we identified a large number of candidate genes involved in hormonal signaling pathways, transcription factors, resistance-related biosynthetic pathways and photosynthesis-related metabolic pathways. Many transcription factor-encoded genes were significantly more strongly expressed in the grafted samples, for example, AP2/ERF, C2H2, MYB, bHLH, and AUX/IAA, which are well-known participants in the regulation of developmental processes and hormonal signaling metabolism. Some differentially expressed genes (DEGs) were enriched in flavonoid biosynthesis and phenylpropanoid biosynthesis and determined plant resistance. In addition, some differentially expressed proteins (DEPs) were enriched in photosynthesis-related pathways, which could improve fruit quality and yield. Moreover, through weighted gene coexpression network analyses, we identified modules of coexpressed genes and hub genes specifically related to grafting for different fruit developmental stages. The results suggested that graft-related modules and hub genes were primarily associated with photosynthate metabolism and hormonal signaling pathways. The results obtained in this study provide a valuable resource for dissecting the role of candidate genes governing graft-related metabolism in oriental melon fruit, suggesting an interesting correlation with the effects of rootstock on fruit development.

Research on allergic rhinitis improvement in asthmatic children after dust mite exposure reduction: a randomized, double-blind, cross-placebo study protocol.

BACKGROUND: Allergic rhinitis (AR) in children is a major respiratory inflammatory disease with a high incidence that is increasing yearly. In China, 54.93% of children with asthma have AR, which often requires synchronous treatment. House dust mites (HDMs) are common allergens that often cause attacks of AR and asthma. Reducing allergen exposure is one of the most important measures to control and treat AR and asthma attacks. Hestelia Mite Bait, containing 0.1% emamectin, is a new tool for trapping and killing dust mites, reducing the number of dust mites on mattresses and thereby potentially reducing stimulation by allergens and ultimately improving asthma and rhinitis symptoms. This single-centre, randomized, double-blind, cross-placebo trial will explore the improvement in AR in asthmatic children after dust mite exposure reduction. METHODS: We will recruit 60 children (aged 3-12 years) who have been diagnosed with AR and asthma and are allergic to dust mites as confirmed by a serum allergen test. Participants will randomly receive the Hestelia Mite Bait intervention for 8 weeks and the placebo intervention for 8 weeks. There will be a 4-week washout period between the two interventions. The primary outcome is the visual analogue scale (VAS) score of AR symptoms; the secondary outcomes include the Rhinitis Control Assessment Test (RCAT) score, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score, changes in the dust mite level, drug usage for asthma and AR, Asthma Control Questionnaire-5 (ACQ-5) score, and frequencies of acute asthma attacks, emergency visits, and hospitalizations. DISCUSSION: This study aims to scientifically and objectively evaluate the effects of mite bait on rhinitis and asthma improvement after dust mite exposure reduction and provides a convenient means for future prevention and treatment of allergic diseases involving the airways in children. TRIAL REGISTRATION: www.chictr.org.cn ChiCTR1900024688. Registered on July 21, 2019.