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Background Serosurveillance is crucial in estimating the range of SARS-CoV-2 infections, predicting the possibility of another wave, and deciding on a vaccination strategy. To understand the herd immunity after the COVID-19 pandemic, the seroprevalence was measured in 3062 individuals with or without COVID-19 from the clinic. Methods The levels of SARS-CoV-2 antibody IgM and IgG were measured by the immuno-colloidal gold method. A fusion fragment of nucleocapsid and spike protein was detected by a qualitative test kit with sensitivity (89%) and specificity (98%). Results The seroprevalence rate for IgM and IgG in all outpatients was 2.81% and 7.51%, respectively. The sex-related prevalence rate of IgG was significantly higher (P 60 years of age (8.61%). Positive rates of IgM and IgG in the convalescent patients were 31.82% and 77.27%, respectively, which was significantly higher than individuals with suspected syndromes or individuals without any clinical signs (P 0.05). Conclusions The low positive rate of the SARS-CoV-2 IgM and nucleic acid (NA) test indicated that the SARS-CoV-2 outbreak is subsiding after 3 months, and the possibility of reintroduction of the virus from an unidentified natural reservoir is low. Seroprevalence provides information for humoral immunity and vaccine in the future., 1. Two months after the COVID-19 outbreak in Wuhan, the seroprevalence for IgM and IgG in the convalescent patients was 31.82% and 77.27%, respectively. In the total outpatient population, the mean seroprevalence for IgM and IgG in all participants was 2.81% and 7.51%, respectively. 2. Seroprevalence for IgG in medical staff was markedly higher than those in residents. 3. The seroprevalence for IgG was significantly higher in women and elderly individuals than those in men and younger individuals. Individuals with comorbidity had higher seroprevalence than those without comorbidity.

Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention. Antimicrobial resistance (AMR) is a major threat to global health. Understanding the emergence, evolution, and transmission of individual antibiotic resistance genes (ARGs) is essential to develop sustainable strategies combatting this threat. Here, we use metagenomic sequencing to analyse ARGs in 757 sewage samples from 243 cities in 101 countries, collected from 2016 to 2019. We find regional patterns in resistomes, and these differ between subsets corresponding to drug classes and are partly driven by taxonomic variation. The genetic environments of 49 common ARGs are highly diverse, with most common ARGs carried by multiple distinct genomic contexts globally and sometimes on plasmids. Analysis of flanking sequence revealed ARG-specific patterns of dispersal limitation and global transmission. Our data furthermore suggest certain geographies are more prone to transmission events and should receive additional attention.

Publisher's version (útgefin grein), Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, health and environmental factors, which we use to predict AMR gene abundances in all countries in the world. Our findings suggest that global AMR gene diversity and abundance vary by region, and that improving sanitation and health could potentially limit the global burden of AMR. We propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR., We are grateful to Hanne Nørgaard Nielsen, Christina Aaby Svendsen, Jacob Dyring Jensen, Birthe S. Rosenqvist Lund, Kate Vina Vibefeldt, Inge Marianne Hansen, Gunhild Larsen, Hanne Mordhorst, and Carsten Bidstrup for technical assistance. We also thank Jeffrey Edward Skiby for internal review. This study has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 643476 (COMPARE), the World Health Organization, The Villum Foundation (VKR023052), and The Novo Nordisk Foundation (NNF16OC0021856: Global Surveillance of Antimicrobial Resistance).

The Acknowledgements section in the original version of this Article was incomplete. “This study has received funding from the European Union’s Horizon 2020 research and innovation program under Grant agreement no. 643476 (COMPARE), the World Health Organization, and The Novo Nordisk Foundation (NNF16OC0021856: Global Surveillance of Antimicrobial Resistance). We would like to thank Miranda de Graaf for the technical assistance at Erasmus MC.” now reads: “This study has received funding from the European Union’s Horizon 2020 research and innovation program under Grant agreement no. 643476 (COMPARE), the World Health Organization, and The Novo Nordisk Foundation (NNF16OC0021856: Global Surveillance of Antimicrobial Resistance). My V. T. Phan was supported by a Marie Sklodowska-Curie Individual Fellowship, funded by the EU H2020 research and innovation programme (Grant Agreement No. 799417). We would like to thank Miranda de Graaf for the technical assistance at Erasmus MC.” The original Article has been corrected.

Yueting Tang,1 Yirong Li,1 Jiayu Sun,2 Huaqin Pan,3 Fen Yao,2 Xiaoyang Jiao2 1Department of Clinical Laboratory, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China; 3Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Xiaoyang JiaoShantou University Medical College, Shantou, Guangdong, People’s Republic of ChinaTel +86-754-88900459Fax +86-754-88557562Email xyjiao@stu.edu.cnPurpose: It is difficult to predict the prognosis of COVID-19 patients at the disease onset. This study was designed to add new biomarkers into conventional inflammatory panels to build an optimal combination panel, to better triage patients and predict their outcomes.Patients and Methods: Biochemical parameters representing multi-organ functions, cytokines, acute-phase proteins, and other inflammatory markers were measured in COVID-19 patients on hospital admission. Receiver operating characteristic (ROC) curves, logistic regression, event-free survival (EFS), and Cox analyses were performed to screen and compare the predictive capabilities of the new panel in patients with different illness severity and outcome.Results: This study included 120 patients with COVID-19, consisting of 32 critical, 28 severe, and 60 mild/moderate patients. Initial levels of the selected biomarkers showed a significant difference in the three groups, all of which influenced patient outcome and EFS to varying degrees. Cox proportional hazard model revealed that procalcitonin (PCT) and interleukin 10 (IL-10) were independent risk factors, while superoxide dismutase (SOD) was an independent protective factor influencing EFS. In discriminating the critical and mild patients, a panel combining PCT, IL-6, and neutrophil (NEUT) yielded the best diagnostic performance with an AUC of 0.99, the sensitivity of 90.60% and specificity of 100%. In distinguishing between severe and mild patients, SOD’s AUC of 0.89 was higher than any other single biomarker. In differentiating the critical and severe patients, the combination of white blood cell count (WBC), PCT, IL-6, IL-10, and SOD achieved the highest AUC of 0.95 with a sensitivity of 75.00% and specificity of 100%.Conclusion: The optimal combination panel has a substantial potential to better triage COVID-19 patients on admission. Better triage of patients will benefit the rational use of medical resources.Keywords: COVID-19, diagnostic panel, cytokine, acute-phase protein

The rapid development of megacities, and their growing connectedness across the world is becoming a distinct driver for emerging disease outbreaks. Early detection of unusual disease emergence and spread should therefore include such cities as part of risk-based surveillance. A catch-all metagenomic sequencing approach of urban sewage could potentially provide an unbiased insight into the dynamics of viral pathogens circulating in a community irrespective of access to care, a potential which already has been proven for the surveillance of poliovirus. Here, we present a detailed characterization of sewage viromes from a snapshot of 81 high density urban areas across the globe, including in-depth assessment of potential biases, as a proof of concept for catch-all viral pathogen surveillance. We show the ability to detect a wide range of viruses and geographical and seasonal differences for specific viral groups. Our findings offer a cross-sectional baseline for further research in viral surveillance from urban sewage samples and place previous studies in a global perspective.

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, health and environmental factors, which we use to predict AMR gene abundances in all countries in the world. Our findings suggest that global AMR gene diversity and abundance vary by region, and that improving sanitation and health could potentially limit the global burden of AMR. We propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR.

Secondary hemophagocytic lymphohistiocytosis (SHLH) is a potentially fatal hyperinflammatory syndrome with a heterogeneous etiology and has nonspecific clinical and laboratory findings. The diagnosis and treatment of adult SHLH is challenging because the etiology of the disease is difficult to identify, and the majority of reported cases are pediatric patients. The aim of this study was to describe the etiology, clinical characteristics, and outcomes of adult SHLH. Fifty‐four adult patients who fulfilled the criteria of SHLH were enrolled in the study. Viral etiology, blood biomarkers, and clinical manifestations of SHLH were analyzed in these patients. Twenty‐four SHLH patients had viraemia, whereas 30 SHLH patients were secondary to other diseases. Epstein‐Barr virus (EBV) was the most common virus that associated SHLH among all viruses studied. Severe SHLH patients with EBV‐viraemia presented significantly high levels of ferritin, lactate dehydrogenase, aspartate transaminase (AST), and alanine transaminase (ALT). Positively relationships existed between EBV DNA titers and levels of AST and ALT (P

The expiration date of biopesticidal products is an essential feature of their use and storage. In the present work, the expiration date of biocontrol agent was predicted using the accelerated aging method. The available bacteria in Bacillus subtilis B579 biocontrol agent were 3.7 ± 0.2 × 1011 CFU/g. It is calculated that the expiration date of the agent was about 17 months at 25°C. During this period, the available bacteria retained more than 90% of the value in the initial product. Thus, this work suggests the expiration date of biocontrol agents composed with spores could be estimated using the accelerated aging method.

Piezoelectric pumps have the potential to be used in a variety of applications, such as in air circulation and compression. However, piezoelectric membrane pumps do not have enough driving capacity, and the heat induced during the direct contact between the driving part and the gas medium cannot be dissipated smoothly. When the gas is blocked, the piezoelectric vibrator generates heat quickly, which may eventually lead to damage. Resonantly driven piezoelectric stack pumps have high performance but no price advantage. In this situation, a novel, resonantly driven piezoelectric gas pump with annular bimorph as the driver is presented. In the study, the working principle of the novel pump was analyzed, the vibration mechanics model was determined, and the displacement amplified theory was studied. The outcome indicates that the displacement amplification factor is related with the original displacement provided by the piezoelectric bimorph. In addition, the displacement amplification effect is related to the stiffness of the spring lamination, adjustment spring, and piezoelectric vibrator, as well as to the systematic damping factor and the driving frequency. The experimental prototypes of the proposed pump were designed, and the displacement amplification effect and gas output performance were measured. At 70 V of sinusoidal AC driving voltage, the improved pump amplified the piezoelectric vibrator displacement by 4.2 times, the maximum gas output flow rate reached 1685 ml/min, and the temperature of the bimorph remained normal after 2000 hours of operation when the gas medium was blocked.