Publications by authors named "Jianmin Jiang"

110 Publications

Characteristics of Three Person-to-Person Transmission Clusters of Severe Fever with Thrombocytopenia Syndrome in Southeastern China.

Am J Trop Med Hyg 2021 Jul 12. Epub 2021 Jul 12.

Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease worldwide. It can be transmitted from person to person, and the fatality rate is very high. During this study, three SFTS clusters including 12 associated cases were identified in three counties in Zhejiang Province from 2018 to 2020. The median age of the three index patients was 70 years, and that of secondary case patients was 59 years. Of note, the mortality rate of the index patients was 100%. The mortality rate of secondary case patients was 11%. The total secondary attack rate (SAR) was 30% (9/30). The SARs of cluster A, cluster B, and cluster C were 38% (3/8), 21% (3/14), and 38% (3/8), respectively. Additionally, the interval from onset to diagnosis was 4 days. The intervals from disease onset to confirmation of the index cases and secondary cases were 7 days and 4 days, respectively. All secondary case patients had a history of close contact with blood or body fluids of the index patients. These results indicate that SFTS patients should not be discharged until recovery. When SFTS patients die, the corpses should be transferred directly from the hospital to the crematorium for cremation by persons wearing proper protective equipment to prevent virus transmission.
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http://dx.doi.org/10.4269/ajtmh.21-0366DOI Listing
July 2021

Phenotypic homogeneity of emetic Bacillus cereus isolates in China.

Lett Appl Microbiol 2021 Jun 26. Epub 2021 Jun 26.

Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.

Emetic Bacillus cereus strains produce a potent cereulide cytotoxin, which can cause acute and fatal cases of food poisoning. We isolated 18 emetic B. cereus strains from a food poisoning event, and from clinical and non-random food surveillance in China and phenotypic characteristics of hemolysis, starch hydrolysis, salicin fermentation, gelatin liquefaction, cytotoxicity, and susceptibility to antibiotics were assessed. All isolates were positive for hemolysis and gelatin liquefaction, and negative for starch hydrolysis and salicin fermentation. Their hemolytic potentials were intermediate to Bacillus anthracis and B. cereus ATCC 14579 (a non-emetic strain). All isolates were cytotoxic to CHO, Hep-2 and Vero cells, and were sensitive to ampicillin. The homogeneous phenotypes of emetic isolates from China are similar to the corresponding traits of European and Japanese isolates that have been characterized, suggesting highly similar phenotypes of emetic B. cereus worldwide.
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http://dx.doi.org/10.1111/lam.13527DOI Listing
June 2021

Learning across Tasks for Zero-Shot Domain Adaptation from a Single Source Domain.

IEEE Trans Pattern Anal Mach Intell 2021 Jun 14;PP. Epub 2021 Jun 14.

Human beings are experts in generalization across domains. For example, a baby can easily identify the bear from a clipart image after learning this category of animal from the photo images. To reduce the gap between the generalization ability of human and that of machines, we propose a new solution to the challenging zero-shot domain adaptation (ZSDA) problem, where only a single source domain is available and the target domain for the task of interest is unseen. Inspired by the observation that the knowledge about domain correlation can improve our generalization capability, we explore the correlation between domains in an irrelevant knowledge task (K-task), where dual-domain samples are available. We denote the task of interest as question task (Q-task) and synthesize its non-accessible target-domain as such that these two tasks have the sharing domain correlation. To realize our idea, we introduce a new network structure, i.e., conditional coupled generative adversarial network (CoCoGAN), which is able to capture the joint distribution of data samples across two domains and two tasks. In addition, we introduce three supervisory signals for CoCoGAN training in a ZSDA task. Experimental results demonstrate that our proposed outperforms the existing methods in both image classification and semantic segmentation.
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http://dx.doi.org/10.1109/TPAMI.2021.3088859DOI Listing
June 2021

Genomic evolution and virulence association of sequence type 37 (ribotype 017) in China.

Emerg Microbes Infect 2021 Dec;10(1):1331-1345

School of Laboratory Medicine, Hangzhou Medical College, Hangzhou, People's Republic of China.

sequence type (ST) 37 (ribotype 017) is one of the most prevalent genotypes circulating in China. However, its genomic evolution and virulence determinants were rarely explored. Whole-genome sequencing, phylogeographic and phylogenetic analyses were conducted for ST37 isolates. The 325 ST37 genomes from six continents, including North America ( = 66), South America ( = 4), Oceania ( = 7), Africa ( = 9), Europe ( = 138) and Asia ( = 101), were clustered into six major lineages, with region-dependent distributions, harbouring an array of antibiotic-resistance genes. The ST37 strains from China were divided into four distinct sublineages, showing five importation times and international sources. Isolates associated with severe infections exhibited significantly higher toxin productions, mRNA levels, and sporulation capacities ( < 0.001). Kyoto Encyclopedia of Genes and Genomes analysis showed 10 metabolic pathways were significantly enriched in the mutations among isolates associated with severe CDI ( < 0.05). Gene mutations in glycometabolism, amino acid metabolism and biosynthesis virtually causing instability in protein activity were correlated positively to the transcription of and negatively to the expression of toxin repressor genes, and Y. In summary, our study firstly presented genomic insights into genetic characteristics and virulence association of ST37 in China. Gene mutations in certain important metabolic pathways are associated with severe symptoms and correlated with higher virulence in ST37 isolates.
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http://dx.doi.org/10.1080/22221751.2021.1943538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253194PMC
December 2021

Persistent Discrimination of TB in Southeastern China: Results from Four Repeated Population-Based Surveys During the Period of 2006-2018.

Risk Manag Healthc Policy 2021 3;14:2333-2344. Epub 2021 Jun 3.

Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China.

Objective: To analyze the changes in discriminatory attitudes and isolated behaviors of the public toward tuberculosis (TB) in the Zhejiang Province and to determine the associated factors with TB discrimination.

Methods: Data were obtained from four cross-sectional population-based investigations from 2006 to 2018. A total of 26,246 respondents were interviewed using unified questionnaires that measured knowledge, attitudes, and behaviors regarding TB. The changes in public attitudes and behaviors towards TB over time were analyzed. The effect of socio-demographic factors and the level of TB awareness on TB discriminatory attitudes and isolated behaviors were evaluated.

Results: The results of these four cross-sectional studies found that TB discrimination had not changed much over the decade. Overall, discriminatory attitudes were present in 63.5% of the respondents who knew about TB (81.2%). Nearly 31.2% of those who reported being surrounded by people with TB (5.8%) showed isolated behaviors. Older respondents, those with a low education level, and farmers were prone to having discriminatory attitudes or behaviors. Those aware of the infectiousness and transmission routes of TB, and those who felt that TB was serious were more likely to discriminate against TB ( < 0.001). Those aware that TB can be cured were non-discriminatory (aOR = 0.77, 95% CI: 0.72-0.82).

Conclusion: Discriminatory attitudes and isolated behaviors toward TB have not changed significantly in southeastern China over the survey years, and persistent discrimination against TB still exists among the public. The multiple causes of discrimination cannot be addressed through basic health education. Tailor-made strategies, relevant policy measures, and an enabling social environment for TB are urgently required.
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http://dx.doi.org/10.2147/RMHP.S311869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8184293PMC
June 2021

Domain Shift Preservation for Zero-Shot Domain Adaptation.

IEEE Trans Image Process 2021 11;30:5505-5517. Epub 2021 Jun 11.

In learning-based image processing a model that is learned in one domain often performs poorly in another since the image samples originate from different sources and thus have different distributions. Domain adaptation techniques alleviate the problem of domain shift by learning transferable knowledge from the source domain to the target domain. Zero-shot domain adaptation (ZSDA) refers to a category of challenging tasks in which no target-domain sample for the task of interest is accessible for training. To address this challenge, we propose a simple but effective method that is based on the strategy of domain shift preservation across tasks. First, we learn the shift between the source domain and the target domain from an irrelevant task for which sufficient data samples from both domains are available. Then, we transfer the domain shift to the task of interest under the hypothesis that different tasks may share the domain shift for a specified pair of domains. Via this strategy, we can learn a model for the unseen target domain of the task of interest. Our method uses two coupled generative adversarial networks (CoGANs) to capture the joint distribution of data samples in dual-domains and another generative adversarial network (GAN) to explicitly model the domain shift. The experimental results on image classification and semantic segmentation demonstrate the satisfactory performance of our method in transferring various kinds of domain shifts across tasks.
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http://dx.doi.org/10.1109/TIP.2021.3084354DOI Listing
June 2021

A spatial analysis of the epidemiology of HIV-infected students in Zhejiang province, China.

BMC Infect Dis 2021 May 7;21(1):430. Epub 2021 May 7.

Department of AIDS and STD Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China.

Background: The upsurge in HIV infections among students is a matter of particular concern. However, few studies have explored the epidemiological characteristics including the risky sexual networking of HIV-infected students in Zhejiang province, China.

Methods: Using the provincial surveillance data of HIV-infected students, we conducted a retrospective epidemiology study to describe the epidemiological characteristics of 628 newly diagnosed cases from 2011 to 2016 and detailed information of 124 cases from 2015 to 2016. Spatial analyses were conducted using ArcGIS software, and statistical analyses were performed using SPSS software.

Results: A total of 628 cases of HIV/AIDS were diagnosed among students in Zhejiang Province, China between 2011 and 2016. The cases showed an overall increasing trend over time, while the proportions of students with HIV disease status, cases diagnosed by HIV voluntary counseling and testing (VCT), and cases of homosexual transmission remained stable over time. Significant spatial heterogeneity in the cases was seen at the county level. Detailed data on 124 HIV-positive individuals collected from the local Center for Disease Control and Prevention (CDC) from 2015 and 2016, showed that the majority of them (85.5%,) engaged in homosexual behavior, and 93.4% had sex with casual partners. These partners included not only social members, but also other students. Online dating applications represented the most common means of seeking and communicating with homosexual partners. The level of awareness regarding the risk of HIV infection, and the amount coverage of face-to-face education towards students were both low.

Conclusions: HIV infections among students were characterized by increasing trend and spatial clustering in Zhejiang Province between 2011 and 2016, with homosexual sexual activity being the main mode of infection. Interventions are urgently required to prevent HIV infection in this population by increasing awareness of the disease. HIV testing programs and information regarding disease prevention specifically through online dating applications are needed.
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http://dx.doi.org/10.1186/s12879-021-06033-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106207PMC
May 2021

Accelerating Epidemiological Investigation Analysis by Using NLP and Knowledge Reasoning: A Case Study on COVID-19.

AMIA Annu Symp Proc 2020 25;2020:1258-1267. Epub 2021 Jan 25.

IBM Research, Beijing, China.

COVID-19 is threatening the health of the entire human population. In order to control the spread of the disease, epidemiological investigations should be conducted, to trace the infection source of each confirmed patient and isolate their close contacts. However, the analysis on a mass of case reports in epidemiological investigation is extremely time-consuming and labor-intensive. This paper presents an end-to-end framework for automatic epidemiological case report analysis and inference, in which a Tuple-based Multi-Task Neural Network (TMT-NN) is designed and implemented for jointly recognizing epidemiological entities and relations from case reports, and an epidemiological knowledge graph and its corresponding inference engine are built to uncover the infection modes, sources and pathways. Preliminary experiments demonstrate the promising results, and we published a real data set of COVID-19 epidemiological investigation corpora at Github, as well as contributing our COVID-19 epidemiological knowledge graph to the open community OpenKG.cn.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8075493PMC
May 2021

The first 90: Progress in HIV detection in Zhejiang Province, 2008-2018.

PLoS One 2021 8;16(4):e0249517. Epub 2021 Apr 8.

Department of AIDS/STD Control and Prevention, Zhejiang Provincial Center for Disease Control, Hangzhou, Zhejiang, People's Republic of China.

To analyze the results of HIV screening and the HIV-positive rate based on different HIV detection strategies in Zhejiang Province, China. Data were downloaded from the AIDS Prevention and Control Information System on May 1, 2019. HIV screening, prevalence, and incidence data were analyzed from 2008 to 2018. The incidence of HIV was calculated from the results of BED testing. SPSS software (ver. 19.0) was used for the analysis. The number of people screened for HIV increased by 229.7% from 2008 to 2018, while the incidence of HIV increased from 1.14‱ (2010) to 1.67‱ (2018), peak by 2015 (2.28‱). The proportion of people screened for HIV in medical institutions increased from 62.0% in 2008 to 67.1% in 2018, while of all positive tests, 47.9% were conducted at medical institutions in 2008, which increased to 63.2% in 2018. VCT and STD clinic attendees, who had only 4.5% of all those undergoing HIV tests, accounted for 23.7% of all HIV positive in 2018. The rate of HIV-positive people and incidence of HIV both increased in Zhejiang Province between 2008 and 2015. The most effective strategy for detecting HIV new cases is screening visitors to VCT and STD clinics.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249517PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8031385PMC
April 2021

Corrigendum: COVIEdb: A Database for Potential Immune Epitopes of Coronaviruses.

Front Pharmacol 2020 8;11:646111. Epub 2021 Feb 8.

Institute of Drug Metabolism and Pharmaceutical Analysis and Zhejiang Provincial Key Laboratory of Anti-Cancer Drug Research, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China.

[This corrects the article DOI: 10.3389/fphar.2020.572249.].
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http://dx.doi.org/10.3389/fphar.2020.646111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898895PMC
February 2021

COVIEdb: A Database for Potential Immune Epitopes of Coronaviruses.

Front Pharmacol 2020 2;11:572249. Epub 2020 Sep 2.

College of Pharmaceutical Sciences, Institute of Drug Metabolism and Pharmaceutical Analysis and Zhejiang Provincial Key Laboratory of Anti-Cancer Drug Research, Zhejiang University, Hangzhou, China.

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http://dx.doi.org/10.3389/fphar.2020.572249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898897PMC
September 2020

Dissemination and Refutation of Rumors During the COVID-19 Outbreak in China: Infodemiology Study.

J Med Internet Res 2021 02 15;23(2):e22427. Epub 2021 Feb 15.

Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.

Background: During the outbreak of COVID-19, numerous rumors emerged on the internet in China and caused confusion among the public. However, the characteristics of these rumors in different phases of the epidemic have not been studied in depth, and the official responses to the rumors have not been systematically evaluated.

Objective: The aims of this study were to evaluate the rumor epidemic and official responses during the COVID-19 outbreak in China and to provide a scientific basis for effective information communication in future public health crises.

Methods: Data on internet rumors related to COVID-19 were collected via the Sina Weibo Official Account to Refute Rumors between January 20 and April 8, 2020, extracted, and analyzed. The data were divided into five periods according to the key events and disease epidemic. Different classifications of rumors were described and compared over the five periods. The trends of the epidemic and the focus of the public at different stages were plotted, and correlation analysis between the number of rumors and the number of COVID-19 cases was performed. The geographic distributions of the sources and refuters of the rumors were graphed, and analyses of the most frequently appearing words in the rumors were applied to reveal hotspots of the rumors.

Results: A total of 1943 rumors were retrieved. The median of the response interval between publication and debunking of the rumors was 1 day (IQR 1-2). Rumors in text format accounted for the majority of the 1943 rumors (n=1241, 63.9%); chat tools, particularly WeChat (n=1386, 71.3%), were the most common platform for initial publishing of the rumors (n=1412, 72.7%). In addition to text rumors, Weibo and web pages were more likely to be platforms for rumors released in multimedia formats or in a combination of formats, respectively. Local agencies played a large role in dispelling rumors among social media platforms (1537/1943, 79.1%). There were significant differences in the formats and origins of rumors over the five periods (P<.001). Hubei Province accounted for most of the country's confirmed rumors. Beijing and Wuhan City were the main centers for debunking of disinformation. The words most frequently included in the core messages of the rumors varied by period, indicating shifting in the public's concern.

Conclusions: Chat tools, particularly WeChat, became the major sources of rumors during the COVID-19 outbreak in China, indicating a requirement to establish rumor monitoring and refuting mechanisms on these platforms. Moreover, targeted policy adjustments and timely release of official information are needed in different phases of the outbreak.
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http://dx.doi.org/10.2196/22427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886374PMC
February 2021

Population Structure and Multidrug Resistance of Non-O1/Non-O139 Vibrio cholerae in Freshwater Rivers in Zhejiang, China.

Microb Ecol 2021 Jan 7. Epub 2021 Jan 7.

School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, NSW, 2052, Australia.

To understand the environmental reservoirs of Vibrio cholerae and their public health significance, we surveyed freshwater samples from rivers in two cities (Jiaxing [JX] and Jiande [JD]) in Zhejiang, China. A total of 26 sampling locations were selected, and river water was sampled 456 times from 2015 to 2016 yielding 200 V. cholerae isolates, all of which were non-O1/non-O139. The average isolation rate was 47.3% and 39.1% in JX and JD, respectively. Antibiotic resistance profiles of the V. cholerae isolates were examined with nonsusceptibility to cefazolin (68.70%, 79/115) being most common, followed by ampicillin (47.83%, 55/115) and imipenem (27.83%, 32/115). Forty-two isolates (36.52%, 42/115) were defined as multidrug resistant (MDR). The presence of virulence genes was also determined, and the majority of the isolates were positive for toxR (198/200, 99%) and hlyA (196/200, 98%) with few other virulence genes observed. The population structure of the V. cholerae non-O1/non-O139 sampled was examined using multilocus sequence typing (MLST) with 200 isolates assigned to 128 STs and 6 subpopulations. The non-O1/non-O139 V. cholerae population in JX was more varied than in JD. By clonal complexes (CCs), 31 CCs that contained isolates from this study were shared with other parts of China and/or other countries, suggesting widespread presence of some non-O1/non-O139 clones. Drug resistance profiles differed between subpopulations. The findings suggest that non-O1/non-O139 V. cholerae in the freshwater environment is a potential source of human infections. Routine surveillance of non-O1/non-O139 V. cholerae in freshwater rivers will be of importance to public health.
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http://dx.doi.org/10.1007/s00248-020-01645-zDOI Listing
January 2021

Prevalence of β-Lactam Drug-Resistance Genes in Contaminating Ready-to-Eat Lettuce.

Foodborne Pathog Dis 2020 12 28;17(12):739-742. Epub 2020 Oct 28.

Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, USA.

Thirty-four isolates from 91 ready-to-eat lettuce packages, obtained from local supermarkets in Northern California, were genotyped by multilocus sequence typing, tested for susceptibility to antimicrobial agents, and screened for β-lactamase genes. We found 15 distinct sequence types (STs). Six of these genotypes (ST1198, ST2625, ST2432, ST2819, ST4600, and ST5143) have been reported as pathogens found in human samples. Twenty-six (76%) isolates were resistant to ampicillin, 17 (50%) to ampicillin/sulbactam, 8 (23%) to cefoxitin, and 7 (20%) to cefuroxime. was the most prevalent β-lactamase gene, identified in eight (23%) isolates. We identified a class A broad-spectrum β-lactamase SED-1 gene, , reported by others in isolated from bile of a patient. This study found that fresh lettuce carries β-lactam drug-resistant , which might serve as a reservoir for drug-resistance genes that could potentially be transmitted to pathogens that cause human infections.
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http://dx.doi.org/10.1089/fpd.2020.2792DOI Listing
December 2020

A Geographic Hotspot and Emerging Transmission Cluster of the HIV-1 Epidemic Among Older Adults in a Rural Area of Eastern China.

AIDS Res Hum Retroviruses 2020 09 6;36(9):712-720. Epub 2020 Aug 6.

Lishui Center for Disease Control and Prevention, Lishui, China.

Despite the implementation of health education and free condom distribution for decades, the HIV/AIDS epidemic among older adults in China shows no sign of declining. This study aims to identify HIV transmission patterns and pathways in a rural county area and provide insight for developing effective HIV prevention strategies among older adults. Epidemiological field surveys combined with phylogenetic analysis were used to identify potential HIV transmission linkage in one rural county with a rapidly increasing HIV epidemic among older adults. A total of 160 HIV-positive individuals and their HIV-positive sexual partners diagnosed between 2015 and 2018 were recruited. Among them, 69.4% ( = 111) were diagnosed at age 50 or older, 68.1% ( = 109) were men, and 55.0% ( = 88) were married. Ninety-six participants self-reported as having been infected with HIV through commercial heterosexual behavior and 24 were infected from their HIV-positive spouse. CRF08_BC (67.0%,  = 73) and CRF07_AE (19.3%,  = 21) were the prevalent HIV stains and formed 15 clusters at distance cutoff of 0.0025. Participants diagnosed with HIV at age ≥50, those who were divorced or bereft their spouse, or infected with HIV locally were more prevalent within the 15 molecular clusters. We identified specific venues as the primary hotspot and found that commercial heterosexual contact between older men and commercial sex workers contributed to the local HIV epidemic. In rural areas with an increasing HIV epidemic, detecting HIV transmission clusters through epidemiological and phylogenetic analysis as well as designing localized HIV prevention strategies should be prioritized.
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http://dx.doi.org/10.1089/AID.2019.0293DOI Listing
September 2020

Isolation and Growth Characteristics of SARS-CoV-2 in Vero Cell.

Virol Sin 2020 06 19;35(3):348-350. Epub 2020 Jun 19.

Key Lab of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, China.

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http://dx.doi.org/10.1007/s12250-020-00241-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303940PMC
June 2020

Video Saliency Prediction via Joint Discrimination and Local Consistency.

IEEE Trans Cybern 2020 May 20;PP. Epub 2020 May 20.

While saliency detection on static images has been widely studied, the research on video saliency detection is still in an early stage and requires more efforts due to the challenge to bring both local and global consistency of salient objects into full consideration. In this article, we propose a novel dynamic saliency network based on both local consistency and global discriminations, via which semantic features across video frames are simultaneously extracted and a recurrent feature optimization structure is designed to further enhance its performances. To ensure that the generated dynamic salient map is more concentrated, we design a lightweight discriminator with a local consistency loss LC to identify subtle differences between predicted maps and ground truths. As a result, the proposed network can be further stimulated to produce more realistic saliency maps with smoother boundaries and simpler layer transitions. The added LC loss forces the network to pay more attention to the local consistency between continuous saliency maps. Both qualitative and quantitative experiments are carried out on three large datasets, and the results demonstrate that our proposed network not only achieves improved performances but also shows good robustness.
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http://dx.doi.org/10.1109/TCYB.2020.2989158DOI Listing
May 2020

Molecular characteristics of Clostridium difficile in children with acute gastroenteritis from Zhejiang.

BMC Infect Dis 2020 May 13;20(1):343. Epub 2020 May 13.

School of Laboratory Medicine, Hangzhou Medical College, No. 481, Binwen Road, Hangzhou, Zhejiang, China.

Background: Clostridium difficile infection (CDI) has an increasing pediatric prevalence worldwide. However, molecular characteristics of C. difficile in Chinese children with acute gastroenteritis have not been reported.

Methods: A five-year cross-sectional study was conducted in a tertiary children's hospital in Zhejiang. Consecutive stool specimens from outpatient children with acute gastroenteritis were cultured for C. difficile, and isolates then were analyzed for toxin genes, multi-locus sequence type and antimicrobial resistance. Diarrhea-related viruses were detected, and demographic data were collected.

Results: A total of 115 CDI cases (14.3%), and 69 co-infected cases with both viruses and toxigenic C. difficile, were found in the 804 stool samples. The 186 C. difficile isolates included 6 of toxin A-positive/toxin B-positive/binary toxin-positive (ABCDT), 139 of ABCDT, 3 of ABCDT, 36 of ABCDT and 2 of ABCDT. Sequence types 26 (17.7%), 35 (11.3%), 39 (12.4%), 54 (16.7%), and 152 (11.3%) were major genotypes with significant differences among different antimicrobial resistances (Fisher's exact test, P < 0.001). The AB isolates had significantly higher resistance, compared to erythromycin, rifampin, moxifloxacin, and gatifloxacin, than that of the AB (χ = 7.78 to 29.26, P < 0.01). The positive CDI rate in infants (16.2%) was significantly higher than that of children over 1 year old (10.8%) (χ = 4.39, P = 0.036).

Conclusions: CDI has been revealed as a major cause of acute gastroenteritis in children with various genotypes. The role of toxigenic C. difficile and risk factors of CDI should be emphatically considered in subsequent diarrhea surveillance in children from China.
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http://dx.doi.org/10.1186/s12879-020-05030-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222317PMC
May 2020

Identification and Prediction of Tuberculosis in Eastern China: Analyses from 10-year Population-based Notification Data in Zhejiang Province, China.

Sci Rep 2020 05 4;10(1):7425. Epub 2020 May 4.

Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.

Tuberculosis, a severe infectious disease caused by the Mycobacterium tuberculosis, arouses huge concerns globally. In this study, a total of 331,594 TB cases in Zhejiang Province were notified during the period of 2009-2018 with the gender ratio of male to female 2.16:1. The notified TB incidences demonstrated a continuously declining trend from 75.38/100,000 to 52.25/100,000. Seasonally, the notified TB cases presented as low in January and February closely followed an apparent rise in March and April. Further stratification analysis by both genders demonstrated the double peak phenomenon in the younger population ("15-35") and the elders (">55") of the whole group. Results from the rate difference (RD) analysis showed that the rising TB incidence mainly presented in the young group of "15-20" and elder group of "65-70", implying that some implementations such as the increased frequency of checkup in specific student groups and strengthening of elder health examination could be explored and integrated into available health policy. Finally, the SARIMA (2,0,2) (0,1,1)12 was determined as the optimal prediction model, which could be used in the further prediction of TB in Zhejiang Province.
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http://dx.doi.org/10.1038/s41598-020-64387-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198485PMC
May 2020

Learning to Explore Saliency for Stereoscopic Videos via Component-Based Interaction.

IEEE Trans Image Process 2020 Apr 13. Epub 2020 Apr 13.

In this paper, we devise a saliency prediction model for stereoscopic videos that learns to explore saliency inspired by the component-based interactions including spatial, temporal, as well as depth cues. The model first takes advantage of specific structure of 3D residual network (3D-ResNet) to model the saliency driven by spatio-temporal coherence from consecutive frames. Subsequently, the saliency inferred by implicit-depth is automatically derived based on the displacement correlation between left and right views by leveraging a deep convolutional network (ConvNet). Finally, a component-wise refinement network is devised to produce final saliency maps over time by aggregating saliency distributions obtained from multiple components. In order to further facilitate research towards stereoscopic video saliency, we create a new dataset including 175 stereoscopic video sequences with diverse content, as well as their dense eye fixation annotations. Extensive experiments support that our proposed model can achieve superior performance compared to the state-of-the-art methods on all publicly available eye fixation datasets.
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http://dx.doi.org/10.1109/TIP.2020.2985531DOI Listing
April 2020

Co-circulation of influenza A(H1N1), A(H3N2), B(Yamagata) and B(Victoria) during the 2017-2018 influenza season in Zhejiang Province, China.

Epidemiol Infect 2020 02 14;148:e296. Epub 2020 Feb 14.

Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang, People's Republic of China.

Influenza is a major human respiratory pathogen. Due to the high levels of influenza-like illness (ILI) in Zhejiang, China, the control and prevention of influenza was challenging during the 2017-2018 season. To identify the clinical spectrum of illness related to influenza and characterise the circulating influenza virus strains during this period, the characteristics of ILI were studied. Viral sequencing and phylogenetic analyses were conducted to investigate the virus types, substitutions at the amino acid level and phylogenetic relationships between sequences. This study has shown that the 2017/18 influenza season was characterised by the co-circulation of influenza A (H1N1) pdm09, A (H3N2) and B viruses (both Yamagata and Victoria lineage). From week 36 of 2017 to week 12 of 2018, ILI cases accounted for 5.58% of the total number of outpatient and emergency patient visits at the surveillance sites. Several amino acid substitutions were detected. Vaccination mismatch may be a potential reason for the high percentage of ILI. Furthermore, it is likely that multiple viral introductions played a role in the endemic co-circulation of influenza in Zhejiang, China. More detailed information regarding the molecular epidemiology of influenza should be included in long-term influenza surveillance.
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http://dx.doi.org/10.1017/S0950268820000412DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7770466PMC
February 2020

Spatial and temporal analysis of severe fever with thrombocytopenia syndrome in Zhejiang Province, China, 2011 - 2015.

J Infect Dev Ctries 2019 01 31;13(1):35-43. Epub 2019 Jan 31.

Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Binjiang District, Hangzhou 310051, Zhejiang, China.

Introduction: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease first discovered in northeast and central China in 2009, and SFTS cases increased year by year in China. This study aimed to identify the spatial and temporal clusters of SFTS in Zhejiang Province, China.

Methodology: We analyzed the surveillance data of SFTS in Zhejiang Province during 2011 - 2015. Descriptive statistics were used to analyze the general characteristics and overall trend of SFTS. Circular statistic method was utilized to identify the seasonality. Space-time scan analysis was performed to explore the high risk spatio-temporal clusters of SFTS cases at county level.

Results: A total of 194 confirmed SFTS cases were reported in Zhejiang Province during 2011 - 2015. We found a significant increase in overall time trend since 2011. The seasonality was statistically significant (P < 0.001), with a mean date (95% CI) of 21st June (12th ~ 30th in June). Totally 21 (23%) counties reported the occurrence of SFTS, which gradually spread throughout Zhejiang. Three spatio-temporal clusters were detected, with one principle cluster (Daishan County, RR 234.48, June 2013 - November 2015) and two secondary clusters (6 counties, RR 30.73, April - October in 2015; Anji County, RR 373.26, May 2014).

Conclusions: Our results suggested that SFTS has increased and spatially expanded over the past years, with a remarkable seasonality. Three spatio-temporal clusters were identified. These findings are important for the improvement of SFTS surveillance and control strategies.
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http://dx.doi.org/10.3855/jidc.10373DOI Listing
January 2019

High-Level Resistance of Toxigenic Genotype to Macrolide-Lincosamide- Streptogramin B in Community Acquired Patients in Eastern China.

Infect Drug Resist 2020 17;13:171-181. Epub 2020 Jan 17.

Centre of Laboratory Medicine, Zhejiang Provincial People Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China.

Background: resistant to macrolide-lincosamide-streptogramin B (MLS) has not been reported in China.

Methods: In a cross-sectional study in two tertiary hospitals, isolates from stool specimens from community-onset, hospital-associated diarrheal patients were analyzed for toxin genes, genotype, and antibiotic resistance, and the patients' clinical charts were reviewed.

Results: A total of 190 (15.2%) isolates (102 AB and 88 AB) from 1250 community acquired (CA) patients were recovered and all were susceptible to vancomycin and metronidazole. High-level resistance (minimum inhibitory concentration > 128 mg/L) to erythromycin and clindamycin was recorded in 77.9% and 88.4% of the tested isolates, respectively. Furthermore, 89.3% (159/178) of the isolates resistant to MLS carried the erythromycin resistance methylase gene (). The statistically significant factors associated with infection (CDI) induced by AB isolates with MLS resistance included a severity score of >2 (odds ratio [95% confidence interval], 7.43 [2.31-23.87]) and platelet count (cells × 10 cells/L) < 100 [5.19 (1.58-17.04)]. The proportion of AB increased with enhanced CDI severity ( = 21.62, 0.001), which was significantly higher than that of -positive AB in severity score of 4 ( = 8.61, = 0.003). The average severity score of -positive isolates was significantly higher than that of -negative isolates in AB ( = -2.41, = 0.016).

Conclusion: The -positive AB with MLS resistance is described for the first time as a potential epidemic clone inducing severe CDI in CA diarrheal patients in Eastern China.
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http://dx.doi.org/10.2147/IDR.S238916DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6974413PMC
January 2020

EEG-based image classification via a region-level stacked bi-directional deep learning framework.

BMC Med Inform Decis Mak 2019 12 19;19(Suppl 6):268. Epub 2019 Dec 19.

The Research Institute for Future Media Computing, College of Computer Science & Software Engineering, Shenzhen University, Shenzhen, 518060, China.

Background: As a physiological signal, EEG data cannot be subjectively changed or hidden. Compared with other physiological signals, EEG signals are directly related to human cortical activities with excellent temporal resolution. After the rapid development of machine learning and artificial intelligence, the analysis and calculation of EEGs has made great progress, leading to a significant boost in performances for content understanding and pattern recognition of brain activities across the areas of both neural science and computer vision. While such an enormous advance has attracted wide range of interests among relevant research communities, EEG-based classification of brain activities evoked by images still demands efforts for further improvement with respect to its accuracy, generalization, and interpretation, yet some characters of human brains have been relatively unexplored.

Methods: We propose a region-level stacked bi-directional deep learning framework for EEG-based image classification. Inspired by the hemispheric lateralization of human brains, we propose to extract additional information at regional level to strengthen and emphasize the differences between two hemispheres. The stacked bi-directional long short-term memories are used to capture the dynamic correlations hidden from both the past and the future to the current state in EEG sequences.

Results: Extensive experiments are carried out and our results demonstrate the effectiveness of our proposed framework. Compared with the existing state-of-the-arts, our framework achieves outstanding performances in EEG-based classification of brain activities evoked by images. In addition, we find that the signals of Gamma band are not only useful for achieving good performances for EEG-based image classification, but also play a significant role in capturing relationships between the neural activations and the specific emotional states.

Conclusions: Our proposed framework provides an improved solution for the problem that, given an image used to stimulate brain activities, we should be able to identify which class the stimuli image comes from by analyzing the EEG signals. The region-level information is extracted to preserve and emphasize the hemispheric lateralization for neural functions or cognitive processes of human brains. Further, stacked bi-directional LSTMs are used to capture the dynamic correlations hidden in EEG data. Extensive experiments on standard EEG-based image classification dataset validate that our framework outperforms the existing state-of-the-arts under various contexts and experimental setups.
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http://dx.doi.org/10.1186/s12911-019-0967-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6921386PMC
December 2019

Tuberculosis outbreaks among students in mainland China: a systematic review and meta-analysis.

BMC Infect Dis 2019 Nov 14;19(1):972. Epub 2019 Nov 14.

Zhejiang provincial Centers for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China.

Background: In recent years, tuberculosis outbreaks in schools have occurred more frequently in China than in other parts of the world, and have posed a public health threat to students and their families. This systematic review aimed to understand the epidemiological characteristics of tuberculosis (TB) outbreaks and analyze the factors associated with TB outbreaks in schools in China.

Methods: We conducted this systematic review following the standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The meta-analysis was performed with STATA using a random effects model.

Results: We included 107 studies involving 1795 student patients with TB in mainland China. The results of the systematic analysis indicated that TB outbreaks were more frequently reported in senior middle schools and in Eastern China. The outbreaks mainly occurred during the winter and spring, and the median outbreak duration was 4 months. The meta-analysis showed that the total attack rate and the class attack rate of tuberculosis outbreaks among students were 4.60% (95% CI 3.80 to 5.70%) and 22.70% (95% CI 19.20 to 27.00%), respectively. Subgroup analysis showed that outbreaks that occurred at universities or colleges had a relatively higher attack rate than those occurred in senior middle schools. The prevalence of latent tuberculosis infection (LTBI) among close contacts was 23.70% (95% CI 19.50 to 28.90%). The median case-finding interval was 2 months, and 47.40% of the index cases had a case-finding delay.

Conclusion: The results of our review indicated that school TB outbreaks were reported most frequently in senior middle schools in China. The attack rates of outbreaks at universities or colleges were higher than those in senior middle schools. The TB outbreaks in schools usually occurred over prolonged periods. The case-finding delay in the index cases must be reduced to prevent transmission in classes and schools. Effective surveillance and screening of presumptive TB cases in schools should be strengthened to reduce outbreaks in schools.
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http://dx.doi.org/10.1186/s12879-019-4573-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6854678PMC
November 2019

Public Awareness of Tuberculosis in Southeast China: A Population-Based Study.

Int J Environ Res Public Health 2019 11 5;16(21). Epub 2019 Nov 5.

Department of Tuberculosis Control and Prevention, Zhejiang provincial Center for Disease Control and Prevention, Hangzhou 310051, China.

Few provinces in China have recently conducted population-based surveys on tuberculosis (TB) awareness at the provincial level. Hence, we conducted a population-based, cross-sectional study to evaluate the level of awareness of TB knowledge among residents of Zhejiang Province, China from October 2018 to December 2018. A total of 7174 individuals were randomly selected to participate in this survey. The rate of awareness of key information on TB was found to be 48.0%. The study's participants exhibited a good understanding of the transmission route (80.8%), curable outcome (78.3%), and designated treatment sites (67.0%) of TB. The rate of awareness of suspicious TB symptoms (36.1%) and the relief policy on diagnosis and first-line therapeutic drugs (38.0%) were found to be relatively low among the respondents. People living in rural areas, those who were less educated, and students all showed a low level of awareness of key knowledge about TB. In conclusion, residents in Zhejiang Province generally lacked key information about TB, which is not conducive to the early detection and treatment of TB. Corresponding efforts should be made for different groups of people to achieve favorable effects on the prevention and control of TB.
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http://dx.doi.org/10.3390/ijerph16214290DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6862559PMC
November 2019

Different molecular characteristics and antimicrobial resistance profiles of in the Asia-Pacific region.

Emerg Microbes Infect 2019 ;8(1):1553-1562

Department of Microbiology, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China.

Molecular epidemiology of infection (CDI) has been extensively studied in North America and Europe; however, limited data on CDI are available in the Asia-Pacific region. A multicentre retrospective study was conducted in this region. isolates were subjected to multilocus sequence typing (ST) and antimicrobial susceptibility testing. Totally, 394 isolates were collected from Hangzhou, Hong Kong, China; Busan, South Korea; Fukuoka, Japan; Singapore; Perth, Sydney, Australia; New York, the United States. isolates included 337 toxin A-positive/B-positive/binary toxin-negative (ABCDT), 48 ABCDT, and nine ABCDT. Distribution of dominant STs varied geographically with ST17 in Fukuoka (18.6%), Busan (56.0%), ST2 in Sydney (20.4%), Perth (25.8%). The antimicrobial resistance patterns were significantly different among the eight sites ( = 325.64, < 0.001). Five major clonal complexes correlated with unique antimicrobial resistances. Healthcare-associated (HA) CDI was mainly from older patients with more frequent antimicrobial use and higher AB positive rates. Higher resistance to gatifloxacin, tetracycline, and erythromycin were observed in HA-CDI patients ( = 4.76-7.89, = 0.005-0.029). In conclusion, multiple genotypes with varied antimicrobial resistance patterns have been circulating in the Asia-Pacific region. AB isolates from older patients with prior antimicrobial use were correlated with HA-CDI.
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http://dx.doi.org/10.1080/22221751.2019.1682472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830245PMC
January 2020

Chrysophanol protects against doxorubicin-induced cardiotoxicity by suppressing cellular PARylation.

Acta Pharm Sin B 2019 Jul 1;9(4):782-793. Epub 2018 Nov 1.

School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China.

The clinical application of doxorubicin (DOX) in cancer chemotherapy is limited by its life-threatening cardiotoxic effects. Chrysophanol (CHR), an anthraquinone compound isolated from the rhizome of L., is considered to play a broad role in a variety of biological processes. However, the effects of CHR׳s cardioprotection in DOX-induced cardiomyopathy is poorly understood. In this study, we found that the cardiac apoptosis, mitochondrial injury and cellular PARylation levels were significantly increased in H9C2 cells treated by Dox, while these effects were suppressed by CHR. Similar results were observed when PARP1 activity was suppressed by its inhibitors 3-aminobenzamide (3AB) and ABT888. Ectopic expression of PARP1 effectively blocked this CHR׳s cardioprotection against DOX-induced cardiomyocyte injury in H9C2 cells. Furthermore, pre-administration with both CHR and 3AB relieved DOX-induced cardiac apoptosis, mitochondrial impairment and heart dysfunction in Sprague-Dawley rat model. These results revealed that CHR protects against DOX-induced cardiotoxicity by suppressing cellular PARylation and provided critical evidence that PARylation may be a novel target for DOX-induced cardiomyopathy.
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http://dx.doi.org/10.1016/j.apsb.2018.10.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6663922PMC
July 2019

Assessment of active tuberculosis findings in the eastern area of China: A 3-year sequential screening study.

Int J Infect Dis 2019 Nov 30;88:34-40. Epub 2019 Jul 30.

Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China; Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China. Electronic address:

Background: Tuberculosis (TB) is a critical global public threat, and limited epidemiology studies have been performed to explore the efficacy of active TB screening.

Methods: Three sites located in eastern China were chosen in 2013, and three rounds of systematic screenings were performed in permanent residents aged older than 15 years.

Results: The TB incidence showed a downtrend after several rounds of active screening at the three sites, and a significant change was observed at site A in the overall population. In the target population at sites A and B, both the elderly and people with a history of TB had a remarkable decline through the first or second round of screening. The implementation of active case-finding identified 2.36 [1.47,3.81] (2013 vs. 2012) and 1.49 [1.1,2.03] (2013-2015 vs. 2010-2012) more potential cases than the passive case-finding by the surveillance system at site A.

Conclusions: Active case-finding of tuberculosis might be effective in high prevalence area with a low economic level, particularly among the elderly and people with a history of TB. Additionally, new rapid diagnosis technology should be considered to decrease the prevalence among people with a history of TB. Ultimately, active screening identified more active TB cases than passive case-finding, particularly in high prevalence area with underdeveloped economics.
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http://dx.doi.org/10.1016/j.ijid.2019.07.029DOI Listing
November 2019

Human Eye Movements Reveal Video Frame Importance.

Computer (Long Beach Calif) 2019 May 14;52(5):48-57. Epub 2019 May 14.

The Smith-Kettlewell Eye Research Institute.

Human eye movements indicate important spatial information in static images as well as videos. Yet videos contain additional temporal information and convey a storyline. Video summarization is a technique that reduces video size, but maintains the essence of the storyline. Here, the authors explore whether eye movement patterns reflect frame importance during video viewing and facilitate video summarization. Eye movements were recorded while subjects watched videos from the SumMe video summarization dataset. The authors find more gaze consistency for selected than unselected frames. They further introduce a novel multi-stream deep learning model for video summarization that incorporates subjects' eye movement information. Gaze data improved the model's performance over that observed when only the frames' physical attributes were used. The results suggest that eye movement patterns reflect cognitive processing of sequential information that helps select important video frames, and provide an innovative algorithm that uses gaze information in video summarization.
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http://dx.doi.org/10.1109/MC.2019.2903246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7975628PMC
May 2019
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