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Cloud storage attracts a lot of clients to join the paradise. For a high data availability, some clients require their files to be replicated and stored on multiple servers. Because clients are generally charged based on the redundancy level required by them, it is critical for clients to obtain convincing evidence that all replicas are stored correctly and are updated to the up-to-date version. In this paper, we propose a dynamic proof of data possession and replication (DPDPR) scheme, which is proved to be secure in the defined security model. Our scheme shares a single authenticated tree across multiple replicas, which reduces the tree's storage cost significantly. Our scheme allows for batch verification for multiple challenged leaves and can verify multiple replicas in a single batch way, which considerably save bandwidth and computation resources during audit process. We also evaluate the DPDPR's performance and compare it with the most related scheme. The evaluation results show that our scheme saves almost 66% tree's storage cost for three replicas, and obtains almost 60% and 80% efficiency improvements in terms of the overall bandwidth and computation costs, respectively, when three replicas are checked and each challenged with 460 blocks.

BACKGROUND Dipeptidyl peptidase-4 (DPP4) is commonly targeted to achieve glycemic control and has potent anti-inflammatory and immunoregulatory effects. Recent structural analyses indicated a potential tight interaction between DPP4 and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), raising a promising hypothesis that DPP4 inhibitor (DPP4i) drugs might be an optimal strategy for treating coronavirus disease 2019 (COVID-19) among patients with diabetes. However, there has been no direct clinical evidence illuminating the associations between DPP4i use and COVID-19 outcomes. AIM To illuminate the associations between DPP4i usage and the adverse outcomes of COVID-19. METHODS We conducted a multicenter, retrospective analysis including 2563 patients with type 2 diabetes who were hospitalized due to COVID-19 at 16 hospitals in Hubei Province, China. After excluding ineligible individuals, 142 patients who received DPP4i drugs and 1115 patients who received non-DPP4i oral anti-diabetic drugs were included in the subsequent analysis. We performed a strict propensity score matching (PSM) analysis where age, sex, comorbidities, number of oral hypoglycemic agents, heart rate, blood pressure, pulse oxygen saturation (SpO2) < 95%, CT diagnosed bilateral lung lesions, laboratory indicators, and proportion of insulin usage were matched. Finally, 111 participants treated with DPP4i drugs were successfully matched to 333 non-DPP4i users. Then, a linear logistic model and mixed-effect Cox model were applied to analyze the associations between in-hospital DPP4i use and adverse outcomes of COVID-19. RESULTS After rigorous matching and further adjustments for imbalanced variables in the linear logistic model and Cox adjusted model, we found that there was no significant association between in-hospital DPP4i use (DPP4i group) and 28-d all-cause mortality (adjusted hazard ratio = 0.44, 95%CI: 0.09-2.11, P = 0.31). Likewise, the incidences and risks of secondary outcomes, including septic shock, acute respiratory distress syndrome, or acute organ (kidney, liver, and cardiac) injuries, were also comparable between the DPP4i and non-DPP4i groups. The performance of DPP4i agents in achieving glucose control (e.g., the median level of fasting blood glucose and random blood glucose) and inflammatory regulation was approximately equivalent in the DPP4i and non-DPP4i groups. Furthermore, we did not observe substantial side effects such as uncontrolled glycemia or acidosis due to DPP4i application relative to the use of non-DPP4i agents in the study cohort. CONCLUSION Our findings demonstrated that DPP4i use is not significantly associated with poor outcomes of COVID-19 or other adverse effects of anti-diabetic treatment. The data support the continuation of DPP4i agents for diabetes management in the setting of COVID-19.

A Mach-Zehnder interferometer (MZI) based on two spherical structures is proposed and temperature and humidity are measured simultaneously. The device is fabricated by inserting two spherical structures into a single mode optical fiber (SMF). The results of the experiment indicate that the temperature sensitivities are 0.079 nm/°C and 0.090 nm/°C from 10 °C to 60 °C, respectively. When the humidity changes from 30% to 70%, the humidity sensitivities are 0.148 nm/%RH and 0.06 nm/%RH, respectively. Therefore, temperature and humidity are measured simultaneously by the sensitive matrix. The new structure is demonstrated to be a particularly useful approach to detect temperature and humidity.

Supplemental Digital Content is available in the text., Rationale: Use of ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) is a major concern for clinicians treating coronavirus disease 2019 (COVID-19) in patients with hypertension. Objective: To determine the association between in-hospital use of ACEI/ARB and all-cause mortality in patients with hypertension and hospitalized due to COVID-19. Methods and Results: This retrospective, multi-center study included 1128 adult patients with hypertension diagnosed with COVID-19, including 188 taking ACEI/ARB (ACEI/ARB group; median age 64 [interquartile range, 55–68] years; 53.2% men) and 940 without using ACEI/ARB (non-ACEI/ARB group; median age 64 [interquartile range 57–69]; 53.5% men), who were admitted to 9 hospitals in Hubei Province, China from December 31, 2019 to February 20, 2020. In mixed-effect Cox model treating site as a random effect, after adjusting for age, gender, comorbidities, and in-hospital medications, the detected risk for all-cause mortality was lower in the ACEI/ARB group versus the non-ACEI/ARB group (adjusted hazard ratio, 0.42 [95% CI, 0.19–0.92]; P=0.03). In a propensity score-matched analysis followed by adjusting imbalanced variables in mixed-effect Cox model, the results consistently demonstrated lower risk of COVID-19 mortality in patients who received ACEI/ARB versus those who did not receive ACEI/ARB (adjusted hazard ratio, 0.37 [95% CI, 0.15–0.89]; P=0.03). Further subgroup propensity score-matched analysis indicated that, compared with use of other antihypertensive drugs, ACEI/ARB was also associated with decreased mortality (adjusted hazard ratio, 0.30 [95% CI, 0.12–0.70]; P=0.01) in patients with COVID-19 and coexisting hypertension. Conclusions: Among hospitalized patients with COVID-19 and coexisting hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB nonusers. While study interpretation needs to consider the potential for residual confounders, it is unlikely that in-hospital use of ACEI/ARB was associated with an increased mortality risk.

An in-line Mach-Zehnder interferometer (MZI) for simultaneous measurement of temperature and refractive index (RI) is proposed and demonstrated. The sensor is composed of cleaved taper, single-mode fiber (SMF) and spherical structure. Using precision device to measure the position of waist, the cleaved taper structure is obtained by cutting the taper structure. The sensitivities of the temperature are 0.052 nm/ °C and 0.037 nm/ °C in the temperature range of 25–70 °C, respectively. The RI sensitivities are −56.59 nm/RIU and −43.53 nm/RIU in the RI range of 1.335–1.38, respectively. This sensor has many advantages such as compact structure and good stability.

The Android packing techniques were originally used to pack and conceal important information of the apps to prevent malicious developers from deconstructing the software logic. However, due to the lack of supervision, packing techniques have become the common methods for Android malwares to harden apps and circumvent virus detection engines in recent years. With obfuscation and encryption techniques, packing engines can alter the code structure of malwares and hide the malicious code to deceive and bypass the detection mechanisms, such as signature matching. For packing techniques, the packers are the agents created by packing engines and used to protect the softwares. Hence the packers pose a major challenge to the automated malware detection when researchers analyze a large collection of Android apps statically. It is necessary to identify packed samples in advance so that researchers can adopt different process procedures. To address this problem, we propose an intelligent AnDroid Packer Detection Framework called DroidPDF. It adopts a concise feature set that is resilient to obfuscation techniques. It also introduces weighted entropy to improve the detection effectiveness and achieves an average F1 Score of 0.9870.

For the ghost in visual background extractor (ViBe) algorithm and the influence of dynamic background, an improved ViBe algorithm is proposed to extract moving object in this paper. The way of background acquisition during modeling is improved to eliminate the ghost. Detect the saliency of the pre-M-frame, and synthetic relatively real background. Modeling with the background can avoid the generation of ghost. The selection of thresholds in the model is improved to reduce the impact of the dynamic background. Adjust the thresholds adaptively according to the background complexity. In addition, find the inner contour of extracted object to fill, which makes the detected targets more complete. Experimental results show that the presented algorithm effectively removes ghosts and enhances anti-interference ability. Compared with several existing methods, the presented algorithm has better performance.

Background Premature ovarian failure (POF) is a common disease in the field of Gynecology. Low intensity pulsed ultrasound (LIPUS) can promote tissue repair and improve function. This study was performed to determine the effects of LIPUS on granulosa cells (GCs) apoptosis and protein expression of B-cell lymphoma-2 (Bcl-2) and BCL2-Associated X (Bax) in 4-vinylcyclohexene diepoxide (VCD)-induced POF mice and investigate the mechanisms of LIPUS on ovarian function and reserve capacity. Methods The current POF mice model was administrated with VCD (160 mg/kg) by intraperitoneal injection for 15 consecutive days. The mice were divided into the POF group, LIPUS group and control group. In the LIPUS group, the right ovary of mice was treated by LIPUS (acoustic intensity was 200 mW/cm2, frequency was 0.3 MHz, and duty cycle was 20%) for 20 min, 15 consecutive days from day 16. The mice of the POF group and control group were treated without ultrasonic output. The basic observation and body weight were recorded. Hematoxylin and eosin staining (H&E staining) and enzyme-linked immunosorbent assay (ELISA) were applied to detect ovarian follicle development, ovarian morphology and sex hormone secretion. Ovarian GCs apoptosis was detected by TUNEL assay and immunohistochemistry. Results The results showed that VCD can induce estrus cycle disorder, follicular atresia, sex hormone secretion decreased and GCs apoptosis in mice to establish POF model successfully. LIPUS significantly promoted follicular development, increased sex hormone secretion, inhibited excessive follicular atresia and GCs apoptosis. The mechanism might be achieved by increasing the protein expression of Bcl-2 and decreasing the expression of Bax in ovaries. Conclusions LIPUS can improve the POF induced by VCD. These findings have the potential to provide novel methodological foundation for the future research, which help treat POF patients in the clinic.

Replication is a fundamental solution for the cloud service provider (CSP) to guarantee data availability. To provide users with convincing evidence that the copies required by them are all stored correctly, a number of multi-copy integrity auditing schemes were presented. Recently, Barsoum and Hasan proposed a map-based provable multi-copy dynamic data possession scheme (IEEE Transactions on Information Forensics and Security, vol. 10, no. 3, pp. 485–497, 2015), which was claimed to be secure and can ensure that the CSP possesses all copies required by the contract. However, in this letter, we show that the scheme is easily subject to a copy-summation attack and a single-copy attack, by which a cheating CSP only needs to invest a storage cost of a single copy—while can still pass the verifier’s challenge at all times. Therefore, the scheme is no longer secure in this case. Furthermore, we propose some simple but effective countermeasures and give a repaired scheme which is free from the above two attacks.

To increase the detection rate of deep vein thrombosis (DVT) and to compare the predictive value of four different risk assessment scales (Caprini, Autar, Pauda, and Khorana scales) for DVT in patients with solid tumors by the receiver operating curve (ROC). A total of 361 patients with all kinds of malignant solid tumors, who accepted anti-tumor therapy in the cancer center between March 3, 2015 to April 13, 2018, were assigned to a group of 230 cases diagnosed with DVT and a control group of 131 cases without DVT. Data were recorded and summarized, and the predictive value of the above four risk assessment scales for DVT in solid tumor patients was compared based on the area under the ROC curve (AUC). The AUC values determined for the Caprini, Autar, Pauda, and Khorana scales were (0.631 ± 0.030), (0.686 ± 0.028), (0.654 ± 0.029), and (0.599 ± 0.032), respectively; maximum sensitivity, specificity, and Youden index were 80.9% for Khorana, 86.3% for Caprini, and 29.6% for Autar scale, respectively. We found no statistically significant differences in the AUC values between Autar and Caprini, Autar and Khorana, as well as Khorana and Pauda (p > 0.05). However, the AUC differences between Autar and Pauda, Caprini and Khorana, as well as Caprini and Pauda were statistically significant (p

Accumulating evidences indicates that chronic neuropathic pain is a kind of neuro-immune disorder with enhanced activation of the immune system. Although the prevalence is very high, neuropathic pain remains extremely difficult to cure. miRNAs are a group of short nonprotein coding RNAs, regulating target genes expression via targeting 3'-untranslated region. More and more research indicates that altered miRNAs expression profile relates to the pathogenesis of neuropathic pain. In this study, we firstly detected the expression of six candidate miRNAs in the plasma samples from 23 patients with neuropathic pain and 10 healthy controls. Subsequently, the level of miR-132 and miR-101 was detected in the sural nerve biopsies. We found miR-101 level was significantly repressed in both the plasma samples and sural nerve biopsies from neuropathic pain patients. Predicted by bioinformatics tools and confirmed by dual luciferase assay and immunoblotting, we identified that KPNB1 is a direct target of miR-101. The negative correlation between miR-101 and KPNB1 was also confirmed in the sural nerve biopsies, and miR-101 reduction relates to the activation of NF-κB signaling in vivo and in vitro which contributes to the pathogenesis of neuropathic pain.

A single-mode-few-mode-thin-core-single-mode (SFTS) structure based optical fiber sensor is fabricated and experimentally studied. The sensing principle relies on the inter-modal interference. Since the core diameter of few-mode fiber (FMF) is larger than that of single-mode fiber (SMF), the FMF helps to allow more light to enter the cladding of thin-core fiber (TCF), which helps TCF to excite cladding modes. The interference between core and cladding modes in TCF occurs at the joint of lead-out SMF and TCF. Experimental results demonstrate a refractive index (RI) sensitivity of −103.34 nm/RIU and a temperature sensitivity of 0.05 nm/°C. The proposed sensor not only can measure temperature, but also can measure RI. In addition, the proposed sensor is simple for without complicated fabrication process.

Metabolic dysfunction is becoming a predominant risk for the development of many comorbidities. Ischemic heart disease (IHD) still imposes the highest disease burden among all cardiovascular diseases worldwide. However, the contributions of metabolic risk factors to IHD over time have not been fully characterized. Here, we analyzed the global disease burden of IHD and 15 associated general risk factors from 1990 to 2019 by applying the methodology framework of the Global Burden of Disease Study. We found that the global death cases due to IHD increased steadily during that time frame, while the mortality rate gradually declined. Notably, metabolic risk factors have become the leading driver of IHD, which also largely contributed to the majority of IHD-related deaths shifting from developed countries to developing countries. These findings suggest an urgent need to implement effective measures to control metabolic risk factors to prevent further increases in IHD-related deaths.

Women with premature ovarian insufficiency (POI) may be more vulnerable to a variety of health risks. To seek a new method to treat the disease, the effects of low-intensity pulsed ultrasound (LIPUS) on promoting repair of ovarian injury in female SD rats induced by 4-vinylcyclohexene diepoxide (VCD) were explored in this research. A total of 24 female SD rats were subjected to intraperitoneal injection of VCD to induce POI. Successful modeling was achieved in 22 rats, which were then randomized into VCD + LIPUS group (n = 13) and VCD group (n = 9). The control group (n = 5) was injected with equal normal saline. Hematoxylin and eosin staining, enzyme-linked immunosorbent assay, Western blot analysis, scanning electron microscope, immunohistochemistry, and terminal deoxynucleotidyl transferase-mediated nick end labeling assay were applied to detect the results. The results indicated that rats in the VCD group showed disorder in the estrous cycle, the number of atresia follicles and apoptosis granulosa cells increased (p < .05). After the LIPUS treatment, the estrous cycle recovered, the number of follicles increased (p < .05), the level of E2 and anti-Müllerian hormone enhanced (p < .05), and the follicle-stimulating hormone decreased (p < .05). The expression of NF-κB p65, TNFα, Bax, ATF4, and caspase-3 in ovarian tissue was significantly decreased (p < .05). These findings showed that LIPUS could promote the repair of the VCD-induced ovarian damage in SD rats, which has the potential to be further applied in the clinic.

Primary breast angiosarcoma (PBA) is a rare malignant tumor. PBA usually undergoes hematogenous metastasis; lymph node metastasis is very rare in such patients, and metastasis of PBA to the supraclavicular lymph nodes has not previously been reported. Here, we describe a rare case of PBA manifested by a diffuse enlargement of the left breast, with metastasis to the left axillary and bilateral supraclavicular lymph nodes. Contrast-enhanced ultrasound and positron emission tomography findings indicated a malignant lesion, whereas magnetic resonance imaging suggested a benign lesion. Core needle biopsy identified the lesion as a lymphangioma, and the histological characteristics suggested a high-grade angiosarcoma. Multimodal imaging and perfusion patterns obtained using various contrast agents can thus help to diagnose PBA.

Coronavirus disease 2019 (COVID-19) is highly contagious. It may rapidly progress to acute respiratory distress syndrome (ARDS) and result in multiorgan dysfunction or death in some cases.(1,2) Here, we report the case of a patient with hepatocellular carcinoma (HCC) who underwent liver transplantation and experienced COVID-19 infection during the perioperative period. This case may help clinicians by alerting them to potential COVID-19 infection in transplant recipients during the outbreak.

Junwu Lin,1,* Hong Qin,2,* Yue Han,3 Xinghua Li,4 YuJuan Zhao,5 Guangsheng Zhai6 1Department of Otolaryngology, Central Hospital, Qingdao, Shandong, People’s Republic of China; 2Department of Otolaryngology, Women and Children’s Hospital, Qingdao, Shandong, People’s Republic of China; 3Department of Urology, Zhangqiu District People’s Hospital, Jinan, Shandong, People’s Republic of China; 4Department of Critical Care Medicine, Zhangqiu District People’s Hospital, Jinan, Shandong, People’s Republic of China; 5Department of Otolaryngology, Rizhao Second People’s Hospital, Rizhao, Shandong, People’s Republic of China; 6Department of Radiotherapy, Zibo Central Hospital, Zibo, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guangsheng ZhaiDepartment of Radiotherapy, Zibo Central Hospital, No. 54, Communist Youth League West Road, Zhangdian District, Zibo 255036, Shandong, People’s Republic of ChinaFax +86-18678186986Email guangshengzhai86@163.comBackground: The development of drug resistance leads many NPC patients to experience disease relapse following the completion of chemotherapy. It is thus essential that the mechanistic basis for such chemoresistance be clarified in an effort to identify approaches to sensitizing NPC tumors to treatment with cisplatin and related agents.Methods: A qRT-PCR approach was used to measure the expression of circNRIP1 in NPC, while luciferase assays were used to identify interactions with downstream targets of circNRIP1 activity including miR-515-5p and IL-25. CCK8 assays were also utilized to detect IC50 values for cisplatin and 5-Fu.Results: The expression of circNRIP1 was significantly increased in the serum of chemoresistant NPC patients. At a functional level, we determined that circNRIP1 is able to sequester miR-515-5p, thereby inhibiting its ability to post-transcriptionally suppress IL-25 expression. We observed a significant negative correlation between the expression of miR-515-5p and circNRIP1 in serum samples from chemoresistant NPC patients, consistent with a functional interaction between these two factors. We further found that 5-Fu and CDDP IC50 values in NPC cells in which circNRIP1 had been knocked down were restored following miR-515-5p inhibitor transfection. Similarly, changes in these IC50 values were reversed in NPC cells transfected with miR-515-5p mimics following the overexpression of IL-25 in these same cells.Conclusion: These data highlight the circNRIP1/miR-515-5p/IL-25 as a novel regulator of 5-Fu and cisplatin resistance in NPC, suggesting that this pathway may be amenable to therapeutic targeting as an approach to treating this cancer type.Keywords: circNRIP1, 5-Fu resistance, cisplatin resistance, NPC, miR-515-5p, IL-25

Background To develop a sensitive and clinically applicable risk assessment tool identifying coronavirus disease 2019 (COVID-19) patients with a high risk of mortality at hospital admission. This model would assist frontline clinicians in optimizing medical treatment with limited resources. Methods 6415 patients from seven hospitals in Wuhan city were assigned to the training and testing cohorts. A total of 6351 patients from another three hospitals in Wuhan, 2169 patients from outside of Wuhan, and 553 patients from Milan, Italy were assigned to three independent validation cohorts. A total of 64 candidate clinical variables at hospital admission were analyzed by random forest and least absolute shrinkage and selection operator (LASSO) analyses. Results Eight factors, namely, Oxygen saturation, blood Urea nitrogen, Respiratory rate, admission before the date the national Maximum number of daily new cases was reached, Age, Procalcitonin, C-reactive protein (CRP), and absolute Neutrophil counts, were identified as having significant associations with mortality in COVID-19 patients. A composite score based on these eight risk factors, termed the OURMAPCN-score, predicted the risk of mortality among the COVID-19 patients, with a C-statistic of 0.92 (95% confidence interval [CI] 0.90–0.93). The hazard ratio for all-cause mortality between patients with OURMAPCN-score >11 compared with those with scores ≤ 11 was 18.18 (95% CI 13.93–23.71; p

Background To develop a sensitive risk score predicting the risk of mortality in patients with coronavirus disease 2019 (COVID-19) using complete blood count (CBC). Methods We performed a retrospective cohort study from a total of 13,138 inpatients with COVID-19 in Hubei, China, and Milan, Italy. Among them, 9,810 patients with ≥2 CBC records from Hubei were assigned to the training cohort. CBC parameters were analyzed as potential predictors for all-cause mortality and were selected by the generalized linear mixed model (GLMM). Findings Five risk factors were derived to construct a composite score (PAWNN score) using the Cox regression model, including platelet counts, age, white blood cell counts, neutrophil counts, and neutrophil:lymphocyte ratio. The PAWNN score showed good accuracy for predicting mortality in 10-fold cross-validation (AUROCs 0.92–0.93) and subsets with different quartile intervals of follow-up and preexisting diseases. The performance of the score was further validated in 2,949 patients with only 1 CBC record from the Hubei cohort (AUROC 0.97) and 227 patients from the Italian cohort (AUROC 0.80). The latent Markov model (LMM) demonstrated that the PAWNN score has good prediction power for transition probabilities between different latent conditions. Conclusions The PAWNN score is a simple and accurate risk assessment tool that can predict the mortality for COVID-19 patients during their entire hospitalization. This tool can assist clinicians in prioritizing medical treatment of COVID-19 patients. Funding This work was supported by National Key R&D Program of China (2016YFF0101504, 2016YFF0101505, 2020YFC2004702, 2020YFC0845500), the Key R&D Program of Guangdong Province (2020B1111330003), and the medical flight plan of Wuhan University (TFJH2018006)., Context and significance Researchers from Wuhan, China developed a complete blood count-based risk score (PAWNN score) that can predict mortality during the entire course of hospitalization in a large cohort with 13,138 COVID-19 patients. This risk score was validated in two independent cohorts from China and Italy and in a longitudinal model. The model can serve as a valuable tool for physicians with very limited medical resources to properly monitor and stratify COVID-19 patients and to reduce mortality., Graphical Abstract, Highlights The blood count-based PAWNN score can accurately predict mortality risk of COVID-19 PAWNN can properly stratify COVID-19 patients with limited medical resources, Liu et al. developed and validated a complete blood count-based score (PAWNN) that can predict mortality during the entire course of hospitalization in a cohort of 13,138 COVID-19 patients. The model can serve as a valuable tool to properly monitor and stratify COVID-19 patients with very limited medical resources.

Background The coronavirus disease 2019 (COVID-19) is an emerged respiratory infectious disease with kidney injury as a part of the clinical complications. However, the dynamic change of kidney function and its association with COVID-19 prognosis are largely unknown. Methods In this multicenter retrospective cohort study, we analyzed clinical characteristics, medical history, laboratory tests, and treatment data of 12,413 COVID-19 patients. The patient cohort was stratified according to the severity of the outcome into three groups: non-severe, severe, and death. Findings. The prevalence of elevated blood urea nitrogen (BUN), elevated serum creatinine (Scr), and decreased blood uric acid (BUA) at admission was 6.29%, 5.22%, 11.66%, respectively. The trajectories showed elevation of BUN level and Scr level, as well as a reduction of BUA level during 28 days after admission in death cases. Increased all-cause mortality risk was associated with elevated baseline levels of BUN and Scr, and decreased level of BUA. Conclusion The dynamic changes of the three kidney function markers were associated with different severity and poor prognosis of COVID-19 patients. BUN showed close association and high potential for predicting adverse outcomes in COVID-19 patients for severity stratification and triage., Graphical Abstract, Highlights ● A cohort of 12,413 COVID-19 patients was retrospectively investigated ● Elevated baseline levels of BUN and Scr correlated with high risk of COVID-19 mortality ● Decreased BUA level on admission was associated with high risk of COVID-19 mortality, Liu et al. show that among 12,413 cases of COVID-19, an elevation of baseline BUN level and Scr level, and a decrease of baseline BUA level were associated with adverse outcomes in patients. These findings may help the risk stratification and triage of COVID-19 patients according to kidney function indicators.

BackgroundThe oncological safety of diagnostic hysteroscopy in patients with stage Ⅰ endometrial cancer remains uncertain and conflicting. The aim of the proposed systematic review and meta-analysis is to summarise the available evidence examining the association between diagnostic hysteroscopy and the prognosis of stage Ⅰ endometrial cancer and to statistically synthesise the results of relevant studies.Methods and analysisSystematic searches of PubMed/MEDLINE, Embase, Cochrane Library and Web of Science will be undertaken using prespecified search strategies. Two authors will independently conduct eligible studies selection process, perform data extraction and appraise the quality of included studies. Original case–control studies, cohort studies and randomised controlled trails published in English will be considered for inclusion. The outcomes of interest will be 5-year recurrence-free survival, disease-specific survival and overall survival. Meta-analyses will be performed to calculate pooled estimates.Ethics and disseminationOur study will be based on published data, and thus there is no requirement for ethics approval. The results will be shared through publication in a peer-reviewed journal and presentations at academic conferences.PROSPERO registration numberCRD42020193696.

Wandong (WD) cattle has recently been identified as a new Chinese native cattle breed by the National Commission for Livestock and Poultry Genetic Resources. The population size of this breed is less than 10,000. WD cattle and Dabieshan (DB) cattle are sympatric but are raised in different ecological environments, on mountains and plains, respectively, and the body sizes of these two breeds are markedly different. Blood samples were obtained from 8 adult female WD cattle and 7 adult female DB cattle (24 months old). The total RNA was extracted from leukocyte cells, and sequencing experiments were conducted on the Illumina HiSeqTM 4000 platform. After the removal of one outlier sample from the WD cattle breed as determined by principal component analysis (PCA), phylogenetic and population structure analyses indicated that WD and DB cattle formed a distinct Central China cattle group and showed evidence of hybridization between Bos. taurus and Bos. indicus. The immune-regulator CD48 (P = 1.3E-6) was associated with breed-specific traits according to loss-of-function variant enrichment analysis. In addition, 113 differentially expressed genes were identified between the two breeds, many of which are associated with the regulation of body growth, which is the major difference between the two breeds. This study showed that WD cattle belong to the group of hybrids between Bos. Taurus and Bos. indicus, and one novel gene associated with breed traits and multiple differentially expressed genes between these two closely related breeds was identified. The results provide insights into the genetic mechanisms that underlie economically important traits, such as body size, in cattle.

The gait feature is non-invasive remote feature and does not require high-resolution images, which has attracted widespread attention and has great potential as a security recognition. As an emerging biological feature, gait recognition still has many challenges, such as the recognition of complex background, perspective change and occlusion. This paper proposes a neural network based on Siamese structure, which takes the gait energy image (GEI) as the input of the network. At the same time, attention mechanism is added to the network, and self-attention is used to establish the connection between the distant pixels so as to better learn the non-local long-distance information. In the training stage, using Multi-Layer Side-Output (MLSO) as a reference, companion loss is added to the intermediate layer to supervise the middle layer. The experiment is carried out on the CASIA-B database, and it is comprehensively compared with the unimproved network and other methods which work well by setting up different training sets and test sets. Experimental data show that the network proposed in this paper has improved the average recognition rate in gait recognition across perspectives.

Lung ultrasound (LUS) has been widely used in the diagnosis and differential diagnosis of neonatal lung diseases (NLDs), but whether it can replace the routine use of chest X-ray (CXR) in neonatal intensive care units (NICUs) remains controversial. This paper summarizes the clinical practice of our neonatal intensive care unit (NICU) during the past three years to explore the feasibility and necessity of using LUS instead of CXR to diagnose NLDs in the NICU setting.The clinical data and LUS examination results from 1,381 newborn infants with respiratory difficulty who were hospitalized in our NICU from March 2017 to February 2020 were retrospectively collected to analyze the types of lung diseases diagnosed and the reliability of LUS for diagnosing NLDs.(1) During this period, 1381 newborn infants with dyspnea were admitted to our NICU, accounting for 41.2% of all hospitalized children. (2) Among the 1381 infants, 17 patients with respiratory distress were confirmed as having severe heart disease by echocardiography, while the remaining 1364 patients had different kinds of lung diseases: pneumonia (697 patients, 51.1%), respiratory distress syndrome (251 patients, 17.4%), transient tachypnea of the newborn (197 patients, 13.3%), atelectasis (89 patients, 5.6%), pneumothorax (46 patients, 3.2%), pulmonary hemorrhage (69 patients, 4.5%), severe pleural effusion (18 patients, 1.32%), congenital pulmonary sequestration (3 patients, 0.22%), bullae of the lung (2 patients, 0.15%), and congenital cystic adenomatoid malformation (2 patients). (5) Among the 1381 infants, 217 received CXR examination before admission, which resulted in misdiagnosis in 45 patients (20.7%) and missed diagnosis in 12 patients (5.5%); the missed diagnosis and misdiagnosis rate was 26.3%.Our 3-year clinical practice experience indicated that LUS could completely replace chest X-ray for the diagnosis and differential diagnosis of NLDs in the NICU. Compared with X-ray, LUS had higher accuracy and reliability in diagnosing NLDs.

Supplemental Digital Content is available in the text., The prognostic power of circulating cardiac biomarkers, their utility, and pattern of release in coronavirus disease 2019 (COVID-19) patients have not been clearly defined. In this multicentered retrospective study, we enrolled 3219 patients with diagnosed COVID-19 admitted to 9 hospitals from December 31, 2019, to March 4, 2020, to estimate the associations and prognostic power of circulating cardiac injury markers with the poor outcomes of COVID-19. In the mixed-effects Cox model, after adjusting for age, sex, and comorbidities, the adjusted hazard ratio of 28-day mortality for high-sensitivity cardiac troponin I was 7.12 ([95% CI, 4.60–11.03] P

Background and aims Coronavirus disease 2019 (COVID-19) is a new infectious disease. To reveal the hepatic injury related to this disease and its clinical significance, we conducted a multicenter retrospective cohort study that included 5,771 adult patients with COVID-19 pneumonia in Hubei Province. Approach and results We reported the distributional and temporal patterns of liver injury indicators in these patients and determined their associated factors and death risk. Longitudinal liver function tests were retrospectively analyzed and correlated with the risk factors and death. Liver injury dynamic patterns differed in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL). AST elevated first, followed by ALT, in severe patients. ALP modestly increased during hospitalization and largely remained in the normal range. The fluctuation in TBIL levels was mild in the non-severe and the severe groups. AST abnormality was associated with the highest mortality risk compared with the other indicators of liver injury during hospitalization. Common factors associated with elevated liver injury indicators were lymphocyte count decrease, neutrophil count increase, and male gender. Conclusion The dynamic patterns of liver injury indicators and their potential risk factors may provide an important explanation for the COVID-19-associated liver injury. Because elevated liver injury indicators, particularly AST, are strongly associated with the mortality risk, our study indicates that these parameters should be monitored during hospitalization.

Background The aim of this study is to compare double‐antigen sandwich enzyme‐linked immunosorbent assay (ELISA) and indirect ELISA in the diagnosis of hepatitis C virus（HCV）infection. Methods and materials A total of 176 samples from the Tumor Hospital Affiliated to Xin Jiang Medical University were utilized to comparison. All serum samples were tested using double‐antigen sandwich ELISA and indirect ELISA. Cohen's kappa statistics were used to assess the agreement between the two assays, and multivariate analysis was used to evaluate risk factors for the discordance between the double‐antigen ELISA and indirect ELISA. Results The positivities of indirect ELISA (Beijing Wantai), double‐antigen sandwich ELISA (Beijing Wantai), and indirect ELISA (Beijing Jinhao) were 74.43%, 68.75%, and 73.30%, respectively. The agreement between the indirect ELISA (Beijing Wantai) and double‐antigen sandwich ELISA (Beijing Wantai) was high (κ = 0.829;P, Compare doubl‐antigen sandwich enzyme‐linked immunosorbent assay (ELISA) and indirect ELISA in the diagnosis of hepatitis C virus (HCV) infection.

We read with interest the study by Lei and colleagues on the association between markers of liver injury and mortality in coronavirus disease 2019 (COVID‐19) in China. The authors have painstakingly collated data from a large number of COVID‐19 patients from multiple centers across Wuhan. They found that an increase in aspartate aminotransferase (AST) and its dynamicity correlated with COVID‐19‐related liver injury and patient outcomes. They concluded that the dynamic patterns of liver injury indicators, represented by AST, correspond with COVID‐19‐related liver injury.

Summary Statins are lipid-lowering therapeutics with favorable anti-inflammatory profiles and have been proposed as an adjunct therapy for COVID-19. However, statins may increase the risk of SARS-CoV-2 viral entry by inducing ACE2 expression. Here, we performed a retrospective study on 13,981 patients with COVID-19 in Hubei Province, China, among which 1,219 received statins. Based on a mixed-effect Cox model after propensity score-matching, we found that the risk for 28-day all-cause mortality was 5.2% and 9.4% in the matched statin and non-statin groups, respectively, with an adjusted hazard ratio of 0.58. The statin use-associated lower risk of mortality was also observed in the Cox time-varying model and marginal structural model analysis. These results give support for the completion of ongoing prospective studies and randomized controlled trials involving statin treatment for COVID-19, which are needed to further validate the utility of this class of drugs to combat the mortality of this pandemic., Graphical Abstract, Highlights • Statin treatment among 13,981 patients with COVID-19 was retrospectively studied • Statin use in this cohort was associated with a lower risk of all-cause mortality • Adding an ACE inhibitor or an ARB did not affect statin-associated outcome in the cohort • The benefit of statins among this cohort may be due to immunomodulatory benefits, Statins have anti-inflammatory benefits and were suggested as an adjunct therapy for COVID-19. But statins may increase the expression of ACE2, the receptor for SARS-CoV-2. Here, Zhang et al. retrospectively analyzed 13,981 COVID-19 cases and found that in-hospital statin use is associated with a lower risk of all-cause mortality.

Background Although multiple signaling cascades and molecules contributing to the pathophysiological process have been studied, the treatments for stroke against present targets have not acquired significant clinical progress. Although CARD3 (caspase activation and recruitment domain 3) protein is an important factor involved in regulating immunity, inflammation, lipid metabolism, and apoptosis, its role in cerebral stroke is currently unknown. Methods and Results Using a mouse model of ischemia‐reperfusion (I‐R) injury based on transient blockage of the middle cerebral artery, we have found that CARD3 expression is upregulated in a time‐dependent manner during I‐R injury. Further animal study revealed that, relative to control mice, CARD3‐knockout mice exhibited decreased inflammatory response and neuronal apoptosis, with reduced infarct volume and lower neuropathological scores. In contrast, neuron‐specific CARD3‐overexpressing transgenic (CARD3‐TG) mice exhibited increased I‐R induced injury compared with controls. Mechanistically, we also found that the activation of TAK1 (transforming growth factor‐β–activated kinase 1) was enhanced in CARD3‐TG mice. Furthermore, the increased inflammation and apoptosis seen in injured CARD3‐TG brains were reversed by intravenous administration of the TAK1 inhibitor 5Z‐7‐oxozeaenol. Conclusions These results indicate that CARD3 promotes I‐R injury via activation of TAK1, which not only reveals a novel regulatory axis of I‐R induced brain injury but also provides a new potential therapeutic approach for I‐R injury.

BackgroundThe 2019 novel coronavirus (COVID-19) has continuous outbreaks around the world. Lung is the main organ that be involved. There is a lack of clinical data on the respiratory sounds of COVID-19 infected pneumonia, which includes invaluable information concerning physiology and pathology. The medical resources are insufficient, which are now mainly supplied for the severe patients. The development of a convenient and effective screening method for mild or asymptomatic suspicious patients is highly demanded.MethodsThis is a retrospective case series study. 10 patients with positive results of nucleic acid were enrolled in this study. Lung auscultation was performed by the same physician on admission using a hand-held portable electronic stethoscope delivered in real time via Bluetooth. The recorded audio was exported, and was analyzed by six physicians. Each physician individually described the abnormal breathing sounds that he heard. The results were analyzed in combination with clinical data. Signal analysis was used to quantitatively describe the most common abnormal respiratory sounds.ResultsAll patients were found abnormal breath sounds at least by 3 physicians, and one patient by all physicians. Cackles, asymmetrical vocal resonance and indistinguishable murmurs are the most common abnormal breath sounds. One asymptomatic patient was found vocal resonance, and the result was correspondence with radiographic computed tomography. Signal analysis verified the credibility of the above abnormal breath sounds.ConclusionsThis study describes respiratory sounds of patients with COVID-19, which fills up for the lack of clinical data and provides a simple screening method for suspected patients.

A Mach–Zehnder interferometer (MZI) based on the cascaded structure of a single-mode fiber (SMF) down-taper and thin-core fiber (TCF) is proposed and experimentally demonstrated. The down-taper acts as mode coupler to excite cladding modes. The extinction ratio of the transmission spectra can reach up to 20dB. By monitoring the wavelength shifts of interference dip1 and dip2, simultaneous measurement of refractive index (RI) and temperature can be achieved. The experimental results show that the wavelengths at interference dip1and dip2 have blue shifts with the increase of RI and red shifts with the increase of temperature. The RI sensitivities at interference dip1 and dip2 are -30.290 nm/RIU and -79.335nm/RIU, respectively. The temperature sensitivities at interference dip1 and dip2 are 0.065 nm/oC and 0.053 nm/oC, respectively. The proposed MZI exhibits the advantages of easy fabrication, high extinction ratio, low cost, and simultaneous measurement of RI and temperature, which will make a significant contribution to RI measurement.

Three-dimensional plasmonic nanorods are theoretically investigated to achieve plasmon-induced transparency and Fano resonances in visible to near-infrared region. The plasmonic nanostructure consists of periodic array of a top in-plane side-by-side assembling nanorod dimer and a bottom nanorod separated by a dielectric spacer. With transverse excitation, which means that the E-component of the incident field is along the short axis of the nanorods, anti-parallel oscillations in the metal-insulator-metal (MIM) structure lead to magnetic resonances in the dielectric cavity, and magnetic surface plasmons (MSPs) can also be induced by the mode couplings in the in-plane nanorod dimer. Interferences of magnetic resonances and localized surface plasmons (LSPs) of nanorods lead to Fano resonances in MIM nanorod dimer. Furthermore, a significantly broad optical magnetism and transparency window is shown through the hybridization of the vertical and in-plane mode interactions. The extinction spectra can be tuned by the aspect ratio (AR), gap and periodicity of nanorods. This unique characteristic of MIM nanorod dimer can realize many potential applications of plasmon-induced transparency and Fano resonances, such as multi-wavelength biosensing and optical antenna. PMMA block is chosen to simulate non-uniform distributed analyte. It is localized on different zones upon the MIM dimer to theoretically determine the sensing effectiveness. Simulation shows that the in-plane small gap of the top MIM dimer largely increases the sensing sensitivity of the magnetic resonance of MIM structure.

The Securities and Exchange Commission (SEC) requires firms to use a “suitable framework” as a basis for evaluating the effectiveness of internal control over financial reporting. The COSO 1992 framework was the most commonly used suitable framework until it was superseded by the COSO 2013 framework. Because strict compliance with the updated framework was not enforced by regulatory authorities, a nontrivial number of firms did not comply in a timely fashion. We investigate determinants and consequences of noncompliance with the COSO 2013 framework following the supersession of the COSO 1992 framework. We find that noncompliance is positively associated with proxies for resource constraints, financial distress, and a weak internal control environment, and negatively associated with auditor industry specialization, board size, and audit committee accounting expertise. Further tests suggest that following supersession of the 1992 framework, investors view quarterly earnings surprises of the noncompliant firms to be less credible and that noncompliance increases regulatory scrutiny. Finally, we find some evidence that accounting conservatism increases after supersession of the 1992 framework for compliant firms relative to noncompliant firms, suggesting that noncompliance can delay the potential benefits of implementing the updated framework.

In this paper ZnSb thin films were prepared by radio frequency magnetron sputteringfrom a stoichiometric Zn4Sb3 target followed by thermal annealing. The influence of sputteringconditions on microstructure, surface morphology, crystallinity and electrical transport propertieswere investigated. For the range of sputtering power of 50 W to 125 W and working pressure of 0.7Pa, it was found that the content of compound ZnSb phase in the films as well as film crystallinitycould be enhanced greatly by increasing the sputtering power, and this effect may be reinforced bydecreasing the working pressure to 0.2 Pa. At 0.7 Pa, A maximum value of 2.99 μW/cmK2 of powerfactor measured at room temperature was obtained at 100 W. The sample prepared at the samepower and lower pressure of 0.2 Pa has a room temperature power factor of 5.46 μW/cmK2 which isalmost doubled.

For the problems of shadow and the influence of dynamic background, a moving object detection method based on multi-feature adaptive background model is presented in this paper. Firstly, establish the chromaticity model and texture model respectively to represent each pixel. Then, adjust the model adaptively according to the background complexity and extract the moving object. Finally, find the inner contour of extracted object to fill, which makes the results more complete. At the same time, update the background model. The test results show that the presented method can eliminate the influence of shadow and dynamic background well. Compared with several other methods, it has a better overall performance.

Tunable microwave photonic filter (MPF) with negative and complex coefficients is proposed and demonstrated. The multiple wavelengths optical source with stability and flatness can be realized by using a broadband source (BBS) and a waveshaper1. The negative coefficients of the MPF can be implemented by an electroopic polarization modulator (PoIM), and the cut-off frequency response can be effectively eliminated. The amplitude and phase of the optical carriers and phase modulation sidebands can be controlled by Fourier domain optical processor (FD-OP), which the complex coefficient and tunability of the MPF can be realized. In the experiment, the 10 taps with 0.2nm are used as input optical source, the free spectrum range (FSR) is 34.91GHz. The center frequency is continuously tuned from 0 to 34.97 GHz and the shape remains unchanged.

According to the double-ball structure and the sensing characteristics of the fiber Bragg grating (FBG), a micro-displacement sensor with temperature compensation is proposed and verified experimentally. The sensing structure is made of a FBG and a double-ball cascade. The first ball is used to excite the cladding mode, and the second can get the coupling interference between the cladding mode and the core mode. In the light of Bragg grating's inherent temperature characteristic, it can only be used to estimate temperature. The drift of single mode fiber interference dip and Bragg grating transmission spectrum are independent of each other. It reduces the influence of cross sensitivity between temperature and displacement. The experimental results show that the micro-displacement and temperature detection ranges are 0~0.16mm and 20~160°C; the micro-displacement and temperature sensitivities of the sensor are -89.892 nm/mm and -0.088 nm/°C, respectively. And the temperature sensitivity of FBG dip is 0.012 nm/°C. The micro-displacement measurement with temperature-compensated can be obtained by calculating the sensing matrix.

With the unique agility and flexibility, unmanned aerial vehicles (UAVs) are widely applied in various scenarios. Especially in the areas with disasters, UAVs can act as base stations (BSs) to provide wireless communication services for ground users. In order to reduce the costs, we prefer to use as few UAVs as possible. However, due to the coverage constraint, each UAV can only provide services for a certain number of ground users. Moreover, considering the acceptable receiving power, the coverage radius of UAV is limited. Combined with the above considerations, we present an efficient 3D placement algorithm of UAV-Mounted BSs to cover all of the ground users. In the horizontal direction, the Edge-Prior Placement Algorithm is proposed, which gives the preferential coverage to the outermost users. The complexity of the algorithm is O(n 2 log n). Then, the optimal height of each UAV is assigned. As a result, these UAVs fly at different heights and cover the ground users with different radii. Simulation results are provided to evaluate the performance of the proposed algorithm. We demonstrate the impacts of the upper bound of coverage radius and capacity constraint on the number of UAVs that are used to cover the ground users, which could provide a guideline for the deployment of UAVs.

A new Mach-Zehnder interferometer sensor , which can simultaneously gauge refractive index (RI) and temperature, is realized. A sphere-trapezoid structure used as a coupler is formed by splicing sphere and trapezoid cone. The extinction ratio of the transmission spectra can achieve 10dB. The RI sensitivities of the two interference valleys are -51.2nm/RIU and -36.5nm/RIU. The temperature sensitivities of them are 0.063nm/°C and 0.064nm/°C. Therefore it can be realized to gauge the RI and the temperature simultaneously. The proposed sensor can also be applied to chemistry and biology, it has broad application prospects.

According to the theory of inter-mode interference, an interferometer based on cascaded core-offset structure with thincore fiber (TCF) is researched. The core-offset structure acts as a coupler, allowing energy to enter the cladding of the fiber, thereby exciting the cladding modes. The interference occurs twice in the proposed interferometer. The first time occurs at the joint of the single-mode fiber (SMF) 2 and TCF, and the second time occurs at the joint of the TCF and the SMF3. Both the temperature and refractive index (RI) sensing experiment are conducted. The maximum temperature and RI sensitivity are -161nm/RIU and 0.069nm/°C, respectively. The studied sensors have good characteristics such as simple manufacturing, low cost and high mechanical strength. So the sensor has the potential to be applied in practice.

Problem definition: Dockless bike-sharing users use a mobile app to rent a bike located throughout a city, lock the bike at their destination, and then make it available to another user. We examine whether dockless bike-sharing systems can offer a technology-enabled solution to traffic congestion problems by providing a cost-effective and sustainable alternative mode of transportation. Academic/practical relevance: Urban planners, policymakers, transportation engineers, and scholars have sought innovative and sustainable solutions to the rush-hour traffic congestion problem. Methodology: We exploit a unique natural experiment setting in which the first dockless bike-sharing service was launched in Chengdu, China, in November 2016. We employ a difference-in-differences framework and utilize detailed ride-sharing order information from DiDi Chuxing (DiDi) to measure the demand for car travel. Results: We find that the entry of dockless bike-sharing decreases the demand for car travel during rush hour. For example, the number of ride-sharing pick-ups decreases by 12 percent during rush hour after the entry of dockless bike-sharing. Moreover, more congested locations witness a greater decline in ride-sharing orders during rush hour. We also find that locations with access to public transit experience a greater decline in car travel demand, which provides empirical evidence that dockless bike-sharing helps solve the first-mile/last mile problem during rush hour. Furthermore, we find a greater reduction in car travel demand during rush hour for locations with a high level of mobility and locations that are closer to the city center. Managerial implications: Overall, the dockless bike-sharing system, which combines information technologies with a sharing economy business model, reduces car travel demand during rush hour and provides a smart solution to the rush-hour traffic congestion problem.

Background. Type 2 diabetes mellitus (T2DM) has become a chronic disease, serious harm to human health. Complications of the blood pipe are the main cause of disability and death in diabetic patients, including vascular lesions that directly affects the prognosis of patients with diabetes and survival. This study was to determine the influence of high glucose and related mechanism of vascular lesion of type 2 diabetes mellitus pathogenesis. Methods. In vivo aorta abdominalis of GK rats was observed with blood pressure, heart rate, hematoxylin and eosin (H&E), Masson, and Verhoeff staining. In vitro cells were cultured with 30 mM glucose for 24 h. RT-QPCR was used to detect the mRNA expression of endothelial markers PTEN, PI3K, Akt, and VEGF. Immunofluorescence staining was used to detect the expression of PTEN, PI3K, Akt, and VEGF. PI3K and Akt phosphorylation levels were detected by Western blot analysis. Results. Heart rate, systolic blood pressure, diastolic blood pressure, and mean blood pressure in the GK control group were higher compared with the Wistar control group and no difference compared with the GK experimental model group. Fluorescence intensity of VEGF, Akt, and PI3K in the high-sugar stimulus group was stronger than the control group; PTEN in the high-sugar stimulus group was weakening than the control group. VEGF, Akt, and PI3K mRNA in the high-sugar stimulus group were higher than the control group; protein expressions of VEGF, Akt, and PI3K in the high-sugar stimulus group were higher than the control group. PTEN mRNA in the high-sugar stimulus group was lower than the control group. Protein expression of PTEN in the high-sugar stimulus group was lower than the control group. Conclusions. Angiogenesis is an important pathogenesis of T2DM vascular disease, and PTEN plays a negative regulatory role in the development of new blood vessels and can inhibit the PI3K/Akt signaling pathway.

BACKGROUND Pneumoperitoneum is commonly used in laparoscopic gynecological surgery. This study investigated the effect of carbon dioxide (CO2) pneumoperitoneum pressure on ovarian function following laparoscopic surgery in infertile women. METHODS A total of 424 infertile patients were allocated to 4 groups according to different CO2 pneumoperitoneum pressures undergo laparoscopic surgery. Complications and the levels of serum estradiol (E2), progesterone (P), luteinizing hormone (LH), testosterone (T), and follicle-stimulating hormone (FSH) were observed and measured. Ovarian function was also evaluated by using mean ovarian volume, maximal ovarian volume, mean follicle number, and maximal follicle diameter. RESULTS A total of 118 cases were included and their data were retrospectively analyzed. Complications were observed in all groups with the highest incidence in participants receiving 15-16 mmHg CO2. Pneumoperitoneum increased the levels of E2, FSH, and LH (P

Corticosteroid therapy is now recommended as a treatment in patients with severe COVID-19. But one key question is how to objectively identify severely ill patients who may benefit from such therapy. Here, we assigned 12,862 COVID-19 cases from 21 hospitals in Hubei Province equally to a training and a validation cohort. We found that a neutrophil-to-lymphocyte ratio (NLR) > 6.11 at admission discriminated a higher risk for mortality. Importantly, however, corticosteroid treatment in such individuals was associated with a lower risk of 60-day all-cause mortality. Conversely, in individuals with an NLR ≤ 6.11 or with type 2 diabetes, corticosteroid treatment was not associated with reduced mortality, but rather increased risks of hyperglycemia and infections. These results show that in the studied cohort corticosteroid treatment is associated with beneficial outcomes in a subset of COVID-19 patients who are non-diabetic and with severe symptoms as defined by NLR., Graphical Abstract, While corticosteroid therapy is effective in the treatment of patients with severe COVID-19, a quantitative clinical parameter to identify such severity and which patients would respond well to corticosteroids has not been developed. Here, Cai et al. find that a simple blood test that measures the neutrophil-to-leukocyte ratio at admission discriminates high versus low mortality risk and a better response to corticosteroid therapy.