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Objective: Spinal muscular atrophy (SMA) is an autosomal recessive disorder mainly affecting the neuromuscular system, which seriously threatens the life and health of patients. But few studies have reported the acceptance rate of SMA gene screening and SMA carrier rate in China. The present study aimed to clarify the two issues in China through a retrospective analysis of 18,818 reproductive age women in Wuhan area of China. Methods: The copy number (CN) of exons 7 and 8 in survival motor neuron 1 (SMN1) gene was detected by real-time quantitative PCR, and the results were verified by multiplex ligation-dependent probe amplification. Results: Carrier screening was offered to 44,953 women of childbearing age in our medical center from March, 2018, to February, 2022, of whom 18,818 were enrolled in the program. A total of 336 women were identified as carriers (1.73%; 326/18,808; without fertility history of the children with SMA). Among 18,818 reproductive age women, 286 spouses (85.12%; 286/336) were successfully recalled for screening. The results showed 17 couples at high risk of having children with SMA, of whom prenatal diagnosis was implemented in 11, and 6 fetuses were identified with SMA. All the 5 pregnant women bearing the 6 SMA fetuses chose to terminate the pregnancy by artificial abortion. Conclusion: Reproductive age women and their spouses in Wuhan area showed a positive attitude toward general screening for SMA carriers. Given the high early mortality of children with SMA, screening for SMA carriers in women of reproductive age is necessary and feasible. [ABSTRACT FROM AUTHOR]

Background: In recent years, the physical fitness situation of college students is worrying in China. Exercise motivation is of great importance for the physical activity and physical fitness. However, existing studies have paid limited attention to the specific effect between exercise motivation, physical activity and physical fitness, and even less to the different genders and exercise motivation dimensions. This study aimed to investigate the promoting effect of sport motivation on physical fitness with different gender and dimension in college students. Methods: Physical fitness levels of 2544 college students in Wuhan and Jingzhou city were measured. Exercise motivation and physical activity was assessed using the Chinese version of the motives for physical activities measure-revised scale and the physical activity survey scale, respectively. Correlation analysis and structural equation model were used to explore the relationship between exercise motivation, physical activity and physical fitness. Bootstrap method was used to test the mediating effect. Multilevel regression analysis was used to examine the effects of different dimensions of exercise motivation on PF. Results: The exercise motivation of college students was directly related to physical fitness (effect value: 0.307) or indirectly related through the mediating effect of physical activity (effect value: 0.092). The mediation effect percentage of physical activity on exercise motivation and physical fitness in male (51.20%) was greater than female (27.18%), and the standardized regression coefficient of the health dimension to PF was β = 0.151, P < 0.001, and the competence dimension to PF was β = 0.189, P < 0.001. Conclusions: The exercise motivation of college students can directly influence PF or indirectly influence PF through the mediating effect of PA. The promoting effect of exercise motivation and PA on PF in college students is related to gender and dimensions of exercise motivation. Therefore, we can improve physical fitness levels of college students by promoting their exercise motivation (especially for health motivation and competence motivation) and increasing their participation in physical activity. This study provides new strategies for improving physical fitness in college students. [ABSTRACT FROM AUTHOR]

Background: The gastrointestinal tract contains a massive microbiota, and targeting the gut could be a potential intervention for sepsis. However, the interaction between sepsis and the intestinal microbiota is defined as an "incompletely understood bidirectional relationship". Methods: This retrospective observational cohort study investigated the fecal microbiota of sepsis patients admitted to the Department of Critical Care Medicine of the Central Hospital of Wuhan, China, from May 2019 to January 2020. 14 septic patients were divided into the non-severe group and the severe group according to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Herein, fecal samples were serially collected on admission, the third, fourth, and fifth days, and ICU discharge. The fecal microbiota was analyzed by 16S rRNA gene sequencing and its correlation with clinical parameters was evaluated. Results: Bacteroidetes, Firmicutes, and Proteobacteria were dominant phyla at ICU admission, and fecal biodiversity was not significantly different between the non-severe group (APACHE II < 15) and the severe group (APACHE II > 15). However, the diversity of the gut microbiota was significantly lower at ICU discharge than that at ICU admission with the extension of treatment time. Further significant difference flora analysis (LEfSe) showed that the genera Veillonella and Ruminococcus were the most discriminant biomarkers at ICU admission in non-severe and severe patients, respectively, while Enterococcus was the most discriminant biomarker at ICU discharge in all septic patients. Of note, liver function tests, including ALT, AST, TBIL, and DBIL correlated with the prevalence of various bacterial genera. Conclusions: The diversity of the gut microbiota in patients with sepsis decreases dramatically during ICU stay, and there are distinct dynamic changes in gut microbiota among patients with different severity in sepsis. [ABSTRACT FROM AUTHOR]

Low-grade heat recovery has received increasing attention as an essential contributor to improving overall energy utilization efficiency and facilitating the carbon neutrality commitment. Here, we developed a techno-economic analysis model of converting low-grade heat into electricity and hydrogen via the osmotic heat engine (OHE) and power-togas facility to alleviate the dilemma of lacking practical application scenarios of waste heat. The contribution margin is optimized in real time by either sending the electricity generated by the OHE into the electrolyzer for hydrogen production or selling it at market price in Wuhan, China, thus to identify the economically viable OHE costs under different conditions. Results show that the allowed heat engine cost is significantly impacted by the capacity factor, lifetime and discount rate. The effect of the capacity size of power-to-gas facility on allowed heat engine cost strongly depends on the hydrogen price. The allowed OHE cost increases with the elevating waste heat temperature for each heat transfer scenario. The hybrid energy system can be economically competitive compared with current mature technologies when the waste heat temperature is higher than 68 ℃ and 105 ℃ for fluid and air as heat transfer fluid, respectively. The economically viable heat engine cost is expected to gradually decline from 50,043 ¥/kW to 18,741 ¥/ kW within next 15 years. Incentive policy would boost the economic viability of converting low-grade heat into electricity and hydrogen. [ABSTRACT FROM AUTHOR]

Trichomonas vaginalis (T. vaginalis) infection is one of the most common sexually transmitted infections worldwide and is associated with several complications. However, the paucity of research regarding the prevalence of T. vaginalis infection in the Tibetan area limits control efforts. We aimed to evaluate the prevalence of T. vaginalis infection in the Tibetan area by a comparison with the prevalence of T. vaginalis in Wuhan city and to unveil the potential risk factors in the Tibetan area. This descriptive, cross-sectional study was conducted among adult women attending gynecology outpatient clinics in two public hospitals (one in Shannan city of Tibet and one in Wuhan city) in China in 2020. Data were retrieved from the medical record system and laboratory information management system, including T. vaginalis infection, bacterial vaginosis, and vulvovaginal candidiasis by wet mount microscopy or nucleic acid hybridization of vaginal secretions from patients. The associations of variables associated with T. vaginalis prevalence were quantified by odds ratios with 95% confidence intervals. The overall prevalence rates of T. vaginalis infection in the Tibetan area and Wuhan city were 20.94% and 2.84%, respectively. The statistically significant factors for the higher prevalence of T. vaginalis infection in the Tibetan area included tertiary educational status (AOR: 0.36 [95% CI: 0.16–0.81]), yearly family income > ¥100,000 (AOR: 0.48 [95% CI: 0.26–0.91]), clinical symptoms (AOR: 4.58[95% CI: 2.32–9.04]), and III–IV grade vaginal cleanliness (AOR: 29.71 [95% CI: 3.95–223.56]) in the multivariate logistic analysis. Interventions targeting improved living standards as well as women's educational level and promoting reproductive hygiene habits are recommended to contribute to the reduction in T. vaginalis infection in the Tibetan area. [ABSTRACT FROM AUTHOR]

Background: The long-term mental health effects of coronavirus disease 2019 (COVID-19) in children are rarely reported. We aimed to investigate the progression of depressive and anxiety symptoms among a cohort of children in the initial epicenter of COVID-19 in China. Methods: Two waves of surveys were conducted in the same two primary schools in Wuhan and Huangshi, Hubei province: Wave 1 from 28 February to 5 March, 2020 (children had been confined to home for 30–40 days) and Wave 2 from 27 November to 9 December, 2020 (schools had reopened for nearly 3 months). Depressive and anxiety symptoms were estimated using the Children's Depression Inventory – Short Form (CDI-S) and the Screen for Child Anxiety Related Emotional Disorders (SCARED), respectively. ΔCDI-S and ΔSCARED scores between Wave 2 and Wave 1 were calculated and further categorized into tertiles. Multivariable linear regression and multinomial logistic regression models were then applied. Results: A total of 1,224 children completed both surveys. The prevalence of mental health outcomes at Wave 2 increased significantly compared to Wave 1, specifically depressive symptoms (age-standardized prevalence rates: 37.5 vs. 21.8%) and anxiety symptoms (age-standardized prevalence rates: 24.0 vs. 19.6%). Higher ΔSCARED scores were observed in females and children in Wuhan, and children with experience of neglect had higher ΔCDI-S (β = 1.12; 95% CI = 0.67–1.58) and ΔSCARED (β = 6.46; 95% CI = 4.73–8.19) scores compared with those without experience of neglect. When the Δ scores were further categorized into tertiles, similar results were found. Conclusions: The prevalence of depressive and anxiety symptoms after schools resumed was increased compared with that during the home quarantine period, even though the COVID-19 pandemic was under control. Females and children in Wuhan, and also children with experience of neglect were at increased risk of mental health disorders. [ABSTRACT FROM AUTHOR]

The clinical use of serum creatine (sCr) and cystatin C (CysC) in kidney function evaluation of critically ill patients has been in continuous discussion. The difference between estimated glomerular filtration rate calculated by sCr (eGFRcr) and CysC (eGFRcysc) of critically ill COVID-19 patients were investigated in this study. This is a retrospective, single-center study of critically ill patients with COVID-19 admitted in intensive care unit (ICU) at Wuhan, China. Control cases were moderate COVID-19 patients matched in age and sex at a ratio of 1:1. The eGFRcr and eGFRcysc were compared. The association between eGFR and death were analyzed in critically ill cases. The potential factors influencing the divergence between eGFRcr and eGFRcysc were explored. A total of 76 critically ill COVID-19 patients were concluded. The mean age was 64.5 ± 9.3 years. The eGFRcr (85.45 (IQR 60.58–99.23) ml/min/1.73m2) were much higher than eGFRcysc (60.6 (IQR 34.75–79.06) ml/min/1.73m2) at ICU admission. About 50 % of them showed eGFRcysc < 60 ml/min/1.73 m2 while 25% showed eGFRcr < 60 ml/min/1.73 m2 (χ2 = 10.133, p = 0.001). This divergence was not observed in moderate group. The potential factors influencing the divergence included serum interleukin-6 (IL-6), tumor necrosis factor (TNF-α) level as well as APACHEII, SOFA scores. Reduced eGFRcr (<60 mL/min/1.73 m2) was associated with death (HR = 1.939, 95%CI 1.078–3.489, p = 0.027). The eGFRcr was generally higher than eGFRcysc in critically ill COVID-19 cases with severe inflammatory state. The divergence might be affected by inflammatory condition and illness severity. Reduced eGFRcr predicted in-hospital death. In these patients, we advocate for caution when using eGFRcysc. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted.Methods: In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020.Results: Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19.Conclusions: The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19. [ABSTRACT FROM AUTHOR]

A pandemic designated as Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading worldwide. Up to date, there is no efficient biomarker for the timely prediction of the disease progression in patients. To analyze the inflammatory profiles of COVID-19 patients and demonstrate their implications for the illness progression of COVID-19. Retrospective analysis of 3,265 confirmed COVID-19 cases hospitalized between 10 January 2020, and 26 March 2020 in three medical centers in Wuhan, China. Patients were diagnosed as COVID-19 and hospitalized in Leishenshan Hospital, Zhongnan Hospital of Wuhan University and The Seventh Hospital of Wuhan, China. Univariable and multivariable logistic regression models were used to determine the possible risk factors for disease progression. Moreover, cutoff values, the sensitivity and specificity of inflammatory parameters for disease progression were determined by MedCalc Version 19.2.0. Age (95%CI, 1.017 to 1.048; P < 0.001), serum amyloid A protein (SAA) (95%CI, 1.216 to 1.396; P < 0.001) and erythrocyte sedimentation rate (ESR) (95%CI, 1.006 to 1.045; P < 0.001) were likely the risk factors for the disease progression. The Area under the curve (AUC) of SAA for the progression of COVID-19 was 0.923, with the best predictive cutoff value of SAA of 12.4 mg/L, with a sensitivity of 83.9% and a specificity of 97.67%. SAAcontaining parameters are novel promising ones for predicting disease progression in COVID-19. [ABSTRACT FROM AUTHOR]

Background Coronavirus disease 2019 (COVID-19) is a pandemic that has affected more than 3 million patients globally. Previous data from Wuhan city showed that acute kidney injury (AKI), proteinuria and hematuria occurred frequently in patients with severe COVID-19. However, the prevalence of kidney injury in milder cases remains unclear. Methods This retrospective study included two major consecutive cohorts of COVID-19 patients in Sichuan Province. Baseline characteristics, laboratory data including renal function, proteinuria and dipstick hematuria, and other laboratory parameters were collected. A subgroup of patients was followed up for 2–4 weeks to evaluate the short-term outcome of renal impairment. Results Overall, 168 COVID-19-positive patients were included in the study. The majority of patients (79.7%) were diagnosed with mild or moderate disease. Half of patients presented with fever; however, in The Tibetan cohort, fever only occurred in 13.4% of patients. On hospital admission, proteinuria and dipstick hematuria were noted in 18.4% and 17.4% of patients, respectively, while AKI only occurred in one patient. Further analysis showed that severe or critical COVID-19 was associated with higher risk of proteinuria [relative risk (RR) 7.37, 95% confidence interval (CI) 2.45–22.18, P = 3.8 × 10−4] and dipstick hematuria (RR 8.30, 95% CI 2.69–25.56, P = 2.3 × 10−4). Proteinuria, dipstick hematuria, or the combination of proteinuria and hematuria could significantly predict severe or critical severe COVID-19. Conclusions Proteinuria and dipstick hematuria are not uncommon in patients with COVID-19 infection, especially in severe or critical cases. [ABSTRACT FROM AUTHOR]

Thrombocytopenia has been implicated in patients infected with severe acute respiratory syndrome coronavirus 2, while the association of platelet count and changes with subsequent mortality remains unclear. The clinical and laboratory data of 383 patients with the definite outcome by March 1, 2020 in the Central Hospital of Wuhan were reviewed. The association between platelet parameters and mortality risk was estimated by utilizing Cox proportional hazard regression models. Among the 383 patients, 334 (87.2%) were discharged and survived, and 49 (12.8%) died. Thrombocytopenia at admission was associated with mortality of almost three times as high as that for those without thrombocytopenia (P < 0.05). Cox regression analyses revealed that platelet count was an independent risk factor associated with in-hospital mortality in a dose-dependent manner. An increment of per 50 × 109/L in platelets was associated with a 40% decrease in mortality (hazard ratio: 0.60, 95%CI: 0.43, 0.84). Dynamic changes of platelets were also closely related to death during hospitalization. Baseline platelet levels and changes were associated with subsequent mortality. Monitoring platelets during hospitalization may be important in the prognosis of patients with coronavirus disease in 2019. [ABSTRACT FROM AUTHOR]

• Generated two decades 30 m resolution summer mean land surface temperature (LST). • The polycentric development of Wuhan first fast and then slowed down. • The area of high LST centers fluctuated in the context of 1 K increase in summer mean LST. • Morphological centers show hysteresis behind high LST centers by about nine years. The emergence of urban polycentric development patterns in response to the pressure of rapid urbanization can profoundly affect the urban heat island (UHI) effect. However, little research has been conducted on this issue at a high spatio-temporal resolution level. To investigate the evolution of urban polycentricity and the accompanying changes in the urban thermal environment, data for 2000 to 2020 from Wuhan in China obtained by multiple sensors were used to extract the urban morphological centers each year and generate annual summer mean land surface temperature (LST) with a 30 m resolution. Results show that the number and size of urban morphological centers in Wuhan increased significantly, from five centers covering 29.75 km2 in 2000 to 15 centers covering 171.72 km2 in 2020. The annual average growth rate was rapid (0.152 km2/a) from 2000 to 2012, then slowed down (0.026 km2/a). The location of newly emerged urban centers aligned with Wuhan's urban development planning. Meanwhile, the urban thermal environment also changed considerably. The summer mean LST have risen by around 1 K, whereas the area of high LST centers fluctuated in the recent two decades. The evolution of urban morphological centers and high LST centers was not always synchronized, with changes in the former showed hysteresis behind the latter, and overlapping areas between the two reaching the maximum at an interval of about nine years. These findings will further our understanding of the urban polycentricity, as well as the evolution of the urban thermal environment in this context. [ABSTRACT FROM AUTHOR]

Although it is a probable human carcinogen, propylene oxide is widely applied in industry and daily life. However, data on neurodevelopmental effects of propylene oxide exposure among children are extremely limited. We aimed to determine the urinary concentrations of propylene oxide metabolite among school-aged children and evaluate the potential association of propylene oxide exposure with risk of dyslexia. A total of 355 dyslexic children and 390 controls were recruited from three cities (Jining, Wuhan, and Hangzhou) in China, between 2017 and 2020. Urinary N-acetyl-S-(2-hydroxypropyl)-L-cysteine (i.e., 2-hydroxypropyl mercapturic acid; 2-HPMA) was measured as the biomarker of propylene oxide exposure. The detection frequency of 2-HPMA was 100%. After adjusting for potential confounders, the odds ratio (OR) for dyslexia per 2-fold increase in urinary 2-HPMA was 1.19 [95% confidence interval (95% CI): 1.01, 1.40, P = 0.042]. Compared with the lowest quartile of urinary 2-HPMA concentrations, children with the highest quartile of 2-HPMA had a 1.63-fold (95% CI: 1.03, 2.56, P = 0.036) significantly increased risk of dyslexia, with a dose-response relationship (P -trend = 0.047). This study provides epidemiological data on the potential association between propylene oxide exposure and the risk of dyslexia in children. Further studies are warranted to confirm the findings and reveal the underlying biological mechanisms. [Display omitted] • School-aged children in China were extensively exposed to propylene oxide. • Urinary 2-HPMA levels differed significantly by sex, age, and smoking exposure. • Urinary propylene oxide metabolite was positively associated with risk of dyslexia. [ABSTRACT FROM AUTHOR]

Multiple factors regulate urban land surface temperature (LST), including land cover, climate, and urban form, among which urban form is now receiving more and more attention. Some studies have discussed the planar effects of urban form on LST, whereas less concern has been devoted to the vertical structure of urban areas, which can have a significant effect on heat redistribution. In this paper, we quantify the three-dimensional building form (3DBF) effects on LST captured by Landsat thermal sensors over four seasons by using a random forest (RF) regression method. The five 3DBF factors of building density (BD), building height (BH), sky view factor (SVF), frontal area index (FAI), and building shadow (BS) are calculated within a grid. The seasonal correlation of the 3DBF factors with LST is analyzed, and seven correlation patterns are modeled for the city of Wuhan in China. The results show that: 1) The best grid scale for the building form analysis in a city such as Wuhan is 180 m. 2) The 3DBF factors have a significant effect on urban LST over the four seasons. BD, BH and BS are the season-stable factors, among which BD has a heating effect, which reaches a maximum of 3.6 °C in spring, while BS has a cooling effect, which reaches −3.4 °C in winter. There is also a transition point for BH between heating and cooling at a height of 10 m. 3) SVF and FAI are season-varying factors, in which SVF has cooling effect, except in summer, while FAI also has a cooling effect, but not in winter. These findings will help us to understand how building form affects urban surface temperature, and will provide a reference for urban policy makers and planners in the future. • 3D building form effects on urban LST were quantified by a random forest model. • Seasonal correlation patterns were modeled for 3D building form (3DBF) factors. • Building density, building height and building shadow are three most important factors and their effects are season-stable. • Sky view factor and frontal area index mainly show cooling effect except in some seasons. [ABSTRACT FROM AUTHOR]

Objective: We aimed to describe the features of 220 nonemergency (mild or common type) COVID-19 patients from a shelter hospital, as well as evaluate the efficiency of antiviral drug, Arbidol in their disease progressions. Methods: Basic clinical characteristics were described and the efficacy of Arbidol was evaluated based on gender, age, maximum body temperature of the patients. Results: Basically, males had a higher risk of fever and more onset symptoms than females. Arbidol could accelerate fever recovery and viral clearance in respiratory specimens, particularly in males. Arbidol also contributed to shorter hospital stay without obvious adverse reactions. Conclusions: In the retrospective COVID-19 cohort, gender was one of the important factors affecting patient's conditions. Arbidol showed several beneficial effects in these patients, especially in males. This study brought more researches enlightenment in understanding the emerging infectious disease. [ABSTRACT FROM AUTHOR]

Synthetic aperture radar tomography (TomoSAR) is a useful tool for retrieving the three-dimensional structure of buildings in urban areas, especially for datasets with a high spatial resolution. However, among the previous TomoSAR estimators, some cannot retrieve the 3-D structure of objects with a high elevation resolution, some cannot maintain the spatial resolution, and some require the selection of a hyperparameter. To overcome these limitations, this paper proposes a new nonparametric iterative adaptive approach with a model selection tool based on the Bayesian information criterion (IAA-BIC) for the application of TomoSAR in urban areas. IAA-BIC employs weighted least squares to acquire a high elevation resolution and works well for both distributed and coherent scatterers, even with single-look. Concurrently, IAA-BIC does not require the user to make any difficult selection regarding a hyperparameter. The proposed IAA-BIC estimator was tested in simulated experiments, and the results confirmed the advantages of the IAA-BIC estimator. Moreover, the three-dimensional structure of the Hubei Science and Technology Venture building in Wuhan, China, was retrieved through the IAA-BIC method with nine very high spatial resolution TerraSAR-X images. The height estimation accuracy for this building was about 1% and 4% relative to its real height for single-look and multi-look, respectively. In addition, a comparison between the IAA-BIC estimator and some of the typical existing TomoSAR estimators (Capon, MUSIC, and compressed sensing (CS)) was also carried out. The results indicate that the IAA-BIC estimator obtains a better resolution for coherent sources than Capon and MUSIC; notably, the IAA-BIC estimator obtains a similar performance to CS, but in less computation time. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has spread globally. Epidemiological susceptibility to COVID-19 has been reported in patients with cancer. We aimed to systematically characterise clinical features and determine risk factors of COVID-19 disease severity for patients with cancer and COVID-19.Methods: In this multicentre, retrospective, cohort study, we included all adult patients (aged ≥18 years) with any type of malignant solid tumours and haematological malignancy who were admitted to nine hospitals in Wuhan, China, with laboratory-confirmed COVID-19 between Jan 13 and March 18, 2020. Enrolled patients were statistically matched (2:1) with patients admitted with COVID-19 who did not have cancer with propensity score on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, illness severity, and clinical interventions were compared between patients with COVID-19 with or without cancer as well as between patients with cancer with non-severe or severe COVID-19. COVID-19 disease severity was defined on admission on the basis of the WHO guidelines. Univariable and multivariable logistic regression, adjusted for age, sex, comorbidities, cancer type, tumour stage, and antitumour treatments, were used to explore risk factors associated with COVID-19 disease severity. This study was registered in the Chinese Clinical Trial Register, ChiCTR2000030807.Findings: Between Jan 13 and March 18, 2020, 13 077 patients with COVID-19 were admitted to the nine hospitals in Wuhan and 232 patients with cancer and 519 statistically matched patients without cancer were enrolled. Median follow-up was 29 days (IQR 22-38) in patients with cancer and 27 days (20-35) in patients without cancer. Patients with cancer were more likely to have severe COVID-19 than patients without cancer (148 [64%] of 232 vs 166 [32%] of 519; odds ratio [OR] 3·61 [95% CI 2·59-5·04]; p<0·0001). Risk factors previously reported in patients without cancer, such as older age; elevated interleukin 6, procalcitonin, and D-dimer; and reduced lymphocytes were validated in patients with cancer. We also identified advanced tumour stage (OR 2·60, 95% CI 1·05-6·43; p=0·039), elevated tumour necrosis factor α (1·22, 1·01-1·47; p=0·037), elevated N-terminal pro-B-type natriuretic peptide (1·65, 1·03-2·78; p=0·032), reduced CD4+ T cells (0·84, 0·71-0·98; p=0·031), and reduced albumin-globulin ratio (0·12, 0·02-0·77; p=0·024) as risk factors of COVID-19 severity in patients with cancer.Interpretation: Patients with cancer and COVID-19 were more likely to deteriorate into severe illness than those without cancer. The risk factors identified here could be helpful for early clinical surveillance of disease progression in patients with cancer who present with COVID-19.Funding: China National Natural Science Foundation. [ABSTRACT FROM AUTHOR]

Deoxynivalenol (DON) is a ubiquitous trichothecene mycotoxin in food. DON and its modified forms can cross the placental barrier and influence the foetus' health. Limited information is available on exposure of dietary DON intake of pregnant women in China recently. We estimated the exposure of dietary DON intake of pregnant women in a large sample size (n = 2534) from China. The total DON (tDON) and free DON (fDON) biomarkers in urine were detected by liquid chromatography–tandem mass spectrometry. The mean concentration of tDON was 34.8 ng/mg creatinine, and the fDON was 15.9 ng/mg creatinine. The estimated exposure of dietary DON intake was 0.96–1.91 μg/kg bw/day, and the difference in exposure of DON between the first and second trimesters was statistically insignificant. Approximately 26%–60% of individuals exceeded the provisional maximum tolerable daily intake (PMTDI). The age, pre-pregnancy BMI, and the sampling seasons may be the risk factor for the occurrence of exceeding PMTDI. This survey is the first exposure biomarker for DON in a large sample size from pregnant women in China. We found that the dietary DON exposure in pregnant women was relatively high and particular concern should be paid to the DON exposure during pregnancy. [Display omitted] • This is the first study to evaluate pregnant women exposure to DON with indirect measurements in urine samples for over 2000 subjects of a single population. • The dietary exposure to DON in pregnant women was relatively high in China and needed to pay particular concern. • Provide a new view on the exposure of dietary DON intake of pregnant women in China. [ABSTRACT FROM AUTHOR]