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Background: Abnormal changes of monocytes have been observed in acute COVID‐19, whereas associations of monocyte count with long COVID were not sufficiently elucidated. Methods: A cohort study was conducted among COVID‐19 survivors discharged from hospital. The primary outcomes were core symptoms of long COVID, distance walked in 6 min, and lung function, and the secondary outcomes were health‐related quality of life and healthcare use after discharge. Latent variable mixture modeling was used to classify individuals into groups with similar trajectory of monocyte count from discharge to 2‐year after symptom onset. Multivariable adjusted generalized linear regression models and logistic regression models were used to estimate the associations of monocyte count trajectories and monocyte count at discharge with outcomes. Results: In total, 1389 study participants were included in this study. Two monocyte count trajectories including high to normal high and normal trajectory were identified. After multivariable adjustment, participants in high to normal high trajectory group had an odds ratio (OR) of 2.52 (95% CI, 1.44–4.42) for smell disorder, 2.27 (1.27–4.04) for 6‐min walking distance less than lower limit of normal range, 2.45 (1.08–5.57) for total lung capacity (TLC) < 80% of predicted, 3.37 (1.16–9.76) for personal care problem, and 1.70 (1.12–2.58) for rehospitalization after discharge at 2‐year follow‐up compared with those in normal trajectory group. Monocyte count at discharge showed similar results, which was associated with smell disorder, TLC < 80% of predicted, diffusion impairment, and rehospitalization. Conclusions: Monocyte count may serve as an easily accessible marker for long‐term management of people recovering from COVID‐19. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths worldwide every year, and most HCC patients are diagnosed with advanced disease and can only receive systemic treatment. TKIs are the most important components of the systemic treatment of HCC and have both good efficacy and adverse events (AEs).  METHODS: This analysis included 207 patients with locally advanced unresectable or metastatic HCC who received oral treatment with apatinib. We analyzed the overall survival (OS) and progression-free survival (PFS) of patients with or without corresponding AEs to evaluate which AEs can predict the efficacy of apatinib.Results: Patients with hand-foot syndrome (HFS; p = 0.005), proteinuria (p = 0.006) and diarrhea (p < 0.001) had significantly better OS than those without corresponding AEs, and the appearance of HFS (p = 0.006) and proteinuria (p = 0.004) was associated with longer PFS.Conclusion: Among all the AEs induced by apatinib in the treatment of advanced HCC, proteinuria could potentially predict PFS, and diarrhea was a potential predictor of OS. [ABSTRACT FROM AUTHOR]

Geothermal pavement systems are a novel type of energy geostructure. They use sub-surface structures to exchange heat with the ground and, thereby, provide thermal energy in addition to structural support. The thermo-activation of pavements has been largely overlooked in the literature. This research focuses on the development of a detailed three-dimensional (3D) finite-element (FE) model to explore the thermal performance of geothermal pavement systems. The 3D FE model developed was successfully validated with both data measured from a full-scale experiment undertaken in Adelaide, South Australia and other published data. The validated model is further employed to evaluate the long-term performance of a geothermal pavement system under both a traditional system configuration and a hybrid system. Furthermore, a life-cycle cost analysis is performed to explore the cost implication of such pavement systems. Results show that a geothermal pavement with total pipe length of 640 m, or a hybrid system (a geothermal pavement system with a pipe length of 320 m and an auxiliary system) can provide for sufficient space heating and cooling for a typical residential building in Australia. It is found that, compared with conventional heating and cooling systems, the geothermal pavement system is indeed a cost-effective solution. This research study indicates that this pavement technology can be successfully implemented in the field and accurately modelled using FE techniques. [ABSTRACT FROM AUTHOR]

Although peroxiredoxin 2 (PRDX2) plays a vital role in relieving oxidative stress, its physiological function in cartilage development remains almost unknown. In this study, we found that the expression of PRDX2 significantly increased in the chondrocytes compared with pre-chondrocytes. PRDX2 knockdown significantly decreased the expression of extracellular matrix (ECM) protein (Col2a and Aggrecan), which led to blocked cartilage formation. Moreover, PRDX2 knockdown also inhibited the expression of connective tissue growth factor (CTGF). CTGF is an important growth factor that regulates synthesis of ECM proteins. We explored the possible regulatory mechanism by which PRDX2 regulated the expression of CTGF. Our results demonstrated that PRDX2 knockdown downregulated the expression of CTGF by inhibiting Wnt5a/Yes-associated protein 1 (YAP1) pathway. In addition, PRDX2 knockdown promoted the expression of interleukin 6 (IL-6), indicating PRDX2 expression had an anti-inflammatory function during antler growth. Mechanistically, PRDX2 knockdown promoted cartilage matrix degradation by activating the IL-6-mediated Janus Kinase 2/Signal Transducer and Activator of Transcription 3 (JAK2/STAT3) signaling pathway. These results reveal that PRDX2 is a potential regulator that promotes cartilage extracellular matrix synthesis. [ABSTRACT FROM AUTHOR]

Background: The diagnosis and treatment of patients with bronchiectasis and nontuberculous mycobacterium (NTM) pulmonary disease are challenging issues and the treatment is also prolonged and depends on the species. There is limited information on patients with bronchiectasis and NTM pulmonary disease in Mainland China.Methods: This cross-sectional study was conducted at the China-Japan Friendship Hospital, Beijing, China. Those adult patients who met the diagnostic criteria for bronchiectasis and obtained a culture result of mycobacteria from lower respiratory tract specimens or lung tissue were included in this study. A logistic regression model was used to identify the related factors in patients with NTM pulmonary disease.Results: A total of 202 patients with bronchiectasis from 19 cities, 155 without and 47 (23.3%) with NTM pulmonary disease, were included. In all the 47 patients with NTM pulmonary disease, Mycobacterium avium complex was the most common species (66.0%), and 72.3% of them were initiated on standard anti-NTM treatment within 3 months after the diagnosis of NTM pulmonary disease. A larger proportion of patients with NTM pulmonary disease had acute exacerbations of ≥ 3 times within 1 year and were diagnosed bronchiectasis ≥ 50 years among patients with NTM pulmonary disease. The HRCT chest images revealed higher proportions of nodular shadow (100% vs. 35.3%), tree-in-bud sign (97.9% vs. 29.0%), cavities (29.8% vs. 5.8%), and airway dilation of the right middle lobe or the left lingular lobe (63.8% vs. 23.9%) in patients with NTM pulmonary disease than in those without NTM pulmonary disease (all P values = 0.001). The multivariable logistic regression model indicated that three and more abnormal features (OR 33.8; 95% CI 11.1-102.8) and main lesions of bronchial expansion in the middle or lingual lobe (OR 6.4; 95% CI 2.4-16.6) in HRCT chest images were independently associated with NTM pulmonary disease (P values = 0.001).Conclusion: In a single center of Mainland China, > 23% of patients with bronchiectasis had NTM pulmonary disease, and most patients were started on standard treatment within 3 months after the diagnosis of NTM pulmonary disease. These findings suggest that patients with bronchiectasis should be thoroughly examined for the presence of NTM pulmonary disease.Trial Registration: NCT03594032. [ABSTRACT FROM AUTHOR]

Introduction and objectives: Exogenous lipoid pneumonia (ELP) is a lung inflammatory disease with low prevalence and has the feature of external lipid substances presented in the alveoli. Therapeutic lung lavage (segmental bronchoalveolar lavage and whole lung lavage) has been gradually recognized as an important therapy for the disease. There was no comprehensive summary on its efficacy and safety. Methods: We searched PubMed, Embase, Cochrane Library, CNKI, Wanfang Database, clinicaltrials.gov, and the references of included studies. After study selection, data extraction and quality assessment, we performed a qualitative description of current data. Results: We included 90 ELP patients from 25 case reports and 8 case series studies. Eighty‐four (93.3%) patients received segmental bronchoalveolar lavage and six (6.7%) patients received whole lung lavage. Eighty‐seven (96.7%) patients got clinical improvement after lavages, while three (3.3%) patients had no improvement and eventually died. The follow‐up status was reported in 29 patients, of whom 24 patients remained well without any use of drugs and 4 patients remained well with some periods of corticosteroids. One patient endured recurrence. The radiological change was reported in 72 patients, of whom 41 (56.9%) patients had full resolution until the last follow‐up. Two studies reported acute pulmonary edema and transient hypoxemia during lavages. Conclusions: Therapeutic lung lavage might be an effective and safe therapy with long‐term benefits for ELP. Current studies were all case reports and case series with relatively high risk of bias. Prospective controlled studies are needed to explore the actual efficacy, safety, individualized indications, and optimized treatment procedures of therapeutic lung lavage for ELP. [ABSTRACT FROM AUTHOR]

Geothermal pavements can be used with ground-source heat pump systems to sustainably provide energy for heating and cooling by incorporating ground heat exchanger elements underneath pavement surfaces. This work investigates the suitability of geothermal pavements at scale, adopting the city of Cardiff, UK, as a case-study. A two-scale modelling framework, combining detailed small-scale with holistic large-scale approaches, is presented, incorporating the accuracy of the former with the continuity of the latter. The results show that between 184 kWh and 345 kWh of thermal energy per metre length of pavement can be supplied annually, depending on soil profile. Moreover, geothermal operation can reduce anthropogenic heat flux into the ground from heated basements, and its associated negative impacts, by about 390 MWh/year. A city-scale analysis using population-consistent geographic areas called LSOAs, estimates that geothermal pavements can supply about 23% of the entire city residential heat demand, or up to 75% with heat sharing between LSOAs. The suitability of geothermal pavements for larger LSOAs is highlighted, supplying up to 100% of the annual domestic heat demand. Investigating the carbon emissions of heating and cooling technologies shows potential reductions of up to 75% when replacing gas boilers and resistance heating with geothermal pavement systems. • Two-scale modelling is used to assess city-scale geothermal pavement potential. • Depending on ground conditions, 184–345 kWh annually/m road of heat can be provided. • Geothermal pavements can reduce anthropogenic heat flux into the ground by ∼ 390 MWh/a. • In low population density areas 100% residential demand can be fulfilled, overall 23%. • Replacing traditional systems can reduce carbon emission by ∼ 75%. [ABSTRACT FROM AUTHOR]

True morphology imaging of individual nanoprobes with high sensitivity and in situ dynamic response is crucial in the dark-field microscopy imaging analysis. However, the geometry and orientation of the probes are experimentally challenging to visualize as their physical dimensions are usually below the diffraction limit. In this work, two-dimensional triangular gold nanoplates (AuNPLs) with the edge length > 600 nm and the thickness ~25 nm displayed clear triangular-shaped far-field scattering patterns (TFSPs) under a dark-field imaging system owing to the strong electrical field strength around the sharp edges and tips. Thus, their actual shape and orientation specific scattering image are directly visualized only by dark-field microscopy and furtherly applied to real-time monitor the etching and alloying progress of AuNPLs. The results showed that the reactive sites of AuNPLs are located at their vertices and sharp edges owing to the sensitive edge effect. This work provides a new perspective to directly monitor the conformation and dynamics of chemical reaction at the single particle level. Two-dimensional triangular gold nanoplates (AuNPLs) with the edge length > 600 nm and the thickness as 25 nm displayed clear triangular-shaped far-field scattering patterns (TFSPs) under a DFM system owing to the strong electrical field strength around the sharp edges and tips. Thus, their actual shape and orientation specific scattering image are directly visualized only with a DFM imaging system and furtherly applied to real-time monitor the etching and alloying progress of AuNPLs. [Display omitted] [ABSTRACT FROM AUTHOR]

Studies on the association of greenness with respiratory health are scarce in developing countries, and previous studies in China have focused on only one or two indicators of lung function. The study aims to evaluate the associations of residential greenness with full-spectrum lung function indicators and prevalence of chronic obstructive pulmonary disease (COPD). This nationwide cross-sectional survey included 50,991 participants from the China Pulmonary Health study. Lung function indicators included four categories: indicators of obstructive ventilatory dysfunction (FEV 1 , FVC and FEV 1 /FVC); an indicator of large-airway dysfunction (PEF); indicators of small-airway dysfunction (FEF 25–75% and FEV 3 /FEV 6); and other indicators. Residential greenness was assessed by the Normalized Difference Vegetation Index (NDVI). Multivariable linear regression models and logistic regression models were used to analyze associations of greenness with lung function and COPD prevalence. Within the 500 m buffer, an interquartile range (IQR) increase in NDVI was associated with higher FEV 1 (24.76 mL), FVC (16.52 mL), FEV 1 /FVC (0.38), FEF 50% (56.34 mL/s), FEF 75% (33.43 mL/s), FEF 25–75% (60.73 mL/s), FEV 3 (18.59 mL), and FEV 6 (21.85 mL). However, NDVI was associated with lower PEF. In addition, NDVI was significantly associated with 10% lower odds of COPD. The stratified analyses found that the associations were only significant in middle-young people, females, and nonsmokers. The associations were influenced by geographic regions. Residential greenness was associated with better lung function and lower odds of COPD in China. These findings provide a scientific basis for healthy community planning. • The analysis included 50,991 participants from the China Pulmonary Health study. • Greenness was associated with better lung function. • Greenness was associated with lower odds of COPD. • The associations were modified by age, sex, geographic region, and smoking history. [ABSTRACT FROM AUTHOR]

The sika deer is one type of seasonal breeding animal, and the growth of its antler is affected by light signals. Melatonin (MLT) is a neuroendocrine hormone synthesized by the pineal gland and plays an important role in controlling the circadian rhythm. Although the MLT/MT1 (melatonin 1A receptor) signal has been identified during antler development, its physiological function remains almost unknown. The role of MLT on antler growth in vivo and in vitro is discussed in this paper. In vivo, MLT implantation was found to significantly increase the weight of antlers. The relative growth rate of antlers showed a remarkable increased trend as well. In vitro, the experiment showed MLT accelerated antler mesenchymal cell differentiation. Further, results revealed that MLT regulated the expression of Collage type II (Col2a) through the MT1 binding mediated transcription of Yes-associated protein 1 (YAP1) in antler mesenchymal cells. In addition, treatment with vascular endothelial growth factor (VEGF) promoted chondrocytes degeneration by downregulating the expression of Col2a and Sox9 (SRY-Box Transcription Factor 9). MLT effectively inhibited VEGF-induced degeneration of antler chondrocytes by inhibiting the Signal transducers and activators of transcription 5/Interleukin-6 (STAT5/IL-6) pathway and activating the AKT/CREB (Cyclin AMP response-element binding protein) pathway dependent on Sox9 expression. Together, our results indicate that MLT plays a vital role in the development of antler cartilage. [ABSTRACT FROM AUTHOR]

Full spectrum of COVID-19 severity still being depicted - Authors' reply Zhou Xu and colleagues point out that mortality, which should be referred correctly and more clearly as case fatality ratio, among the first 41 cases with laboratory-confirmed 2019 novel coronavirus disease (COVID-19; previously known as 2019-nCoV) was misleading in our Article.[1] We definitely agree that the case fatality ratio among the first 41 cases cannot represent the case fatality ratio of the full disease spectrum during the outbreak of COVID-19. From the perspective of treatment, even the most up-to-date case fatality ratio is expected to decrease as diagnosis and treatment procedure for patients with pneumonia who are infected with SARS-CoV-2 is improving,[3] potential drugs to treat COVID-19 are being evaluated for efficacy and safety in ongoing clinical trials,[[4]] and management is becoming more intense, not only for patients with severe infection but also for those with moderate, mild, or even asymptomatic infection. [Extracted from the article]

Vascular endothelial growth factor A (VEGFA) and its receptor VEGFR2 are the main targets of antiangiogenic therapies, and proteinuria is one of the common adverse events associated with the inhibition of the VEGFA/VEGFR2 pathway. The proteinuric kidney damage induced by VEGFR2 tyrosine kinase inhibitors (TKIs) is characterized by podocyte foot process effacement. TKI therapy promotes the formation of abnormal endothelial‒podocyte crosstalk, which plays a key role in TKI-induced podocyte injury and proteinuric nephropathy. This review article summarizes the underlying mechanism by which the abnormal endothelial‒podocyte crosstalk mediates podocyte injury and discusses the possible molecules and signal pathways involved in abnormal endothelial‒podocyte crosstalk. What is more, we highlight the molecules involved in podocyte injury and determine the essential roles of Rac1 and Cdc42; this provides evidence for exploring the abnormal endothelial‒podocyte crosstalk in TKI-induced nephrotoxicity. [ABSTRACT FROM AUTHOR]

Polymer grafted inorganic nanoparticles attract significant attention, but pose challenges because of the complexity. In this work, a facile strategy to the graft polymer onto the surface of nanoparticles have been introduced. The vinyl functionalized SiO2 nanoparticles (NPs) were first prepared by the surface modification of the unmodified SiO2 using γ-methacryloxy propyl-trimethoxylsilane. The NPs were then mixed with polyvinylidene fluoride (PVDF), which was followed by the Co-60 Gamma radiation at room temperature. PVDF molecular chains were chemically grafted onto the surface of SiO2 nanoparticles by the linking of the double bond on the NPs. The graft ratio of PVDF on SiO2 NPs surface can be precisely controlled by adjusting the absorbed dose and reactant feed ratio (maximum graft ratio was 31.3 wt%). The strategy is simple and it should be applied to the surface modification of many other nanoparticles. The prepared PVDF-grafted SiO2 NPs were then dispersed in the PVDF matrix to make the nanocomposites. It was found that the modified NPs can be precisely dispersed into the PVDF matrix, as compared with pristine silica. The filling content of modifications SiO2 NPs on the PVDF nanocomposites is almost doubled than the pristine SiO2 counterpart. Accordingly, the mechanical property of the nanocomposites is significantly improved. [ABSTRACT FROM AUTHOR]

In this work, the localization of reactive compatibilizer (RC, containing poly(methyl methacrylate) (PMMA) backbone with randomly distributed glycidyl methacrylate (GMA) on it) at the polyvinylidene fluoride/poly(l-lactic acid) (PVDF/PLLA) interface has been manipulated by means of GMA contents. At the very beginning of mixing, RC tends to stay in the PVDF phase due to the miscibility between PVDF and PMMA. Upon further shearing, more and more PLLA chains have been grafted on PMMA backbone, producing PLLA–g–PMMA copolymer. The balanced stress on two sides accounts for the localization of compatibilizers at the PVDF/PLLA interface. Finally, the stress of the PLLA side has been enhanced remarkably due to the higher graft density of PLLA, resulting in the enrichment of the copolymer in the PLLA matrix. The migration of RC from the PVDF phase to the immiscible interface and PLLA matrix can be accelerated by employing RC with higher GMA content. Furthermore, the compatibilizer localization produces a significant influence on the morphology and ductility of the PVDF/PLLA blend. Only when the compatibilizers precisely localize at the interface, the blend exhibits the smallest domain and highest elongation at break. Our results are of great significance for not only the fabrication of PLLA with high ductility, but also the precise localization of compatibilizers at the interface of the immiscible blend. [ABSTRACT FROM AUTHOR]

Background: Pulmonary primitive neuroectodermal tumor (PNET), a member of the Ewing sarcoma family of tumors, is a rare malignancy that is associated with a grim prognosis. To date, fewer than 30 cases of pulmonary PNET have been reported. In this case report, we present the clinical details of a 12-year-old girl with pulmonary PNET who underwent surgical treatment. We also conducted an analysis and summary of other relevant studies and the surgical outcomes. Case presentation: In May 2018, a 12-year-old girl was admitted with symptoms of cough and blood-tinged phlegm. A computed tomography scan revealed a large mass, measuring 12.9 cm × 8.1 cm, in the right middle and lower lungs. A percutaneous lung biopsy confirmed poorly differentiated tumor cells with a nested growth pattern. Immunohistochemical staining demonstrated positive expression of CD99, CD56, Vimentin, and Synaptophysin. The patient was diagnosed with pulmonary PNET. Following three cycles of neoadjuvant chemotherapy, a substantial reduction in tumor volume was observed. Subsequently, the patient underwent a surgical procedure involving pneumonectomy and partial resection of the left atrium with the assistance of cardiopulmonary bypass. The patient was discharged 37 days after surgery. During a three-year follow-up period, she exhibited no signs of tumor recurrence and has successfully returned to school. Conclusions: This case highlights the successful management of an advanced PNET with neoadjuvant chemotherapy, pneumonectomy, and partial resection of the left atrium employing cardiopulmonary bypass. The patient remained disease-free after three years. Our analysis of surgically treated cases indicates that neoadjuvant chemotherapy can contribute to improved prognoses for PNET patients. It is crucial to emphasize that complete surgical excision remains the cornerstone of treatment, underscoring the importance of surgeons considering radical surgical approaches whenever feasible for patients with pulmonary PNETs. [ABSTRACT FROM AUTHOR]

Kiwifruit has a high decay rate, in part because quality changes during storage cannot be easily monitored in real time. In order to better monitor the shelf life of kiwifruit and understand the quality changing process during storage, internal quality indexes such as hardness, respiratory intensity and TSS(Total Soluble Solid) were considered into the prediction models. The prediction models were constructed based on BPNN (Back Propagation Neural Network), Random Forest (RF) and XGBoost (eXtreme Gradient Boosting) respectively. And transfer learning algorithm was used to construct the quality prediction models with BPNN, RF, and XGBoost algorithms as the base learner. In the experiments, sample data were augmented by adding Gaussian noise, which effectively prevented the model from over-fitting. The experimental results showed that the prediction accuracy of each index based on transfer learning was better than that of individual BPNN, RF and XGBoost. Moreover, the average prediction accuracy of the models based on transfer learning was 96.2%, and that of respiratory intensity was as high as 99.4%. Therefore transfer learning can be used to effectively analyze and predict changes of kiwifruit quality indexes during storage. [ABSTRACT FROM AUTHOR]

Background: The full range of long-term health consequences of COVID-19 in patients who are discharged from hospital is largely unclear. The aim of our study was to comprehensively compare consequences between 6 months and 12 months after symptom onset among hospital survivors with COVID-19.Methods: We undertook an ambidirectional cohort study of COVID-19 survivors who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7 and May 29, 2020. At 6-month and 12-month follow-up visit, survivors were interviewed with questionnaires on symptoms and health-related quality of life (HRQoL), and received a physical examination, a 6-min walking test, and laboratory tests. They were required to report their health-care use after discharge and work status at the 12-month visit. Survivors who had completed pulmonary function tests or had lung radiographic abnormality at 6 months were given the corresponding tests at 12 months. Non-COVID-19 participants (controls) matched for age, sex, and comorbidities were interviewed and completed questionnaires to assess prevalent symptoms and HRQoL. The primary outcomes were symptoms, modified British Medical Research Council (mMRC) score, HRQoL, and distance walked in 6 min (6MWD). Multivariable adjusted logistic regression models were used to evaluate the risk factors of 12-month outcomes.Findings: 1276 COVID-19 survivors completed both visits. The median age of patients was 59·0 years (IQR 49·0-67·0) and 681 (53%) were men. The median follow-up time was 185·0 days (IQR 175·0-198·0) for the 6-month visit and 349·0 days (337·0-361·0) for the 12-month visit after symptom onset. The proportion of patients with at least one sequelae symptom decreased from 68% (831/1227) at 6 months to 49% (620/1272) at 12 months (p<0·0001). The proportion of patients with dyspnoea, characterised by mMRC score of 1 or more, slightly increased from 26% (313/1185) at 6-month visit to 30% (380/1271) at 12-month visit (p=0·014). Additionally, more patients had anxiety or depression at 12-month visit (26% [331/1271] at 12-month visit vs 23% [274/1187] at 6-month visit; p=0·015). No significant difference on 6MWD was observed between 6 months and 12 months. 88% (422/479) of patients who were employed before COVID-19 had returned to their original work at 12 months. Compared with men, women had an odds ratio of 1·43 (95% CI 1·04-1·96) for fatigue or muscle weakness, 2·00 (1·48-2·69) for anxiety or depression, and 2·97 (1·50-5·88) for diffusion impairment. Matched COVID-19 survivors at 12 months had more problems with mobility, pain or discomfort, and anxiety or depression, and had more prevalent symptoms than did controls.Interpretation: Most COVID-19 survivors had a good physical and functional recovery during 1-year follow-up, and had returned to their original work and life. The health status in our cohort of COVID-19 survivors at 12 months was still lower than that in the control population.Funding: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, the National Natural Science Foundation of China, the National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, the China Evergrande Group, Jack Ma Foundation, Sino Biopharmaceutical, Ping An Insurance (Group), and New Sunshine Charity Foundation. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the prevalence of cardiac injury and its association with mortality in hospitalized patients infected with avian influenza A (H7N9) virus.Design: Retrospective cohort study.Setting: A total of 133 hospitals in 17 provinces, autonomous regions, and municipalities of mainland China that admitted influenza A (H7N9) virus-infected patients between January 22, 2015, and June 16, 2017.Patients: A total of 321 patients with influenza A (H7N9) virus infection were included in the final analysis.Interventions: None.Measurements and Main Results: Demographics and clinical characteristics were collected from medical records. Cardiac injury was defined according to cardiac biomarkers, electrocardiography, or echocardiography. Among the 321 patients, 203 (63.2%) showed evidence of cardiac injury. Compared with the uninjured group, the cardiac injury group had lower PaO2/FIO2 (median, 102.0 vs 148.4 mm Hg; p < 0.001), higher Acute Physiology and Chronic Health Evaluation II score (median, 17.0 vs 11.0; p < 0.001), longer stay in the ICU (10.0 vs 9.0 d; p = 0.029), and higher proportion of in-hospital death (64.0% vs 20.3%; p < 0.001). The proportion of virus clearance until discharge or death was lower in the cardiac injury group than in the uninjured group (58.6% vs 86.4%; p < 0.001). Multivariable-adjusted Cox proportional hazards regression analysis showed that cardiac injury was associated with higher mortality (hazards ratio, 2.06; 95% CI, 1.31-3.24) during hospitalization.Conclusions: Cardiac injury is a frequent condition among hospitalized patients infected with influenza A (H7N9) virus, and it is associated with higher risk of mortality. [ABSTRACT FROM AUTHOR]

The long-term health consequences of COVID-19 remain largely unclear. The aim of this study was to describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity. We did an ambidirectional cohort study of patients with confirmed COVID-19 who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7 and May 29, 2020. Patients who died before follow-up; patients for whom follow-up would be difficult because of psychotic disorders, dementia, or readmission to hospital; those who were unable to move freely due to concomitant osteoarthropathy or immobile before or after discharge due to diseases such as stroke or pulmonary embolism; those who declined to participate; those who could not be contacted; and those living outside of Wuhan or in nursing or welfare homes were all excluded. All patients were interviewed with a series of questionnaires for evaluation of symptoms and health-related quality of life, underwent physical examinations and a 6-min walking test, and received blood tests. A stratified sampling procedure was used to sample patients according to their highest seven-category scale during their hospital stay as 3, 4, and 5–6, to receive pulmonary function test, high resolution CT of the chest, and ultrasonography. Enrolled patients who had participated in the Lopinavir Trial for Suppression of SARS-CoV-2 in China received SARS-CoV-2 antibody tests. Multivariable adjusted linear or logistic regression models were used to evaluate the association between disease severity and long-term health consequences. In total, 1733 of 2469 discharged patients with COVID-19 were enrolled after 736 were excluded. Patients had a median age of 57·0 years (IQR 47·0–65·0) and 897 (52%) were male and 836 (48%) were female. The follow-up study was done from June 16 to Sept 3, 2020, and the median follow-up time after symptom onset was 186·0 days (175·0–199·0). Fatigue or muscle weakness (52%, 855 of 1654) and sleep difficulties (26%, 437 of 1655) were the most common symptoms. Anxiety or depression was reported among 23% (367 of 1616) of patients. The proportions of 6-min walking distance less than the lower limit of the normal range were 17% for those at severity scale 3, 13% for severity scale 4, and 28% for severity scale 5–6. The corresponding proportions of patients with diffusion impairment were 22% for severity scale 3, 29% for scale 4, and 56% for scale 5–6, and median CT scores were 3·0 (IQR 2·0–5·0) for severity scale 3, 4·0 (3·0–5·0) for scale 4, and 5·0 (4·0–6·0) for scale 5–6. After multivariable adjustment, patients showed an odds ratio (OR) of 1·61 (95% CI 0·80–3·25) for scale 4 versus scale 3 and 4·60 (1·85–11·48) for scale 5–6 versus scale 3 for diffusion impairment; OR 0·88 (0·66–1·17) for scale 4 versus scale 3 and OR 1·76 (1·05–2·96) for scale 5–6 versus scale 3 for anxiety or depression, and OR 0·87 (0·68–1·11) for scale 4 versus scale 3 and 2·75 (1·61–4·69) for scale 5–6 versus scale 3 for fatigue or muscle weakness. Of 94 patients with blood antibodies tested at follow-up, the seropositivity (96·2% vs 58·5%) and median titres (19·0 vs 10·0) of the neutralising antibodies were significantly lower compared with at the acute phase. 107 of 822 participants without acute kidney injury and with an estimated glomerular filtration rate (eGFR) of 90 mL/min per 1·73 m2 or more at acute phase had eGFR less than 90 mL/min per 1·73 m2 at follow-up. At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery. National Natural Science Foundation of China, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, and Peking Union Medical College Foundation. [ABSTRACT FROM AUTHOR]

The research of text sentiment analysis based on deep learning is increasingly rich, but the current models still have different degrees of deviation in understanding of semantic information. In order to reduce the loss of semantic information and improve the prediction accuracy as much as possible, the paper creatively combines the doc2vec model with the deep learning model and attention mechanism and proposes a new hybrid sentiment analysis model based on the doc2vec + CNN + BiLSTM + Attention. The new hybrid model effectively exploits the structural features of each part. In the model, the understanding of the overall semantic information of the sentence is enhanced through the paragraph vector pretrained by the doc2vec structure which can effectively reduce the loss of semantic information. The local features of the text are extracted through the CNN structure. The context information interaction is completed through the bidirectional cycle structure of the BiLSTM. The performance is improved by allocating weight and resources to the text information of different importance through the attention mechanism. The new model was built based on Keras framework, and performance comparison experiments and analysis were performed on the IMDB dataset and the DailyDialog dataset. The results have shown that the accuracy of the new model on the two datasets is 91.3% and 93.3%, respectively, and the loss rate is 22.1% and 19.9%, respectively. The accuracy on the IMDB datasets is 1.0% and 0.5% higher than that of the CNN-BiLSTM-Attention model and ATT-MCNN-BGRUM model in the references. Comprehensive comparison has shown the overall performance is improved, and the new model is effective. [ABSTRACT FROM AUTHOR]

At present, establishing a multidimensional characteristic model of a boiler combustion system plays an important role in realizing its dynamic optimization and real-time control, so as to achieve the purpose of reducing environmental pollution and saving coal resources. However, the complexity of the boiler combustion process makes it difficult to model it using traditional mathematical methods. In this paper, a kind of hyper-parameter self-optimized broad learning system by a sparrow search algorithm is proposed to model the NOx, SO2 emissions concentration and thermal efficiency of a circulation fluidized bed boiler (CFBB). A broad learning system (BLS) is a novel neural network algorithm, which shows good performance in multidimensional feature learning. However, the BLS has several hyper-parameters to be set in a wide range, so that the optimal combination between hyper-parameters is difficult to determine. This paper uses a sparrow search algorithm (SSA) to select the optimal hyper-parameters combination of the broad learning system, namely as SSA-BLS. To verify the effectiveness of SSA-BLS, ten benchmark regression datasets are applied. Experimental results show that SSA-BLS obtains good regression accuracy and model stability. Additionally, the proposed SSA-BLS is applied to model the combustion process parameters of a 330 MW circulating fluidized bed boiler. Experimental results reveal that SSA-BLS can establish the accurate prediction models for thermal efficiency, NOx emission concentration and SO2 emission concentration, separately. Altogether, SSA-BLS is an effective modelling method. [ABSTRACT FROM AUTHOR]

The accuracy of the Cobb measurement is essential for the diagnosis and treatment of scoliosis. Manual measurement is however influenced by the observer variability hence affecting progression evaluation. In this paper, we propose a fully automatic Cobb measurement method to address the accuracy issue of manual measurement. We improve the U-shaped network based on the multi-scale feature fusion to segment each vertebra. To enable multi-scale feature extraction, the convolution kernel of the U-shaped network is substituted by the Inception Block. To solve the problem of gradient disappearance caused by the widening of the network structure from the Inception Block, we propose using Res Block. CBAM (Convolutional Block Attention Module) can help the network judges the importance of the feature map to modify learning weight. Also, to further enhance the accuracy of feature extraction, we add the CBAM to the U-shaped network bottleneck. Finally, based on the segmented vertebrae, the efficient automatic Cobb angle measurement method is proposed to estimate the Cobb angle. In the experiments, 75 spinal X-ray images are tested. We compare the proposed U-Shaped network with the state-of-the-art methods including DeepLabV3 + , FCN8S, SegNet, U-Net, U-Net +  + , BASNet, and U2Net for vertebra segmentation. Our results show that compared to these methods, the Dice coefficient is improved by 32.03%, 33.58%, 12.42%, 5.65%, 4.55%, 4.42%, and 3.27%, respectively. The CMAE of the calculated Cobb measurement is 2.45°, which is lower than the average error of 5-7° of manual measurement. The experimental results indicate that the improved U-shaped network improves the accuracy of vertebra segmentation. The proposed efficient automatic Cobb measurement method can be used in clinics to reduce observer variability. [ABSTRACT FROM AUTHOR]

Background Detailed characteristics of rheumatic symptoms of coronavirus disease 2019 (COVID-19) were still unknown. We aim to investigate the proportions, characteristics, and risk factors of this condition. Methods In this prospective, longitudinal cohort study, discharged patients with COVID-19 were interviewed face-to-face at 12 months after symptom onset. Rheumatic symptoms following COVID-19 included newly occurring joint pain and/or joint swelling. The risk factors of developing rheumatic symptoms were identified by multivariable logistic regression analysis. Results In total, 1296 of 2469 discharged patients with COVID-19 were enrolled in this study. Among them, 160 (12.3% [95% confidence interval {CI}, 10.6%–14.3%]) suffered from rheumatic symptoms following COVID-19 at 12-month follow-up. The most frequently involved joints were the knee joints (38%), followed by hand (25%) and shoulder (19%). Rheumatic symptoms were independent of the severity of illness and corticosteroid treatment during the acute phase, while elderly age (odds ratio [OR], 1.22 [95% CI, 1.06–1.40]) and female sex (OR, 1.58 [95% CI, 1.12–2.23]) were identified as the risk factors for this condition. Conclusions Our investigation showed a considerable proportion of rheumatic symptoms following COVID-19 in discharged patients, which highlights the need for continuing attention. Notably, rheumatic symptoms following COVID-19 were independent of the severity of illness and corticosteroid treatment during the acute phase. [ABSTRACT FROM AUTHOR]

Antler growth depends on the proliferation and differentiation of mesenchymal stem cells (MSCs), and this process may be adversely affected by oxidative stress. Melatonin (MLT) has antioxidant functions, but its role in Cervidae remains largely unknown. In this article, flow cytometry, reactive oxygen species (ROS) identification, qPCR, and other methods were used to investigate the protective mechanism of MLT in H2O2-induced oxidative stress of antler MSCs. The results showed that MLT significantly increases cell viability by relieving the oxidative stress of antler MSCs. MLT inhibits cell apoptosis by protecting mitochondrial function. We blocked the melatonin receptor with luzindole (Luz) and found that the receptor blockade significantly increases H2O2-induced hyperoxide levels and causes significant inhibition of mitochondrial function. MLT treatment activates the nuclear factor E2-related factor 2 (Nrf2) antioxidant signaling pathway, up-regulates the expression of NAD(P)H quinone oxidoreductase 1 (NQO1) and other genes and it could inhibit apoptosis. In contrast, the melatonin receptor blockade down-regulates the expression of Nrf2 pathway-related genes, but significantly up-regulates the expression of apoptotic genes. It was indicated that MLT activates the Nrf2 pathway through the melatonin receptor and alleviates H2O2-induced oxidative stress and apoptosis in antler MSCs. This study provides a theoretical basis for further studying the oxidative stress and antioxidant process of antler MSCs and, thereby, increasing antler yields. [ABSTRACT FROM AUTHOR]

• Long-term exposure to PM 2.5 are associated with large- and small- airway function. • Organic matter and nitrate show stronger associations with lung function than PM 2.5. • Exposure to PM 2.5 constituents might be more important in impairing lung function. The associations of long-term exposure to various constituents of fine particulate matter (≤2.5 μm in aerodynamic diameter, PM 2.5) air pollution with lung function were not clearly elucidated in developing countries. The aim was to evaluate the associations of long-term exposure to main constituents of PM 2.5 with lung function in China. This is a nationwide, cross-sectional analysis among 50,991 study participants from the China Pulmonary Health study. Multivariable linear regression models were used to obtain differences of forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC), FEV 1 /FVC, peak expiratory flow (PEF), and forced expiratory flow at 25–75% of exhaled FVC (FEF 25-75%) associated with an interquartile range (IQR) change of PM 2.5 or its constituents. Residential annual PM 2.5 levels varied from 26 μg/m3 to 92 μg/m3 (average: 53 μg/m3). An IQR increase of PM 2.5 concentrations was associated with lower FEV 1 (19.82 mL, 95% CI: 11.30–28.33), FVC (17.45 mL, 95% CI: 7.16–27.74), PEF (86.64 mL/s, 95% CI: 59.77–113.52), and FEF 25-75% (31.93 mL/s, 95% CI: 16.64–47.22). Black carbon, organic matter, ammonium, sulfate, and nitrate were negatively associated with most lung function indicators, with organic matter and nitrate showing consistently larger magnitude of associations than PM 2.5 mass. This large-scale study provides first-hand epidemiological evidence that long-term exposure to ambient PM 2.5 and some constituents, especially organic matter and nitrate, were associated with lower large- and small- airway function. [ABSTRACT FROM AUTHOR]

Objective: Coronavirus disease 2019 (COVID‐19) has caused hundreds of thousands of infections and deaths. Efficient diagnostic methods could help curb its global spread. The purpose of this study was to develop and evaluate a method for accurately diagnosing COVID‐19 based on computed tomography (CT) scans in real time. Methods: We propose an architecture named "concatenated feature pyramid network" ("Concat‐FPN") with an attention mechanism, by concatenating feature maps of multiple. The proposed architecture is then used to form two networks, which we call COVID‐CT‐GAN and COVID‐CT‐DenseNet, the former for data augmentation and the latter for data classification. Results: The proposed method is evaluated on 3 different numbers of magnitude of COVID‐19 CT datasets. Compared with the method without GANs for data augmentation or the original network auxiliary classifier generative adversarial network, COVID‐CT‐GAN increases the accuracy by 2% to 3%, the recall by 2% to 4%, the precision by 1% to 3%, the F1‐score by 1% to 3%, and the area under the curve by 1% to 4%. Compared with the original network DenseNet‐201, COVID‐CT‐DenseNet increases the accuracy by 1% to 3%, the recall by 4% to 9%, the precision by 1%, the F1‐score by 1% to 3%, and the area under the curve by 2%. Conclusion: The experimental results show that our method improves the efficiency of diagnosing COVID‐19 on CT images, and helps overcome the problem of limited training data when using deep learning methods to diagnose COVID‐19. Significance: Our method can help clinicians build deep learning models using their private datasets to achieve automatic diagnosis of COVID‐19 with a high precision. [ABSTRACT FROM AUTHOR]

Herein, we proposed a new strategy to enhance compatibility and flame retardancy of the immiscible and flammable polylactic acid (PLLA)/polypropylene (PP) blend materials simultaneously. It is found that the boehmite nanorods are located at the PLLA-PP interface by in-situ reactions and the compatibility between phases is greatly improved, resulting in significant enhancement of mechanical properties and flame retardancy: tensile strength and elongation at break of the blends with 7 wt% reactive nanorods are 163% and 601% higher than that without nanorods, respectively. Meanwhile, the peak heat release rate (PHRR) decreases 51.4% and limiting oxygen index (LOI) increases 22.6%. The synergetic improvements are directly attributed to the strengthened interface and the interface takes the role of the flame retarding belt. The research opens a new avenue to fabricate non-halogen flame retardant multicomponent polymer materials with simultaneously enhanced mechanical properties. [Display omitted] •Ternary Poly(L-lactic acid)/Polypropylene/boehmite nanorods nanocomposites were prepared. •Epoxide groups modified boehmite nanorods are thermodynamically located at the PLLA/PP blend interface by the in-situ reactions. •The interfacially located nanorods improve the mechanical properties and flame retardancy of the PLLA/PP blends simultaneously. [ABSTRACT FROM AUTHOR]

There have been arguments on whether angiotensin-converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) treatment alters the risk of coronavirus disease 2019 (COVID-19) susceptibility and disease severity. We identified a total of 102 eligible studies for systematic review, in which 49 studies adjusting for confounders were included in the meta-analysis. We found no association between prior ACEI/ARB use and risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the general population (adjusted odds ratio [aOR], 1.00; 95% confidence interval [CI],.94–1.05). The risk of mortality (aOR,.87; 95% CI,.66–1.04) and severe outcomes (aOR,.95; 95% CI,.73–1.24) were also unchanged among COVID-19 patients taking ACEIs/ARBs. These findings remained consistent in subgroup analyses stratified by populations, drug exposures, and other secondary outcomes. This systematic review provides evidence-based support to current medical guidelines and position statements that ACEIs/ARBs should not be discontinued. Additionally, there has been no evidence for initiating ACEI/ARB regimen as prevention or treatment of COVID-19. [ABSTRACT FROM AUTHOR]

Background The characteristics of neutralizing antibodies (NAbs) and antibody against major antigen proteins related to clinical outcomes in severe coronavirus disease 2019 (COVID-19) patients were still less known. Methods NAbs and antibodies targeting nucleocapsid (N), spike protein (S), and the receptor-binding domain (RBD) in longitudinal plasma samples from the LOTUS China trial were measured by microneutralization assay and enzyme-linked immunosorbent assay (ELISA). Viral load was determined by real-time reverse transcription polymerase chain reaction (RT-PCR). A total of 576 plasma and 576 throat swabs were collected from 191 COVID-19 patients. Antibody titers related to adverse outcome and clinical improvement were analyzed. Multivariable adjusted generalized linear mixed model for random effects were developed. Results After day 28 post symptoms onset, the rate of antibody positivity reached 100% for RBD-immunoglobulin M (IgM), 97.8% for S-IgM, 100% for N-immunoglobulin G (IgG), 100% for RBD-IgG, 91.1% for N-IgM, and 91.1% for NAbs. The NAbs titers increased over time in both survivors and nonsurvivors and correlated to IgG antibodies against N, S, and RBD, whereas its presence showed no statistical correlation with death. N-IgG (slope −2.11, 95% confidence interval [CI] −3.04 to −1.18, P <.0001), S-IgG (slope −2.44, 95% CI −3.35 to −1.54, P <.0001), and RBD-IgG (slope −1.43, 95% CI −1.98 to −.88, P <.0001) were negatively correlated with viral load. S-IgG titers were lower in nonsurvivors than survivors (P =.020) at week 4 after symptoms onset. Conclusions IgM and IgG against N, S, and RBD and NAbs developed in most severe COVID-19 patients and do not correlate clearly with clinical outcomes. The levels of IgG antibodies against N, S, and RBD were related to viral clearance. [ABSTRACT FROM AUTHOR]

At present, anti-angiogenic drugs (AADs) are widely used in the systemic treatment of hepatocellular carcinoma (HCC) or other types of cancer, and have achieved good anti-cancer effect, whereas treatment-related proteinuria can affect the routine use of AADs, which in turn abates the overall efficacy. Currently, most clinicians prescribe angiotensin-converting enzyme inhibitors (ACEIs) to alleviate proteinuria according to diabetic nephropathy guidelines or expert recommendations. However, the efficacy of ACEIs in reducing AAD-related proteinuria and its effect on the anticancer effect of AADs is unknown. Our clinical data showed that some HCC patients experienced tumor progression by ACEIs administration for the treatment of proteinuria caused by AADs. Here, we confirmed that in different tumor-bearing mouse models, ACEIs did not delay the appearance of proteinuria or alleviate proteinuria caused by AADs but compromised the anticancer efficacy of AADs. This effect is unrelated to the change in the VEGF signaling pathway. Our data showed that the combination of ACEIs and AADs flared the production of kidney-derived erythropoietin (EPO). In turn, EPO compromises the anti-angiogenic effects of AADs and decreases antitumor activity. In conclusion, for the treatment of proteinuria caused by AADs, ACEIs have no efficacy while also promoting AADs resistance. This finding is of great significance to guide clinical standardized management of side effects of anti-angiogenic therapy for cancer patients. • ACEIs cannot reduce or delay proteinuria caused by AADs. • ACEIs alone do not promote tumor growth of liver cancer subcutaneous tumor. • High doses of AADs easily induce stable proteinuria, but the anticancer effect is better. • Proteinuria caused by AADs is reversible after withdrawal. • ACEIs promotes the production of kidney-derived EPO and reduces the anticancer efficacy of AADs. [ABSTRACT FROM AUTHOR]

• PCSK9 inhibition ameliorated cardiac inflammation of EAM mice by reducing Th17 cell differentiation. • PCSK9 was expressed by CD4+ T cells, CD8+ T cells, macrophages, and cardiomyocytes in the heart of experimental autoimmune myocarditis (EAM) mice. • PCSK9 promoted Th17 cell differentiation through LDLR/STAT3/ROR-γt pathway. • PCSK9 is a promising target in myocarditis, and inhibition of PCSK9 may provide new therapeutic strategies for patients with myocarditis. Proprotein convertase subtilisin kexin type 9 (PCSK9) was characterized as a protein regulating circulating cholesterol metabolism; however, recent studies demonstrated a role for PCSK9 in inflammatory and autoimmune diseases unrelated to cholesterol alterations. The implication of PCSK9 in myocarditis is unclear and we aim at investigating the roles and mechanisms of PCSK9 in myocarditis. Male BALB/c mice received subcutaneous immunization with MyHC-α peptide on days 0 and 7 to establish the experimental autoimmune myocarditis (EAM) model. PCSK9 inhibitor, evolocumab, was administered subcutaneously once a week starting on day 0 and all mice were euthanized on day 21. Our results showed that PCSK9 inhibition ameliorated the cardiac inflammation of EAM mice. PCSK9 inhibition reduced both the levels of cardiac and peripheral blood PCSK9. We found that CD4+ T cells, CD8+ T cells, macrophages, and cardiomyocytes in the heart of EAM mice could express PCSK9. PCSK9 inhibition decreased the differentiation of cardiac Th17 cells by lowering ROR-γt levels but had no effects on Th1, Th2, and Treg cell differentiation. In vitro experiments of CD4+ T cells, we found that PCSK9 directly promoted Th17 cell differentiation through LDLR/STAT3/ROR-γt pathway. Collectively, we demonstrated that PCSK9 inhibition ameliorated the severity of EAM mice by reducing Th17 cell differentiation. PCSK9 is a promising target for treating myocarditis. [ABSTRACT FROM AUTHOR]

Reactive polymer processing is an effective and environmentally-friendly means of preparing new materials based on combining components with various properties. Numerous investigations have been carried out to explore the reaction processes that occur during the melt blending of polymers. However, reactive processing is far from fully understood because it involves a complicated combination of shear and extensional flows as well as high temperatures and pressures. In this work, a two-step compatibilizing strategy (called reactive splicing compatibilization) has been used to compatibilize immiscible Poly(lactic acid) (PLLA)/Poly(butylene adipate- co -terephthalate) (PBAT) blends with two different PBAT molecular weights (termed H-PBAT and L-PBAT, respectively), using styrene- co -glycidyl methacrylate (SG) as the grafting counterpart. Reactive compatibilizers with various architectures were prepared by pre-grafting either PLLA or PBAT (or both) onto the SG main chains. The remaining unreacted epoxide groups of the pregrafted SG underwent in situ reactions to form double grafted copolymers as compatibilizers for the final blends. The reactivity of SG with these polymers was found to decrease in the order of L-PBAT > PLLA > H-PBAT. Reactive compatibilizers having various architectures were applied to PLLA/PBAT blends with compositions ranging from 90/10 to 10/90 (w/w). The most efficient pre-grafted reactive compatibilizer was determined for the blends with certain composition. A higher proportion of H-PBAT had to be pre-grafted onto the SG to achieve the best compatibilization efficiency when increasing the PLLA content in PLLA/H-PBAT blends. In the case of PLLA/L-PBAT blends, PLLA chains had to be pre-grafted onto the SG for the best compatibilization when L-PBAT was the primary component of the blend. These results provide a better understanding of the reactive processing mechanism. Evidently, the dynamic shear applied during melt processing continuously renews the interface between the different phases to provide sites for reactions between the blend components. These reactions are affected by both the reactivity of the components and the contact time, which in turn is determined by the blend composition. The compatibilizers located at the blend interface were found to have very similar symmetrical binary grafted structures for blends with different compositions. Image 1 • A two-step compatibilizing strategy (called reactive splicing compatibilization) has been used to compatibilize the immiscible Poly(lactic acid) (PLLA)/Poly(butylene adipate- co -terephthalate) (PBAT) blends with two different PBAT molecular weights, using styrene-co-glycidyl methacrylate (SG) as the grafting counterpart. • More than 100 compatibilized blends have been prepared and compared the compatibilization effects of the different compatibilizers. • This work demonstrates the locations of the various reactions and the factors affecting the reactive processing. • The work is very important for better understanding the reactive processing, especially the functions of the dynamic shearing, the reactivity and the composition effects. [ABSTRACT FROM AUTHOR]

Background: The long-term health consequences of COVID-19 remain largely unclear. The aim of this study was to describe the long-term health consequences of patients with COVID-19 who have been discharged from hospital and investigate the associated risk factors, in particular disease severity.Methods: We did an ambidirectional cohort study of patients with confirmed COVID-19 who had been discharged from Jin Yin-tan Hospital (Wuhan, China) between Jan 7, 2020, and May 29, 2020. Patients who died before follow-up, patients for whom follow-up would be difficult because of psychotic disorders, dementia, or re-admission to hospital, those who were unable to move freely due to concomitant osteoarthropathy or immobile before or after discharge due to diseases such as stroke or pulmonary embolism, those who declined to participate, those who could not be contacted, and those living outside of Wuhan or in nursing or welfare homes were all excluded. All patients were interviewed with a series of questionnaires for evaluation of symptoms and health-related quality of life, underwent physical examinations and a 6-min walking test, and received blood tests. A stratified sampling procedure was used to sample patients according to their highest seven-category scale during their hospital stay as 3, 4, and 5-6, to receive pulmonary function test, high resolution CT of the chest, and ultrasonography. Enrolled patients who had participated in the Lopinavir Trial for Suppression of SARS-CoV-2 in China received severe acute respiratory syndrome coronavirus 2 antibody tests. Multivariable adjusted linear or logistic regression models were used to evaluate the association between disease severity and long-term health consequences.Findings: In total, 1733 of 2469 discharged patients with COVID-19 were enrolled after 736 were excluded. Patients had a median age of 57·0 (IQR 47·0-65·0) years and 897 (52%) were men. The follow-up study was done from June 16, to Sept 3, 2020, and the median follow-up time after symptom onset was 186·0 (175·0-199·0) days. Fatigue or muscle weakness (63%, 1038 of 1655) and sleep difficulties (26%, 437 of 1655) were the most common symptoms. Anxiety or depression was reported among 23% (367 of 1617) of patients. The proportions of median 6-min walking distance less than the lower limit of the normal range were 24% for those at severity scale 3, 22% for severity scale 4, and 29% for severity scale 5-6. The corresponding proportions of patients with diffusion impairment were 22% for severity scale 3, 29% for scale 4, and 56% for scale 5-6, and median CT scores were 3·0 (IQR 2·0-5·0) for severity scale 3, 4·0 (3·0-5·0) for scale 4, and 5·0 (4·0-6·0) for scale 5-6. After multivariable adjustment, patients showed an odds ratio (OR) 1·61 (95% CI 0·80-3·25) for scale 4 versus scale 3 and 4·60 (1·85-11·48) for scale 5-6 versus scale 3 for diffusion impairment; OR 0·88 (0·66-1·17) for scale 4 versus scale 3 and OR 1·77 (1·05-2·97) for scale 5-6 versus scale 3 for anxiety or depression, and OR 0·74 (0·58-0·96) for scale 4 versus scale 3 and 2·69 (1·46-4·96) for scale 5-6 versus scale 3 for fatigue or muscle weakness. Of 94 patients with blood antibodies tested at follow-up, the seropositivity (96·2% vs 58·5%) and median titres (19·0 vs 10·0) of the neutralising antibodies were significantly lower compared with at the acute phase. 107 of 822 participants without acute kidney injury and with estimated glomerular filtration rate (eGFR) 90 mL/min per 1·73 m2 or more at acute phase had eGFR less than 90 mL/min per 1·73 m2 at follow-up.Interpretation: At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression. Patients who were more severely ill during their hospital stay had more severe impaired pulmonary diffusion capacities and abnormal chest imaging manifestations, and are the main target population for intervention of long-term recovery.Funding: National Natural Science Foundation of China, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, National Key Research and Development Program of China, Major Projects of National Science and Technology on New Drug Creation and Development of Pulmonary Tuberculosis, and Peking Union Medical College Foundation. [ABSTRACT FROM AUTHOR]

Use of corticosteroids is common in the treatment of coronavirus disease 2019, but clinical effectiveness is controversial. We aimed to investigate the association of corticosteroids therapy with clinical outcomes of hospitalized COVID-19 patients. In this single-centre, retrospective cohort study, adult patients with confirmed coronavirus disease 2019 and dead or discharged between 29 December 2019 and 15 February 2020 were studied; 1:1 propensity score matchings were performed between patients with or without corticosteroid treatment. A multivariable COX proportional hazards model was used to estimate the association between corticosteroid treatment and in-hospital mortality by taking corticosteroids as a time-varying covariate. Among 646 patients, the in-hospital death rate was higher in 158 patients with corticosteroid administration (72/158, 45.6% vs. 56/488, 11.5%, p < 0.0001). After propensity score matching analysis, no significant differences were observed in in-hospital death between patients with and without corticosteroid treatment (47/124, 37.9% vs. 47/124, 37.9%, p 1.000). When patients received corticosteroids before they required nasal high-flow oxygen therapy or mechanical ventilation, the in-hospital death rate was lower than that in patients who were not administered corticosteroids (17/86, 19.8% vs. 26/86, 30.2%, log rank p 0.0102), whereas the time from admission to clinical improvement was longer (13 (IQR 10–17) days vs. 10 (IQR 8–13) days; p < 0.001). Using the Cox proportional hazards regression model accounting for time varying exposures in matched pairs, corticosteroid therapy was not associated with mortality difference (HR 0.98, 95% CI 0.93–1.03, p 0.4694). Corticosteroids use in COVID-19 patients may not be associated with in-hospital mortality. [ABSTRACT FROM AUTHOR]

At present, anti-angiogenic drugs (AADs) are widely used in the systemic treatment of hepatocellular carcinoma (HCC) or other types of cancer, and have achieved good anti-cancer effect, whereas treatment-related proteinuria can affect the routine use of AADs, which in turn abates the overall efficacy. Currently, most clinicians prescribe angiotensin-converting enzyme inhibitors (ACEIs) to alleviate proteinuria according to diabetic nephropathy guidelines or expert recommendations. However, the efficacy of ACEIs in reducing AAD-related proteinuria and its effect on the anticancer effect of AADs is unknown. Our clinical data showed that some HCC patients experienced tumor progression by ACEIs administration for the treatment of proteinuria caused by AADs. Here, we confirmed that in different tumor-bearing mouse models, ACEIs did not delay the appearance of proteinuria or alleviate proteinuria caused by AADs but compromised the anticancer efficacy of AADs. This effect is unrelated to the change in the VEGF signaling pathway. Our data showed that the combination of ACEIs and AADs flared the production of kidney-derived erythropoietin (EPO). In turn, EPO compromises the anti-angiogenic effects of AADs and decreases antitumor activity. In conclusion, for the treatment of proteinuria caused by AADs, ACEIs have no efficacy while also promoting AADs resistance. This finding is of great significance to guide clinical standardized management of side effects of anti-angiogenic therapy for cancer patients. [ABSTRACT FROM AUTHOR]

Polymer blend nanocomposites with the nanoparticles exclusively located at the interface have attracted significant attention while the compatibilization functions of such nanoparticles in the blends are still controversial. Herein, the pristine boehmite nanorods (p-BNRs) and epoxide group modified boehmite nanorods (m-BNRs) have been synthesized and incorporated in the immiscible Poly(l -lactide)/Poly(1,4-butylene succinate) (PLLA/PBSU) blends. It is found that both p-BNRs and m-BNRs are thermodynamically located at the interface and the phase morphologies of the two nanocomposites are very similar at the same nanofiller loadings. However, the two nanocomposites exhibit different mechanical properties. The PLLA/PBSU blend nanocomposites with m-BNRs show increased elongation at break, enhanced notched impact strength and improved yield strength, as compared with the binary PLLA/PBSU blends. In contrast, p-BNRs lead to drastically deteriorating mechanical properties of the PLLA/PBSU blends even with all p-BNRs located at the interface. The investigation indicates that p-BNRs at the interface have barren surface and are lack of specific interactions with the polymers in the neighboring phases. In contrast, the epoxide groups on m-BNRs reacted with the end carboxylic acid groups of both PLLA and PBSU and the polymer chains were chemically bonded onto the surface of nanorods. The chemically bonded polymer chains on the nanorods at the interface can entangle with the molecular chains of the two polymers to enhance the interfacial adhesion. This paper demonstrates the significance of molecular chain entanglements of the compatibilizing nanoparticles and paves a new possibility to fabricate new materials with simultaneously enhanced strength and toughness. Image 1 • Ternary Poly(l -lactide)/Poly(1,4-butylene succinate)/boehmite nanorods nanocomposites were prepared. • Both pristine boehmite nanorods and epoxide groups modified boehmite nanorods are thermodynamically located at the interface of PLLA/PBSU. • Barren nanorods deteriorate the mechanical properties of PLLA/PBSU blends, but surface grafted nanorods enhance the mechanical properties drastically. • Molecular entanglements of the grafted nanorods are the prerequisite for the compatibilization of immiscible polymer blends. [ABSTRACT FROM AUTHOR]

Background: The European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria are widely used in the diagnosis of invasive pulmonary aspergillosis (IPA), but they only apply to immunocompromised patients. We here aimed to identify clinical characteristics helpful to the diagnosis of IPA in non-immunocompromised patients.Methods: This is a multicenter retrospective study. Data were collected from adult patients with IPA admitted to 15 tertiary hospitals in China from 2010 to 2016.Results: We included 254 patients in the study, of whom 66 (26.0%) were immunocompromised, and 188 (74.0%) were not. Airway-invasion-associated computed tomography (CT) signs including patchy exudation along the airway (67.6% vs. 45.5%, P = 0.001) and thickened airway wall (42.0% vs. 16.7%, P < 0.001) were more common in non-immunocompromised patients than in immunocompromised ones, and angio-invasive CT signs were more common in immunocompromised patients (55.3% vs.72.7%, P = 0.013). Typical angio-invasive CT signs were delayed in non-immunocompromised IPA patients, whereas airway-invasive signs appear earlier. Host immunocompromised condition was associated with ICU admission and/or intubation (OR 1.095; 95% CI 1.461-6.122; P = 0.003). Poor prognosis (35.5% vs. 21.1%, P = 0.005) was more common in immunocompromised patients.Conclusion: Airway-invasion-associated CT presentations at early stages of the disease are characteristic of IPA in non-immunocompromised hosts. [ABSTRACT FROM AUTHOR]

Background: Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described.Methods: In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death.Findings: 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03-1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61-12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64-128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0-24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days.Interpretation: The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.Funding: Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development. [ABSTRACT FROM AUTHOR]

Background: A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients.Methods: All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not.Findings: By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0-58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0-13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα.Interpretation: The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies.Funding: Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease (CKD) is a major public health challenge given its high global prevalence and associated risks of cardiovascular disease and progression to end stage renal disease. Although it is known that numerous metabolic changes occur in CKD patients, identifying novel metabolite associations with kidney function may enhance our understanding of the physiologic pathways relating to CKD. Objectives: The objective of this study was to elucidate novel metabolite associations with kidney function among participants of two community-based cohorts with carefully ascertained metabolomics, kidney function, and covariate data. Methods: Untargeted ultrahigh-performance liquid chromatography–tandem mass spectrometry was used to detect and quantify blood metabolites. We used multivariate adjusted linear regression to examine associations between single metabolites and creatinine-based estimated glomerular filtration rate (eGFRcr) among 1243 Bogalusa Heart Study (BHS) participants (median eGFRcr: 94.4, 5th–95th percentile: 66.0–119.6 mL/min/1.73 m2). Replication, determined by statistical significance and consistent effect direction, was tested using gold standard measured glomerular filtration rate (mGFR) among 260 Multi-Ethnic Study of Atherosclerosis (MESA) participants (median mGFR: 72.0, 5th–95th percentile: 43.5–105.0 mL/min/1.73 m2). All analyses used Bonferroni-corrected alpha thresholds. Results: Fifty-one novel metabolite associations with kidney function were identified, including 12 from previously unrelated sub-pathways: N6-carboxymethyllysine, gulonate, quinolinate, gamma-CEHC-glucuronide, retinol, methylmalonate, 3-hydroxy-3-methylglutarate, 3-aminoisobutyrate, N-methylpipecolate, hydroquinone sulfate, and glycine conjugates of C10H12O2 and C10H14O2(1). Significant metabolites were generally inversely associated with kidney function and smaller in mass-to-charge ratio than non-significant metabolites. Conclusion: The 51 novel metabolites identified may serve as early, clinically relevant, kidney function biomarkers. [ABSTRACT FROM AUTHOR]

Endometritis is the inflammatory response of the endometrial lining of the uterus and is associated with low conception rates, early embryonic mortality, and prolonged inter-calving intervals, and thus poses huge economic losses to the dairy industry worldwide. Ginsenoside Rb1 (GnRb1) is a natural compound obtained from the roots of Panax ginseng, having several pharmacological and biological properties. However, the anti-inflammatory properties of GnRb1 in lipopolysaccharide (LPS)-challenged endometritis through the TLR4-mediated NF-κB signaling pathway has not yet been researched. This study was planned to evaluate the mechanisms of how GnRb1 rescues LPS-induced endometritis. In the present research, histopathological findings revealed that GnRb1 ameliorated LPS-triggered uterine injury. The ELISA and RT-qPCR assay findings indicated that GnRb1 suppressed the expression level of pro-inflammatory molecules (TNF-α, IL-1β and IL-6) and boosted the level of anti-inflammatory (IL-10) cytokine. Furthermore, the molecular study suggested that GnRb1 attenuated TLR4-mediated NF-κB signaling. The results demonstrated the therapeutic efficacy of GnRb1 in the mouse model of LPS-triggered endometritis via the inhibition of the TLR4-associated NF-κB pathway. Taken together, this study provides a baseline for the protective effect of GnRb1 to treat endometritis in both humans and animals. [ABSTRACT FROM AUTHOR]

• Various new morphologies of CeCO 3 OH were synthesized by a facile hydrothermal route. • Ce 2 (CO 3) 3 ⋅6H 2 O was found as an intermediate product in studied synthetic process. • Decomposition behaviors of CeCO 3 OH in H 2 /Ar atmosphere are revealed. • Ceria with higher photocatalytic activity was obtained by decomposing CeCO 3 OH in H 2. The novel tactic that shape-controlled CeO 2- x with excellent photocatalytic activity by designing morphology of CeCO 3 OH and decomposing in hydrogen was proved. [Display omitted] In this work, various new-observed structured CeCO 3 OH were synthesized by a self-assembly hydrothermal method, and a novel tactic to produce CeO 2- x with excellent photocatalytic activity by decomposing CeCO 3 OH in H 2 was proposed and identified. By controlling the synthetic conditions, almond-like, subglobose shape and hollow-sphere of CeCO 3 OH, 3D-broom-like of Ce 2 O 3 · 2CO 2 · nH 2 O (n = (1–2)), and sheet-like of Ce 2 (CO 3) 3 · 6H 2 O were synthesized. The crystal growth and formation of the cerium carbonate compounds were carefully studied using XRD, SEM and TEM. TG, thermodynamic calculation and in-situ XRD were employed to reveal the decomposition behavior of almond-like CeCO 3 OH in air, Ar and H 2. The results show that the decomposition temperatures of CeCO 3 OH in Ar and H 2 are higher than that of in air, and suggest that Ce 2 O 3 has a low thermodynamic stability during the decomposition of CeCO 3 OH in Ar and H 2 , and Ce3+ will be mostly oxidized by H 2 O firstly and then by both of H 2 O and CO 2. The ceria samples obtained by decomposing from CeCO 3 OH in different atmosphere maintain indistinguishable shape and particle size. The XPS, Raman spectra and ESR results indicate that the one obtained in H 2 has the richest surface oxygen vacancies (OVs), narrowest band gap of 3.12 eV, lowest intensity in PL spectra and a significantly enhanced photodegradation ratio of methylene blue. The MB photodegradation ratio after 120 min reaction with the catalysts of CeO 2 -Air, CeO 2 -Ar and CeO 2 -H 2 is 43.14%, 54.43% and 73.41%, with a calculated reaction rate constant of 0.00539, 0.00652 and 0.01097 min-1, respectively. The offered novel tactic of decomposing CeCO 3 OH in H 2 is an efficient and facile technique for active CeO 2- x production. [ABSTRACT FROM AUTHOR]

Reactive compatibilization is an effective method to improve the compatibility of immiscible polymer blends. The in-situ-formed graft/block copolymers should be thermodynamically located at the interface to bridge the neighboring phases. Unfortunately, they are often pulled out of the interface because of the asymmetric molecular structures. Here, we propose a new strategy to compatibilize immiscible polymer blends called reactive splicing compatibilization. Poly (styrene- co -glycidyl methacrylate) (SG) with high glycidyl methacrylate (GMA) content is used as the reactive backbone chain. Both poly (l -lactic acid) (PLLA) and poly (butylene adipate-co-terephthalate) (PBAT) molecular chains can be easily grafted onto the SG main backbone by the reaction of the terminal carboxylic acid groups with the epoxide groups in the melt. Direct melt blending SG with PLLA and/or PBAT leads to reactive compatibilizers with various molecular architectures, which are used for subsequent compatibilization of PLLA/PBAT blends. It was found that the compatibilizer architecture significantly affects the compatibilization efficiency. The best compatibilization occurs with a reactive compatibilizer of SG-g-PBAT with the SG to PBAT weight ratio of 1:2. The compatibilized PLLA/PBAT (50/50 w/w) blend has precise co-continuous phase morphology with very few micelles. The blend exhibits extremely high Charpy notched impact strength of 90.2 kJ/m2 and tensile strength of 33.3 MPa. The principle of the facile splicing compatibilization strategy is highly applicable to many other immiscible blends with both components containing reactive groups. We report the splicing compatibilization strategy for immiscible polymer blends. The compatibilizer architecture effects on the compatiblization efficiency were investigated. Image 1 • New compatibilization strategy called reactive splicing compatibilization was proposed. • Reactive comb compatibilizers with various architectures were synthesized by melt blending. • Molecular architecture effects on compatibilization of PBAT/PLLA blends were investigated. • PLLA/PBAT blends with superior toughness and high tensile strength were prepared. [ABSTRACT FROM AUTHOR]