Search

China has became the world's second largest pharmaceutical market, and the number of her registered clinical trials exceeded 3000 in 2021. Although thousands of healthy volunteers are participating in a large number of clinical trials in this country, there is no report about the characteristics, recognition, attitude of Chinese healthy volunteers and their concerns of clinical trials. A questionnaire survey was designed and given to 324 healthy volunteers participating in clinical trials in Wuhan, China. Four important findings emerged from our data. First, young, single and less educated men constituted the majority of Chinese healthy volunteers. Second, differences between the male and female healthy volunteers were observed. Female healthy volunteers are supposed to face more challenges and pressure in life, be more cautious about the clinical trials and more concerned about their health and feelings than the male. Third, no sociodemographic characteristic was associated with poorly understanding of the protocol research content, which was subjectively evaluated. Fourth, more support from society/family and more positive media reports about the participation of healthy volunteers in clinical trials are badly needed. These findings would help us to get a better understanding of Chinese healthy volunteers as a group for protecting them and promoting drug development. [ABSTRACT FROM AUTHOR]

This article use an ultrasound biomicroscopy image to quantitatively assess the position of ICL haptic and found the ICL haptic-related parameters have an important influence on the clinical vault. Purpose: To assess the position of implantable collamer lens (ICL) haptic after ICL V4C implantation using standardized panoramic ultrasound bimicroscopy (UBM), to analyze its characteristics, associated factors, and the relationship with the clinical vault quantitatively. Setting: Hankou Aier Eye Hospital, Wuhan, Hubei, China. Design: Cross-sectional study. Methods: 167 subjects (323 eyes) implanted with ICL V4C who had a 3-month follow-up with UBM examination were included in this study. The relative position of ICL to the adjacent structure and ICL haptic-related parameters (the final tip point of ICL haptic [ftICL haptic], measured from the scleral spur to the final tip of the ICL haptic, the posterior of the ICL to ICL haptic [ICL arc], measured from the posterior surface of the ICL to the ICL haptic plane, and the height of the crystalline lens from the ICL haptic (lens arc), measured from the anterior surface of the crystalline lens to the ICL haptic plane and other parameters), were estimated on the UBM image. Eyes were divided into 3 subgroups according to the ftICL haptic (Group 1: ≤0.5 mm; Group 2: 0.5 to 1.0 mm; and Group 3:≥1.0 mm, respectively), and the factors associated with the ICL haptic-related parameters and their impact on the clinical vault were evaluated. Results: The haptics could be imaged in the ciliary sulcus, on the ciliary body, and under the ciliary body in 629 (48.7%), 525 (40.6%), and 138 (10.7%) eyes, respectively. The ftICL haptic and the summation of ICL arc and lens arc showed a correlation with the clinical vault (r = −0.34, P =.00; r = 0.87, P =.00). When the ftICL haptic results were divided into 3 groups, the percentage of eyes that exhibited clinical vault >750 μm were lowest in Group 3. Multivariate regression analysis showed spherical equivalent, white-to-white (WTW), anterior chamber volume (ACV) and iris–ciliary angle (ICA); the difference between the implanted ICL size and horizontal sulcus-to-sulcus (ICL size-STS) were associated with the ftICL haptic. The IOP, WTW, ACV, and the ICL size-STS were significantly associated with ICL arc, while the ICA and lens rise were associated with lens arc. Conclusions: The position of ICL haptic was associated with the clinical vault. Its quantitative evaluation may provide valuable information to help clinicians to select the best ICL size before surgery and understand the formation of clinical vault after surgery. [ABSTRACT FROM AUTHOR]

Background: Currently, SARS-CoV-2 liver invasion, inflammatory cytokines, and antiviral drugs are widely thought to be associated with liver dysfunction in COVID-19 patients. Besides, previous studies indicated that ACEI/ARB drugs can increase the expression of hepatic ACE2, a cell entry receptor for SARS-CoV-2. This study aims to investigate whether ACEI/ARB aggravates liver injury and the association of inflammatory cytokines and antiviral drugs with liver dysfunction in patients with hypertension and COVID-19.Method: This retrospective study included 127 hypertensive patients with long-term use or nonuse of ACEI/ARBs hospitalized for COVID-19 from January 30 to April 7, 2020, in Tongji hospital of Wuhan, China. Demographic, clinical, laboratory, treatment, and outcome data were collected.Results: Of the 127 patients with COVID-19 and hypertension, 43 taking long-term of ACEI/ARBs and 84 without using ACEI/ARBs. Abnormal liver function was observed in part of ACEI/ARB and non-ACEI/ARB users but without significant differences between these two groups. Serum inflammatory cytokines, IL-6, IL-8, and TNFα, as well as inflammation-related markers, ferritin, procalcitonin, and C-reactive protein, were significantly elevated in patients with liver dysfunction. IL-6 level was positively correlated with liver function tests on admission and highly consistent with the changes of abnormal ALT, AST, and GGT during hospitalization, but the correlations of other inflammatory cytokines were low. There was no significant association between the use of antiviral drugs and liver dysfunction in these patients.Conclusion: The elevation of inflammatory cytokine, IL-6, but not ACEI/ARB and antiviral drugs, is closely associated with liver dysfunction in patients with hypertension and COVID-19. [ABSTRACT FROM AUTHOR]

• Most recreational flows through the urban park rely on its major roads. • Recreational flows generally follow the distance decay law from the park entrance before reaching the midpoint of the recreation process. • Recreational stoppages in urban parks occur mainly in the first half of the trip. • GPS tracking is a reliable tool for quantifying the space-time dynamics of recreational activities in detail. With increasingly diversified and personalized lifestyles, visitors' recreation behaviors within urban parks have become more and more active and changeable; meeting this novel change in demand has become a new challenge for effective park design and management. In fact, it has become an urgent task to understand more precisely how visitors flow through parks and in what patterns. This paper used Global Positioning System (GPS) tracking data to quantitatively identify the actual spatial movement and time cost of visitors to Jiefang Park, Wuhan, China. The results show that most recreational flows through the park relied on its major roads. These flows generally follow the distance decay law from the park entrance before reaching the midpoint of the recreation process, and recreational stoppages of these flows also occurred mainly in the first half of the trip, exhibiting three different characteristics. Based on the empirical evidence, this paper summarizes three generalized patterns of recreational flows in order to depict the general recreation behaviors of urban park visitors. These findings could help predict the spatial movement and time budget of park visitors and thus provide support for future park design and management. [ABSTRACT FROM AUTHOR]

The evolution and clinical significance of abnormal liver chemistries and the impact of hepatitis B infection on outcome in patients with COVID-19 is not well characterized. This study aimed to explore these issues. This large retrospective cohort study included 2,073 patients with coronavirus disease 2019 (COVID-19) and definite outcomes in Wuhan, China. Longitudinal liver function tests were conducted, with associated factors and risk of death determined by multivariate regression analyses. A prognostic nomogram was formulated to predict the survival of patients with COVID-19. The characteristics of liver abnormalities and outcomes of patients with COVID-19, with and without hepatitis B, were compared after 1:3 propensity score matching. Of the 2,073 patients, 1,282 (61.8%) had abnormal liver chemistries during hospitalization, and 297 (14.3%) had a liver injury. The mean levels of aspartate aminotransferase (AST) and direct bilirubin (D-Bil) increased early after symptom onset in deceased patients and showed disparity compared to levels in discharged patients throughout the clinical course of the disease. Abnormal AST (adjusted hazard ratio [HR] 1.39; 95% CI 1.04–1.86, p = 0.027) and D-Bil (adjusted HR 1.66; 95% CI 1.22–2.26; p = 0.001) levels at admission were independent risk factors for mortality due to COVID-19. A nomogram was established based on the results of multivariate analysis and showed sufficient discriminatory power and good consistency between the prediction and the observation. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes. Abnormal AST and D-Bil levels at admission were independent predictors of COVID-19-related mortality. Therefore, monitoring liver chemistries, especially AST and D-Bil levels, is necessary in hospitalized patients with COVID-19. Liver test abnormalities (in particular elevations in the levels of aspartate aminotransferase [AST] and direct bilirubin [D-Bil]) were observed after symptom onset in patients who went on to die of coronavirus disease 2019 (COVID-19). Abnormal levels of AST and D-Bil at admission were independent predictors of COVID-19-related mortality. HBV infection in patients did not increase the risk of poor COVID-19-associated outcomes. [Display omitted] • Levels of AST and D-Bil elevated early after the symptom onset in deceased patients and showed disparity compared with that in discharged patients throughout the clinical course of COVID-19. • Abnormal admission AST and D-Bil levels were independent predictors of COVID-19 mortality. • A novel nomogram was built based on admission AST and D-Bil levels as well as other baseline characteristics to predict the in-hospital mortality of COVID-19. • Hepatitis B infection was not found to be associated with the risk of lethal outcome in patients with COVID-19. [ABSTRACT FROM AUTHOR]

[Display omitted] • A comparative study of urban expansion and WESs in two megacities was conducted. • In Chengdu, urban expansion had an edge-based pattern that encompassed city-wide. • In Wuhan, suburban expansion is growing rapidly due to leapfrogging development. • Urban expansion has larger negative effects on WY and WP in Wuhan's suburbs. • Ecological land in the megacities' center suffered from indirect loss of WESs. The megacity expansion that continues to occur in developing countries is an unavoidable trend at this stage, yet there exists a dearth of knowledge regarding the comprehensive impacts of urban expansion on water-related ecosystem services (WESs) within these areas. Taking Chengdu and Wuhan, two megacities in the upper and middle Yangtze River Economic Belt in China as the study area, this study first compare the magnitude, rate, spatial divergence, and the mode of urban expansion; then evaluate its impact on three typical types of WESs, i.e., water yield (WY), water purification (WP), and habitat quality (HQ) using spatial econometric models and bivariate Moran's I. The research findings show that Chengdu's suburbs tend to experience edge-based expansion along rivers, while Wuhan's city center also spreads outward in edge-based from the river junctions of the Yangtze and Han rivers. Urban expansion negatively impacts all three types of WESs, and its effect in Chengdu is greater than in Wuhan. WY in the suburbs of Wuhan is severely impacted by urban expansion, while WP in the suburbs of Chengdu is as well. HQ in Chengdu's city center suffers the largest negative impact. The study also reveals a spatial spillover effect of urban expansion, with extensive negative externalities on all WESs in the city centers of both cities and positive externalities on WY and WP in the southwestern suburbs of Chengdu. Based on these results, we suggest that megacities in developing countries should focus on protecting HQ in the city center and limiting cross-regional edge-based expansion in suburbs. Attention should be paid to the water-ecological protection of the suburb rivers. City managers should consider ecological zoning geared toward the conservation of WESs to address the adverse impacts of expansion. [ABSTRACT FROM AUTHOR]