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Energy harvesting has been extensively developed to scavenge energy from mechanical oscillations. Many investigations focus on the resonant issues which can activate large-amplitude responses in the region of the fundamental frequency. Hence, there are many ultra-low slowly changing excitation sources in the actual environment. To adapt to the slowly changing vibrational excitations, in this paper, we explore a novel bursting oscillations to collect energy induced by the low-frequency excitations. The slowly changing ambience excitation is proposed by a cosinoidal voltage source, and the nonlinear restoring force is realized using a nonlinear capacitor. A novel harvester of electromechanical device is developed, the electromechanical coupling equations are presented, and the bursting response is observed via numerical integration. The superiority of the presented bursting energy harvester is contrasted with the resonance and nonresonance frequencies. Based on the method of fast–slow dynamical analysis method, the dynamical mechanism of bursting oscillations is revealed via the transformed phase diagram. Furthermore, the effects of system parameters on the bursting motion are discussed.

Background Schistosomiasis japonica is a chronic parasitic disease that seriously harms people's health. Oncomelania hupensis is the only intermediate host of Schistosoma japonicum. The micro-environmental factors surrounding the snail have a great impact on the survival, growth and reproduction of O. hupensis, but there are few relevant systematic analyses until the present. This scoping review aims to identify and summarize the micro-environmental factors that greatly affect O. hupensis, and to find gaps in research thus to provide directions for future in-depth studies. Main body This scoping review searched databases with search terms of the combinations of “Micro(-)environment”, “Oncomelania” and their expanded aspects. A total of 133 original articles were recruited. Predefined data fields were extracted including research methods, influencing factors, and their effects on O. hupensis. Most studies focused on vegetation factors (54.1%), and other factors noted were soil composition (27.8%), water environmental factors (24.1%), and predator (3.0%), respectively. The factors with positive impacts included water level, pH value, soil temperature, soil humidity, the coverage and height of vegetation at suitable levels. This could provide more detailed information for O. hupensis habitat identification and prediction. The factors with negative impacts included plant extracts, snail control and disease prevention forests, and microorganisms with molluscicidal activities. It revealed a potential application as ecological molluscicides in the future. Factors such as physico-chemical properties of water, soil chemistry showed a gap in scientific studies, thus required further extensive research. Conclusions Micro-environmental factors including water quality, soil composition as well as the technology and application of biomolluscicides (plant extracts and microorganisms) deserve more attention. Relative study findings on micro-environment have good potentials in snail control applications. Further studies should be implemented to investigate the impact of micro-environmental factors on snails and close the research gaps.

Speed modulation of blood pumps has been proved to help restore vascular pulsatility and implemented clinically during treatment for cardiac failure. However, its effect on blood trauma has not been studied thoroughly.In this paper, we study the flow field of an axial pump FW-X under the modes of co-pulse, counter pulse, and constant speed to evaluate the blood trauma. Based on the coupling model of cardiovascular systems and axial blood pump, aortic pressure and the pump flow were obtained and applied as the boundary conditions at the pump outlet and inlet. The level of shear stress and hemolysis index were derived from computational fluid dynamics (CFD) simulation.Results showed that the constant speed mode had the lowest shear stress level and hemolytic index at the expense of diminished pulsatility. Compared with the constant speed mode, the hemolysis index of co-pulse and counter pulse mode was higher, but it was helpful to restore vascular pulsatility.This method can be easily incorporated in the in vitro testing phase to analyze and decrease a pump's trauma before animal experimentation, thereby reducing the cost of blood pump development.

Background Global distributions and trends of the risk-attributable burdens of chronic obstructive pulmonary disease (COPD) have rarely been systematically explored. To guide the formulation of targeted and accurate strategies for the management of COPD, we analyzed COPD burdens attributable to known risk factors. Methods Using detailed COPD data from the Global Burden of Disease study 2019, we analyzed disability-adjusted life years (DALYs), years lived with disability (YLDs), years of life lost (YLLs), and deaths attributable to each risk factor from 1990 to 2019. Additionally, we calculated estimated annual percentage changes (EAPCs) during the study period. The population attributable fraction (PAF) and summary exposure value (SEV) of each risk factor are also presented. Results From 1990 to 2019, the age-standardized DALY and death rates of COPD attributable to smoking and household air pollution, occupational particles, secondhand smoke, and low temperature presented consistently declining trends in almost all socio-demographic index (SDI) regions. However, the decline in YLD was not as dramatic as that of the death rate. In contrast, the COPD burden attributable to ambient particulate matter, ozone, and high temperature exposure showed undesirable increasing trends in the low- and low-middle-SDI regions. In addition, the age-standardized DALY and death rates attributable to each risk factor except household air pollution and low temperature were the highest in the low-middle-SDI region. In 2019, the COPD burden attributable to smoking ambient particulate matter, ozone, occupational particles, low and high temperature was obviously greater in males than in females. Meanwhile, the most important risk factors for female varied across regions (low- and low-middle-SDI regions: household air pollution; middle-SDI region: ambient particles; high-middle- and high-SDI region: smoking). Conclusions Increasing trends of COPD burden attributable to ambient particulate matter, ozone, and high temperature exposure in the low-middle- and low-SDI regions call for an urgent need to implement specific and effective measures. Moreover, considering the gender differences in COPD burdens attributable to some risk factors such as ambient particulate matter and ozone with similar SEV, further research on biological differences between sexes in COPD and relevant policy-making of disease prevention are required.

To provide evidence on the effects of vitamin D supplementation on knee osteoarthritis (KOA) and new targets for clinical prevention and treatment of KOA. The PubMed, Embase, Web of science, Wanfang, CNKI and SinoMed databases were retrieved to investigate the effects of vitamin D supplementation on patients with KOA. The search time was from databases establishment to 15 November 2020. RevMan5.3 software was used for meta-analysis. The results were expressed as standardized mean difference (SMD) with 95% confidence interval (CI) or weighted mean difference (WMD) with 95% confidence interval (CI). A total of 1599 patients with osteoarthritis of the knee were included in the study, which involved six articles. The results of the meta-analysis showed that vitamin D supplementation is statistically significant for WOMAC score (SMD = − 0.67, 95% CI − 1.23 to − 0.12) in patients with KOA, including WOMAC pain score (SMD = − 0.32, 95% CI − 0.63 to − 0.02), function score (SMD = − 0.34, 95% CI − 0.60 to − 0.08) and stiffness score (SMD = − 0.13, 95% CI − 0.26 to − 0.01). In subgroup analysis, vitamin D supplementation less than 2000 IU was statistically significant for the reduction of stiffness score (SMD = − 0.22, 95% CI − 0.40 to − 0.04). Vitamin D supplements can reduce synovial fluid volume progression in patients with KOA (SMD = − 0.20, 95% CI − 0.39 to − 0.02). There was no statistical significance in improving tibia cartilage volume (SMD = 0.12, 95% CI − 0.05 to 0.29), joint space width (SMD = − 0.10, 95% CI − 0.26 to 0.05) and bone marrow lesions (SMD = 0.03, 95% CI − 0.26 to 0.31). Vitamin D supplements can improve WOMAC pain and function in patients with KOA. But there is a lack of strong evidence that vitamin D supplementation can prevent structural progression in patients with KOA.

Two wood-inhabiting fungal species, Trechispora daweishanensis and T. xantha spp. nov. are proposed based on morphological features and molecular evidence. Trechispora daweishanensis is characterized by basidiomata with an annual growth habit, a tuberculate hymenophore, a monomitic hyphal system with clamped generative hyphae and ellipsoid, hyaline, thin-walled, smooth basidiospores measuring 3.8–5 × 2.7–3.5 µm. Trechispora xantha is characterized by resupinate, cracked basidiomata with a buff-coloured hymenial surface, a monomitic hyphal system and ellipsoid, hyaline, thin-walled, smooth basidiospores measuring 4.3–5.7 × 3.2–4 µm. Sequences of ITS and nLSU gene regions of the studied samples were generated. The phylogenetic analysis based on molecular data of ITS+nLSU sequences supported the novelty of these two species. Furthermore, we provide a key to the known species of Trechispora in China.

Background and purpose Initial cardiovascular fingolimod effects might compromise baroreflex responses to rapid blood pressure (BP) changes during common Valsalva-like maneuvers. This study evaluated cardiovascular responses to Valsalva maneuver (VM)-induced baroreceptor unloading and loading upon fingolimod initiation. Patients and methods Twenty-one patients with relapsing-remitting multiple sclerosis performed VMs before and 0.5, 1, 2, 3, 4, 5, and 6 hours after fingolimod initiation. We recorded heart rate (HR) as RR intervals (RRI), systolic and diastolic BP (BPsys, BPdia) during VM phase 1, VM phase 2 early, VM phase 2 late, and VM phase 4. Using linear regression analysis between decreasing BPsys and RRI values during VM phase 2 early, we determined baroreflex gain (BRG) reflecting vagal withdrawal and sympathetic activation upon baroreceptor unloading. To assess cardiovagal activation upon baroreceptor loading, we calculated Valsalva ratios (VR) between maximal and minimal RRIs after strain release. Analysis of variance or Friedman tests with post hoc analysis compared corresponding parameters at the eight time points (significance: p Results RRIs at VM phase 1, VM phase 2 early, and VM phase 2 late were higher after than before fingolimod initiation, and maximal after 4 hours. Fingolimod did not affect the longest RRIs upon strain release, but after 3, 5, and 6 hours lowered the highest BPsys values during overshoot and all BPdia values, and thus reduced VRs. BRG was slightly higher after 3 and 5 hours, and significantly higher after 4 hours than before fingolimod initiation. Conclusions VR-decreases 3–6 hours after fingolimod initiation are physiologic results of fingolimod-associated attenuations of BP and HR increases at the end of strain and do not suggest impaired cardiovagal activation upon baroreceptor loading. Stable and at the time of HR nadir significantly increased BRGs indicate improved responses to baroreceptor unloading. Thus, cardiovascular fingolimod effects do not impair autonomic responses to sudden baroreceptor loading or unloading but seem to be mitigated by baroreflex resetting.

Hybrid fiber composites are widely used to improve the anti-penetration performance. Carbon/Kevlar hybrid composites are used in aircrafts and safety devices, thanks to the strong toughness of Kevlar fibers and high strength of carbon fibers. In the present work, the contact force of hybrid composites under oblique impact is derived. The viscoelastic constitutive model of Kevlar layer is investigated and the dissipation energies of composites for different high velocity oblique impacts are simulated. The results show that hybrid composites have good bullet-proof performance, the contact forces are fluctuant in short time and the frictional dissipation energy allows us to prevent penetration.

A supramolecular strategy was developed for electrocatalytic water splitting in the presence of a macrocyclic compound. The improvement in the oxygen evolution reaction (OER) was observed on the surface of an electrode modified via the facile layer-by-layer assembly of polypyrrole (PPy), reduced graphene oxide (rGO) and cucurbit[6]uril (Q[6]) in sequence. The electrochemical performance was evaluated, and the results indicate the remarkable activity of the proposed supramolecular electrocatalyst toward the OER in alkaline media. The morphology and chemical structure of the electrocatalyst were estimated before and after the OER process. Linear sweep voltammetry measurements suggested that a current density of 10 mA cm−2 at an overpotential of 377 mV was achieved, which is very close to the value of IrO2 under the same conditions, and the calculated Tafel slope of 167 mV dec−1 and electrochemical impedance spectroscopy results imply that a fast charge transfer occurs on the electrode with the functionalization of Q[6]. The developed catalyst could be considered as a potential alternative material for high-efficiency electrocatalytic OER.

Objectives: To explore the clinical effect and safety of laparoscopic radical cystectomy + orthotopic ileal neobladder and open surgery. Methods: The study was conducted at Jingzhou First People’s Hospital from January 2017 to July 2018. In this study 87 patients undergoing radical cystectomy + orthotopic ileal neobladder were chosen and classified into an observation group (48 cases) and a control group (39 cases) according to the surgical methods. The observation group underwent laparoscopic surgery, while the control group underwent open surgery. Perioperative period and prognostic conditions were compared in both groups. Results: The intraoperative bleeding amount obviously decreased. The recovery time of gastroenteric function and postoperative hospitalization time were significantly shortened. Postoperative pain was significantly alleviated. Compared with the control group, the observation group showed significant differences (P0.05). The differences in both groups in terms of the daytime/nighttime urinary continence rate, maximum urinary flow rate, internal bladder pressure, maximum bladder pressure during urination, internal urethral pressure, bladder capacity, and residual urine volume six months after the operation were not statistically significant (P>0.05). There was no significant difference in postoperative complications, including urinary fistula, bleeding, urinary tract infection, pulmonary infection, dysuria, lymphatic leakage, ureterostenosis, or relapse (P>0.05). The ileus incidence rate in the observation group was obviously lower than that in the control group, and the difference was statistically significant (P

A rotary-concentrating device for thermal conduction is constructed to control and guide thermal energy transmitting in elastic plates. The designed device has the ability of concentrating for thermal conduction and controlling the processes of thermal diffusion in a plate. The multilayered isotropic material properties of the rotary-concentrating device are derived based on the transformation and rotary medium method and a rotation parameter to control the thermal diffusion process is introduced. The efficiency of the rotary-concentrating device for thermal conduction is verified. Stability of temperature fields in a plate with the rotary-concentrating device is analyzed to study the performance of rotary-concentrating. Numerical examples show that the constructed rotary-concentrating device for thermal conduction can effectively rotate and focus on the thermal energy into the device for a wide range of diffusion temperatures, which can enhance the thermal conduction. Therefore, this study can provide a theoretical support for potential applications in fields of energy harvesting and thermal conduction control.

Thrombosis and its related events have become a major concern during the development and optimization of ventricular assist devices (VADs, also called blood pumps), and limit their clinical use and economic benefits. Attempts have been made to model the thrombosis formation, considering hemodynamic and biochemical processes. However, the complexities and computational expenses are prohibitive. Blood stasis is one of the key factors which may lead to the formation of thrombosis and excessive thromboembolic risks for patients. This study proposed a novel approach for modeling blood stasis, based on a two-phase flow principle. The locations of blood residual can be tracked over time, so that regions of blood stasis can be identified. The blood stasis in an axial blood pump is simulated under various working conditions, the results agree well with the experimental results. In contrast, conventional hemodynamic metrics such as velocity, time-averaged wall shear stress (TAWSS), and relative residence time (RRT), were contradictory in judging risk of blood stasis and thrombosis, and inconsistent with experimental results. We also found that the pump operating at the designed rotational speed is less prone to blood stasis. The model provides an efficient and fast alternative for evaluating blood stasis and thrombosis potential in blood pumps, and will be a valuable addition to the tools to support the design and improvement of VADs.

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

In this study, nanostructured pyramidal black silicon is prepared by metal assisted chemical etching method, in which the silver nitrate (AgNO3) is used as the metal catalyst. Effects of the concentration of AgNO3 on passivation and optical properties of the black silicon are investigated. The experimental results show that at the AgNO3 concentration of 0.03 M, the nanostructure length is about 300 nm, and the reflectance of the black silicon with a stack of silicon nitride (SiNx) and aluminum oxide (Al2O3) is 0.8%, which is comparable to that of the conventional black silicon with micrometer-long nanowires. In addition, an acceptably low surface recombination rate of 42 cm/s can be obtained. Plasma chemical vapor deposited SiNx is deposited well on the top of nanostructures of black silicon, but shows poor coverage at the bottom region. Spatial atomic layer deposited Al2O3 can conformally cover the nanostructures with high passivation quality. Simulation result indicates an improvement of 5.5% of conversion efficiency for the nanostructured pyramidal black silicon solar cell compared to industrial silicon solar cell. The short nanostructured pyramidal surface with low reflectance and high passivation is expected to be helpful for black silicon technology applied to photovoltaic applications.

Modified curcumin, which has the advantages of low toxicity, high solubility, and little color change after modification, is very suitable for nonaqueous supercritical carbon dioxide cotton dyeing. However, the existing curcumin modification technology focuses on improving its solubility. Modified curcumin is directly adsorbed onto cotton fabrics, and the main interaction forces are van der Waals forces, which causes the poor fastness of modified curcumin to dyed cotton fabrics. In this study, reactive groups (hydroxyalkyls) were introduced into curcumin to enhance its fastness to cotton fabrics. The results showed that, similar to alkyl groups, hydroxyalkyl groups can enhance the color depth of dyed cotton fabrics by elevating the solubility of modified curcumin in supercritical carbon dioxide. The higher the solubility of modified curcumin in supercritical carbon dioxide was, the higher the K/S value of the dyed cotton fabric. Furthermore, the hydroxyl groups on the modified curcumin could form ether bonds with the hydroxyl groups on cotton fabrics. Therefore, the washing and rubbing fastness of hydroxyalkyl-curcumin-dyed cotton fabric was better than that of alkyl-curcumin-dyed cotton fabric.

Intraventricular blood stasis is a design consideration for continuous flow blood pumps and might contribute to adverse events such as thrombosis and ventricular suction. However, the blood flow inside left ventricles (LVs) supported by blood pumps is still unclear. In vitro experiments were conducted to imitate how the hydraulic performance of an axial blood pump affects the intraventricular blood flow of a severe heart failure patient, such as velocity distribution, vorticity, and standard deviation of velocity. In this study, a silicone model of the LV was constructed from the computed tomography data of one patient with heart failure and was 3D printed. Then, intraventricular flow was visualized by particle image velocimetry equipment within a mock circulation loop. The results showed that the axial blood pump suctions most of the blood in a severely failing LV, there was an altered flow status within the LV, and blood stasis appeared in the central region of the LV. Some blood may be suctioned from the aortic valve to the blood pump because the patient's native heart was severely failing. Blood stasis at the LV center may cause thrombosis in the LV. The vortex flow near the inner wall of the LV can thoroughly wash the left ventricular cavity.

Background and aimsMetabolic dysfunction-associated fatty liver disease (MAFLD) is a newly emerged term that is suggested to better reflect the pathogenesis of nonalcoholic fatty liver disease (NAFLD); however, the association between hyperuricemia and MAFLD has not been explored in the Chinese population. Meantime, this study also examined the temporal relationship between the two entities in a longitudinal cohort.MethodsWe conducted a retrospective cross-sectional study including 1,587,962 individuals from 19 health check-up centers in China from 2009-2017 and a longitudinal study with 16,112 individuals. A logistic regression model was applied to determine the association between hyperuricemia and MAFLD in a cross-sectional study. The Cox regression model was used to explore the association between hyperuricemia at baseline and subsequent onset of MAFLD or the association between the presence of MAFLD at baseline and the subsequent incidence of hyperuricemia. The cross-lagged analysis was applied to exam the temporal relationship between hyperuricemia and MAFLD.ResultsIn the cross-sectional study, hyperuricemia showed a strong positive association with MAFLD after controlled potential confounders. In the longitudinal cohorts, hyperuricemia at baseline was associated with the new-onset of MAFLD, with a hazard ratio (HR) of 1.765 (95% CI: 1.512, 2.060). Interestingly, baseline MAFLD was also associated with the subsequent incidence of hyperuricemia, with an HR of 1.245 (95% CI: 1.106, 1.400). The cross-lagged path analysis revealed a bidirectional relationship between hyperuricemia and MAFLD.ConclusionsThe results suggested that hyperuricemia and MAFLD form a vicious cycle, resulting in more deterioration of metabolic status.

BackgroundEmerging evidence suggests an association between remnant cholesterol (RC) and vascular damage and hypertension. However, this association has not been explored in a large-scale population in China, and a temporal relationship between RC and hypertension also needs to be investigated.MethodsWe conducted a retrospective cross-sectional study in 2,199,366 individuals and a longitudinal study in 24,252 individuals with repeated measurements of lipid profile and blood pressure in at least a 3-year follow-up. The logistic model was used to explore the association between lipid components and hypertension in the cross-sectional analysis. The Cox model was used to analyze the association between high RC (HRC) at baseline and the subsequent incidence of hypertension or the association between hypertension at baseline and incidence of HRC. The cross-lagged panel model was applied to analyze the temporal relationship between RC and hypertension.ResultsRC level as a continuous variable had the highest correlation with hypertension among lipid profiles, including RC, low-density lipoprotein cholesterol, total cholesterol, non-high-density lipoprotein cholesterol, and triglycerides, with an odds ratio of 1.59 (95% confidence interval: 1.58–1.59). In the longitudinal cohort, HRC at baseline was associated with incident hypertension. We further explored the temporal relationship between RC and hypertension using the cross-lagged analysis, and the results showed that RC increase preceded the development of hypertension, rather than vice versa.ConclusionsRC had an unexpected high correlation with the prevalence and incidence of hypertension. Moreover, RC increase might precede the development of hypertension, suggesting the potential role of RC in the development of hypertension.

Acetyl-CoA carboxylase (ACC) is one of the more promising therapeutic targets for non-alcoholic steatohepatitis (NASH), but current ACC inhibitors already tested in clinical trials also exert the unwanted adverse side effect of hypertriglyceridemia. In two recent studies by Calle et al. in Nature Medicine and Zhang et al. in Science Translational Medicine, new strategies for ACC targeting were explored for NASH therapy that successfully resolved the adverse effect of hyperlipidemia while maintaining potent anti-NASH efficacy. These findings bring encouraging new momentum to the clinical application of ACC inhibition for NASH therapy.

Auriculariales is diverse, embracing a number of corticioid, poroid, and hydnoid genera. The present study covers a new wood-inhabiting fungal species of Heteroradulum niveum sp. nov that is proposed on the basis of a combination of morphological features and molecular evidence. The species is characterized by the resupinate basidiomata, a monomitic hyphal system with generative hyphae with clamp connections; tubular cystidia; two- to four-celled basidia; and allantoid, colorless, thin-walled, smooth, IKI–, CB–, basidiospores (6.5–13.5 × 2.7–5.5 µm). Sequences of ITS and nLSU rRNA gene regions of the specimens were generated, and phylogenetic analyses were carried out with methods of maximum parsimony, maximum likelihood, and Bayesian inference. These phylogenetic analyses inferred from ITS+nLSU indicated that H. niveum is nested in Heteroradulum within Auriculariales. Further study within Heteroradulum on the basis of ITS+nLSU dataset revealed that it formed a monophyletic lineage with a strong support (100% BS, 100% BP, 1.00 BPP) and then grouped with H. yunnanensis.

The relationship between rheumatoid arthritis (RA) and the risk of leukemia was still controversial. This study aimed to assess the risk of leukemia in patients with rheumatoid arthritis by systematic review and meta-analysis.Relevant studies were identified by searching PubMed, Embase, Cochrane Library, and SinoMed up to December 2019. Random effects model analysis was used to pool standardized incidence ratios (SIRs) and 95% confidence interval.A total of 15 relevant studies that met the criteria were included. Compared with the general population, patients with RA showed an increased risk of leukemia (SIR = 1.51, 95% CI: 1.34-1.70). The statistical heterogeneity was moderate with an IOur findings suggested that the risk of leukemia in RA was increased compared with the general population. Key points • This is the first systematic review and meta-analysis to assess the risk of leukemia in RA. • Our study suggested that the risk of leukemia in RA was increased compared with the general population. • This study indicated that the risk of leukemia in RA was higher in non-Asian populations.

The clinical features and immune responses of asymptomatic individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have not been well described. We studied 37 asymptomatic individuals in the Wanzhou District who were diagnosed with RT-PCR-confirmed SARS-CoV-2 infections but without any relevant clinical symptoms in the preceding 14 d and during hospitalization. Asymptomatic individuals were admitted to the government-designated Wanzhou People's Hospital for centralized isolation in accordance with policy1. The median duration of viral shedding in the asymptomatic group was 19 d (interquartile range (IQR), 15-26 d). The asymptomatic group had a significantly longer duration of viral shedding than the symptomatic group (log-rank P = 0.028). The virus-specific IgG levels in the asymptomatic group (median S/CO, 3.4; IQR, 1.6-10.7) were significantly lower (P = 0.005) relative to the symptomatic group (median S/CO, 20.5; IQR, 5.8-38.2) in the acute phase. Of asymptomatic individuals, 93.3% (28/30) and 81.1% (30/37) had reduction in IgG and neutralizing antibody levels, respectively, during the early convalescent phase, as compared to 96.8% (30/31) and 62.2% (23/37) of symptomatic patients. Forty percent of asymptomatic individuals became seronegative and 12.9% of the symptomatic group became negative for IgG in the early convalescent phase. In addition, asymptomatic individuals exhibited lower levels of 18 pro- and anti-inflammatory cytokines. These data suggest that asymptomatic individuals had a weaker immune response to SARS-CoV-2 infection. The reduction in IgG and neutralizing antibody levels in the early convalescent phase might have implications for immunity strategy and serological surveys.

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

We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.

Paeoniforin (Pae) is a monoterpenoid glycoside compound and has many biological activities, such as immunosuppression, anti-inflammation and anti-cell proliferation. However, the effects and mechanisms of Pae on chronic heart failure (CHF) remain unclear. This study was conducted to assess the effects and mechanisms of Pae on myocardial fbrosis in isoprenaline (Iso)-induced CHF rats. Pae (20 mg/kg) was intragastrically administrated to CHF rats for 6 weeks. Cardiac structure and function were assessed. The protein and mRNA levels of transforming growth factor β1 (TGF-β1) and p38 were detected. Compared to Iso group, Pae could alleviate myocardial fibrosis and improve cardiac function in CHF rats. The levels of collagen volume fraction (13.75%±3.77% vs. 30.97%±4.22%, P

A new methodology is developed in this work to solve a one-dimensional (1D) nonlinear wave propagation problem. In its response, the space variable is converted to time functions at different locations, and the resultant time functions are merged with the time variable. Since the merged variables are essentially time-delay variables, the main point of the methodology is that the governing equation of the nonlinear wave propagation problem can be converted to a corresponding nonlinear delay differential equation (DDE) with multiple delays. The new methodology is shown how to formulate the converted DDE, and a modified incremental harmonic balance method is used to solve the 1D nonlinear DDE by introducing a delay matrix operator, where a formula of the Jacobian matrix is derived and can be efficiently and automatically used in the Newton method. This new methodology is demonstrated by solving examples of 1D monatomic chains under the nonlinear Hertzian contact law and with cubic springs. Results well match those in previous works, but derivation effort of solutions and calculation time can be significantly reduced here. When the algorithm of the methodology is compiled as a computer program, there is no additional derivation required to solve wave propagation problems associated with different governing equations.

Patients with a history of mild traumatic brain injury (post-mTBI patients) may have enduring cardiovascular-autonomic dysregulation and emotional problems. Olfactory stimulation (OS) triggers emotional and cardiovascular-autonomic responses that might be compromised in post-mTBI patients. We therefore evaluated these responses to OS in post-mTBI patients. In 17 post-mTBI patients (interval since mTBI: 32.4 ± 6.8 months) and 17 age- and sex-matched controls, we recorded respiration, electrocardiographic RR intervals, and systolic and diastolic blood pressures (BPsys, BPdia) before and during pleasant vanilla stimulation and unpleasant hydrogen sulphide (H2S) stimulation. Participants rated OS-related pleasantness, arousal, intensity, and familiarity on 9-point Likert scales. Analyses of variance (ANOVAs) with post hoc analyses compared parameters within each group before and during OS. To assess associations between pleasantness, arousal, intensity, and familiarity, we correlated OS scores within groups (significance

An electrochemiluminescence (ECL) sensor based on a benzo[3]uril-modified glassy carbon electrode with sensitized luminescence, with the coexistence of 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid (HEPES) as the coreactant, was successfully constructed. The sensitization mechanism was proposed by analyzing the results of the control experiments for establishing the relationship of the luminescence effect with the concentration of HEPES. Under the optimized conditions, the fabricated sensor system was applied for the detection of Fe3+ in an aqueous solution with good sensitivity and selectivity. A low detection limit of 0.41 nM was achieved, indicating superior sensor performance over the previous analytical methods. The ECL sensor system was employed for the detection of Fe3+ in human serum samples to produce excellent recoveries ranging from 96.17% to 101.81%.