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ObjectivesTo investigate superiority of a telerehabilitation program for Covid-19 (TERECO) over no rehabilitation with regard to functional exercise capacity, lower-limb muscle strength (LMS), pulmonary function, health-related quality of life (HRQOL), and perceived dyspnoea.DesignParallel-group randomised controlled-trial with 1:1 block-randomisation.SettingThree major hospitals from Jiangsu and Hubei provinces, China.Participants120 Covid-19 survivors with modified Medical Research Council (mMRC) dyspnoea score of 2-3 who had been discharged from hospital were randomised. 61 were allocated to the control group and 59 to the TERECO group.InterventionThe control group received educational instructions. The TERECO group participated in a 6-week home-based, pulmonary rehabilitation program delivered via smartphone and monitored with chest-worn heart rate telemetry. Exercise types comprised breathing control and thoracic expansion, aerobic exercise, and LMS exercise.OutcomesPrimary outcome was 6-minute walking distance (6MWD) in metres. Secondary outcomes were LMS measured as squat time in seconds; pulmonary function assessed by spirometry with parameters being forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, maximum voluntary ventilation (MVV), and peak expiratory flow; HRQOL measured with SF-12 physical component score (PCS) and mental component score (MCS); and mMRC dyspnoea, favourable outcome (no dyspnoea). Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up).Results120 patients were randomised, 15 (12.5%) were lost to follow-up at study endpoint. No serious adverse events occurred. 38 participants in the TERECO group complied with the exercise protocol (64.41% of randomized). The adjusted between-group difference in change in 6MWD from baseline was 65.45 metres (95% CI 43.8-87.1, pConclusionsThis trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and SF-12 PCS. We found no persistent effects on pulmonary function, SF-12 MCS, and perceived dyspnoea.Trial registrationChinese Clinical Trial Registry: ChiCTR2000031834, 11 Apr 2020, URL: http://www.chictr.org.cn/showproj.aspx?proj=52216KEY POINTSWhat is already knownMany Covid-19 survivors discharged from hospital have reduced exercise capacity, impaired pulmonary function, muscle weakness, and reduced quality of life, all of which might be addressed with pulmonary rehabilitation.However, evidence on effective pulmonary rehabilitation measures for this population is currently lacking. As delivery of conventional rehabilitation services is furthermore limited due to pandemic control measures, telerehabilitation programs represent a possible alternative.What the study addsWe developed a telerehabilitation program for Covid-19 survivors (TERECO program) that is delivered via smartphone and can be carried out at home.Our study suggests that TERECO was safe and participants of the TERECO program had improved exercise capacity, lower-limb muscle strength, and physical quality of life. No relevant group differences were found for lung function, self-reported breathlessness, and mental quality of life.The TERECO program is inexpensive and could be implemented on a large scale to improve physical health of Covid-19 survivors after discharge from hospital.

The changing family planning policy from One-Child to Two-Child Policy, led to a significant increase in the proportion of pregnancies with variant interpregnancy intervals (IPIs) after previous cesarean section (CS). To examine the relationship between IPI and perinatal outcomes, we conducted a retrospective cohort study of 1854 women having a history of CS and delivered in 2016 at West China Second University Hospital. With an IPI of 24-59 months as the reference, the associations between various IPIs (

To explore the dynamic compressive properties of carbon nanofibers reinforced concrete (CNFC), a 100mm-diameter Split Hopkinson Pressure Bar (SHPB) was used to carry out the impact compression test respectively on the plain concrete samples and the CNFC samples with different fiber volume fractions (respectively, 0.1%, 0.2%, 0.3% and 0.5%). On this basis, the change characteristics of concrete at five different strain rate levels in dynamic compressive strength, dynamic compression deformation, impact toughness and dynamic elastic modulus of concrete were compared and analyzed. The results show that the dynamic compressive strength, dynamic compression deformation and impact toughness of concrete are enhanced by carbon nanofibers to varying degrees. Specifically, when the content of carbon nanofibers is 0.3%, its enhancement effect on dynamic compressive strength is the best; when the content of carbon nanofibers is 0.2%, it helps enhance the dynamic elastic modulus of concrete, but other content can only have the opposite effect. The dynamic compressive strength, impact toughness and dynamic elastic modulus of plain concrete and CNFC gradually increase with the increase of strain rate level, indicating the existence of significant linear relationship; although the dynamic peak strain and ultimate strain increase wholly with the increase of strain rate, there is no obvious linear correlation between them. In addition, the micro test results show that the addition of an appropriate amount of carbon nanofibers help exert the small size effect, strengthen crack resistance and improve the microstructure of the matrix, effectively enhancing the dynamic compressive properties of concrete under impact load.

Background: Immature immunologic function is the primary reason that premature infants are prone to infection after birth. The outbreak of coronavirus infected disease 2019 (COVID-19) has led to an increase in the incidence of preterm birth, representing a new survival risk for preterm infants. Objectives: From February 2020 to May 2020, 57 premature infants of gestational age (GA) less than 37 weeks (28 +3 -36 +5wks ) born to 48 mothers were hospitalized in Zhongnan Hospital of Wuhan University, Wuhan China. Among them, 14 premature infants were delivered by 13 mothers infected with severe acute respiratory syndrome (SARS-CoV-2) in the third trimester. Methods: Due to the epidemic of COVID-19 in Wuhan and the policy of lockdown, all pregnant women underwent examination for SARS-CoV-2 nucleic acid, serum antibody and lung computer tomography (CT) before delivery. After birth, new-borns’ peripheral blood was collected, and immune cells counts and cytokine concentrations were assessed. Subjects’ clinical data were recorded and analysed. Results: Absolute lymphocyte count (ALC) and CD4 cells of preterm infants increased with GA. CD3, CD4, CD8, CD19, CD16-56 cell counts were positively correlated with ALC. Concentrations of IL-2, IL-4, IFN-γ and TNF-α were in the normal reference range and were not correlated with GA and birth weight (BW). Median IL-6 level in preterm infants was 14.71 pg/ml (IQR 6.47-46.14 pg/ml), which was 5.07-fold higher than the reference intervals, 3.9 pg/ml (IQR, 1.79-14.28 pg/ml), and the ratio of IL-6/IL-10 was 3.77. IL-10 was positively correlated with IL-2, IL-4 and IL-6. Immune cell counts, cytokine levels and clinical prognosis of premature infants born to mothers with SARS-CoV-2 were not different from those without maternal SARS-CoV-2 infection. Conclusions: Immune function in preterm infants was characterized by increased CD4 cells with GA and a positive correlation between high levels of IL-6 and IL-10. Maternal infection with SARS-CoV-2 is not an independent perinatal risk factor for premature infants with immature immune function. Trial Registration: The present study was registered as a clinical study in the Chinese Clinical Trial Registry (ChiCTR-ORC-16008872). Funding Statement: This work was supported by a grant from the Chinese National Natural Science Fund 81170005 and 81670007. Declaration of Interests: No conflict of interest. Ethics Approval Statement: The Institutional Review Board of Zhongnan Hospital of Wuhan University approved this study (approval no. 2015019). All guardians signed informed consents.

Understanding the ecological impacts of large-scale hydraulic projects is critical for maintaining ecosystem health while meeting human water needs. It is, however, currently hindered by a lack of direct evidence on ecological impacts associated with this type of project particularly on water quality and fish communities. Here, we characterized patterns and variations of fish communities and water quality in five impounded lakes of the Chinese South-to-North Water Diversion Project (SNWDP), with the aim of better understanding potential ecological impacts of inter-basin water transfers. We found that 1) the impacts of water transfer on water quality in the impounded lakes was generally characterized by hydrological parameters (e.g. total suspended solids, turbidity, transparency, chlorophyll a, dissolved oxygen, conductivity and total hardness) in an upstream-downstream direction; 2) increased hydrological connectivity may have favored biological invasion (e.g. Tridentiger bifasciatus) and promoted a potential biotic homogenization among the impounded lakes: and 3) there was a pattern of decreased fish abundance and biomass from the upstream to downstream lakes with fish communities strongly driven by changing water quality patterns across the impounded lakes. These findings improve our understanding of ecological impacts of large-scale hydraulic projects and provide a significant basis for water agencies with similar water transfer systems to optimize their water transfer management in order to minimize ecological impacts.

The signatures of topological superconductivity (TSC) in the superconducting materials with topological nontrivial states prompt intensive researches recently. Utilizing high-resolution angle-resolved photoemission spectroscopy and first-principles calculations, we demonstrate multiple Dirac fermions and surface states in superconductor BaSn$_3$ with a critical transition temperature of about 4.4 K. We predict and then unveil the existence of two pairs of type-\uppercase\expandafter{\romannumeral1} topological Dirac fermions residing on the rotational axis. Type-\uppercase\expandafter{\romannumeral2} Dirac fermions protected by screw axis are confirmed in the same compound. Further calculation for the spin helical texture of the observed surface states originating from the Dirac fermions give an opportunity for realization of TSC in one single material. Hosting multiple Dirac fermions and topological surface states, the intrinsic superconductor BaSn$_3$ is expected to be a new platform for further investigation of the topological quantum materials as well as TSC., 6 pages, 4 figures