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Cost-effective and efficient 2D porous Ni/CS composites were synthesized by a facile and scalable NaCl template-assisted route. The optimized 4-Ni/CS composite demonstrated high performances for the UOR and urea splitting cell.

Mild and efficient synthesis of DMC has been successfully performed by electrolyzing low-cost and abundant urea and methanol.

pH is one of the important parameters of a biological microenvironment, which is closely related to cell growth, development, vitality, division, and differentiation. Monitoring the pH of a microenvironment is helpful to monitor the cell metabolism as well as to understand the cellular life cycle. The sensitivity of liquid metals (LMs) to hydrogen ions has aroused our interest. Here, we propose a novel but facile pH sensor using liquid gallium (LM for short) droplet morphological change as the readout. The pH sensing characteristics of the LM droplet were examined, especially the shape response. LM can form solid native oxide skin rapidly in oxygenated solution, and the oxide layer will be removed in acidic or alkaline solutions, which will cause a great change in surface tension. The phenomenon is the change of LM morphology from macroscopic observation. We explored the electrochemical characteristics of LM at different pH values, explained the mechanism of surface change, and calibrated the relationship curve between LM morphology and pH and the interference of impurity ions on the sensor. Finally, we proposed a detection algorithm for the LM pH morphology sensor and tried to automatically detect pH with a mobile app, which was applied to the pH detection of cell culture solution. We believe that the response characteristics of LM to hydrogen ions have great potential in microenvironment detection.

This paper proposes three new types of connectors adopted in discrete connected new-type precast concrete diaphragms (DCNPD). An experimental investigation of innovated connectors under shear load was conducted to evaluate the failure mode, strain and bearing capacity of joint connections in DCNPD. Based on the experimental results, the hairpin connector (HPC) was selected for simulation verification and further analysis under combined loads to provide crucial information on bearing capacity, ductility, reduction rule, deformation and stiffness in order to reveal its working mechanism. The results indicate that three types of connectors can provide effective connection for slab joints. The ideal fracture failure mode of anchor bar or cover plate is realised in all joint connections. The shear capacity of HPC is weakened by simultaneous tension when it is under combined loads. With the increase of tension-to-shear force ratio, the ductility of HPC is improved, and the shear ductility is relatively better. The evaluation of yield displacement and bearing capacity, degradation law in strength, deformation and stiffness of HPC provides a theoretical basis for the development of joint connection and seismic design of DCNPD, which is vital for the application of DCNPD in precast concrete structures.

To clarify the regulatory effect and molecular mechanism of Arisaema heterophyllum Blume (AhBl) monomer stigmasterol on lung adenocarcinoma in human lung adenocarcinoma cells NCI-H1975 cultured in vitro and in nude mice. Oil red O staining, free fatty acid detection, adenosine triphosphate (ATP), and NADPH were applied to elucidate the regulatory effect of stigmasterol on the energy metabolism of NCI-H1975 cells. Simultaneously, colony formation assay and nude mouse tumorigenesis were performed to clarify the underlying mechanisms of stigmasterol on the proliferation and tumorigenesis of NCI-H1975 cells. Furthermore, peroxisome proliferator-activated receptor gamma (PPARγ) inhibitor GW9662 was supplemented to determine the expression changes of cyclins to clarify the regulation mechanism of stigmasterol. The results revealed that stigmasterol administration markedly inhibited the viability but promoted lipid deposition of NCI-H1975 cells. Meanwhile, the reduction of cell energy metabolism affected cell proliferation and colony formation. qPCR and western blot assays indicated that stigmasterol played a role in regulating the expression of cyclins and PPARγ signaling pathway proteins. Nude mouse tumorigenesis suggested that tumor size and weight in the stigmasterol-treated group were apparently lower as compared with the control group. Tumor tissue cells developed varying degrees of degeneration and large areas of ischemic necrosis presented in the central and peripheral cells. Immunohistochemistry results revealed that Ki67 expression in the stigmasterol group was substantially inhibited, while PPARγ expression was greatly elevated as compared with the control. GW9662 could mediate the inhibitory effect of stigmasterol on NCI-H1975 cells. The current study demonstrated that stigmasterol targeted PPARγ and inhibited the viability and tumorigenicity of lung adenocarcinoma cells NCI-H1975.

In order to study the seismic performance of the reinforced concrete staggered slab-column structure, one 1/7 scaled test specimen was fabricated and tested. The acceleration response, displacement distribution, dynamic characteristics, torsion responses, failure mechanism, shear force, and strain of test specimen were measured and evaluated. Test results indicated that the natural frequency and acceleration magnification factor of the test specimen gradually reduced, while the floor shear force and torsion response gradually increased. Meanwhile, the maximum inter-story drift angle of test specimen in the elastic and elastic-plastic stage was 1/196 and 1/78, respectively, indicating that the lateral stiffness of staggered slab-column structure was relatively small. The inter-story angles of the second and fifth floors were larger than adjacent floors. It was suggested that the stiffness of the test specimen was inhomogeneously distributed due to staggered slabs and a lack of frame beams. The damage of columns between staggered slabs was obviously larger than other columns. The plastic hinges were successively observed at slab-column junctions on the first and second floor and bottom of columns. Finally, the plastic hinges at slab-column junctions lost their capacity, followed by plastic hinges at the bottom of columns, and the test specimen collapsed. The failure process of the staggered slab-column structure exhibited undesirable brittle failure mode. Based on the experimental results, several design suggestions were proposed to improve the overall seismic behavior of the staggered slab-column structure. Such comprehensive research helps enhance understanding of this newly developed type of structure.

High-performance and intelligent fibers are indispensable parts of wearable electronics in the future. This work mainly demonstrates the preparation of flexible intelligent liquid metal (LM) fibers with three core-sheath structures. An ultra-thin (10-50 μm), conductive, and highly flexible LM was deposited on the fiber core [carbon/polyethylene terephthalate (C/PET)--150-500 μm] along the fiber direction and then deposited on a polymer-protective layer [polyvinyl alcohol/epoxy resin (PVA/EP)--10 μm]. Four kinds of LM intelligent fibers were manufactured, including the C-LM-PVA fiber, C-LM-EP fiber, PET-LM-PVA fiber, and PET-LM-EP fiber. These LM intelligent fibers (diameter, 150-600 μm) were demonstrated with a high conductivity of 7.839 × 10

This study describes a new strengthening technique that involves the combination of CFRP jackets, CFRP sheets and high- strength grouting material. Three different strengthening alternatives were employed to strengthen three severely damaged RC columns. Based on the experimental results, the failure mode, hysteresis curve, skeleton curve, ductility, energy dissipation ability, stiffness degradation and strength degradation of both the original and strengthened test specimens were compared and discussed. All three strengthened test specimens exhibited similar damaging processes, yielding of longitudinal reinforcement, cracks on CFRP jackets, rupture of CFRP sheets and collapse of high-strength grouting material were successively observed in the loading procedure. The results showed that the three strengthened seismic damaged concrete columns all presented a bending failure mode and met the “strong shear, weak bending” design attributes. Compared with the original columns, the ductility and energy dissipation capacity of the three strengthened test specimens were significantly improved, while the capacity and stiffness were not fully restored. Strengthened test specimen Z3-R, which was strengthened by the combination of CFRP jackets, CFRP sheets and high-strength grouting material, showed the best seismic performance among all three strengthened test specimens. A finite element model based on OpenSees was developed and validated by a comparison with experimental results. The effects of the axial compression ratio and thickness of CFRP sheets were also discussed through parametric studies.

Liquid metals (LM) have shown a very broad development prospect over the past decades. This review article focuses on the latest research dedicated to liquid metal materials and their applications in five significant areas: stretchable conductive composite, intelligent sensing electronic skin, catalysis, 3D printing material, and driving machines. The fabrication, specific properties and application of stretchable liquid metal‐polymer composites that can be used as self‐healing materials have been summarized. Liquid metal deposition printing technology, liquid phase 3D printing, suspension 3D printing technology, micro‐contact printing technology, and in vivo 3D printing molding technology have also been reviewed. Furthermore, the application of liquid metal catalyst in aldehyde reaction, photocatalysis, and electrocatalysis have been discussed. We have shown that electricity, magnetism, sound, light and heat could stimulate the movement of liquid metal. Through this comprehensive overview of the latest research, the main practical application, development, and mechanism of liquid metal were summarized and described. The future development of liquid metal technology was prospected, thus providing a strong basic research support for the further development of LM materials and their applications., The latest research on liquid metal materials and their application to a broad range of fields have been summarized. Particularly, the application of liquid metal materials to stretchable conductive composites, intelligent sensing electronic skin, catalysis, 3D printing materials, and driving machines has been reviewed.

Developing cost-effective, high-efficiency and heterogeneous catalysts is of prime importance for the green synthesis of diethyl carbonate (DEC) from ethyl carbamate (EC) and ethanol. Herein, a series of MgO/γ-Al

This paper aims to investigate the seismic performance of hollow floor interior slab-column connection (HFISC). In this new connection system, several tube fillers are placed in slab to form hollow concrete. Moreover, locally solid zone, shear components, and hidden beam around the connections are installed to improve the bearing capacity and ductility of specimens. Three slab-column connections with different shear components were tested under cyclic loading and every specimen was constructed with parallel tube fillers in the north direction and orthogonal tube fillers in the south direction. The seismic behavior of specimens was evaluated according to the hysteretic response, skeleton curve, ductility, stiffness degradation, and energy dissipation. A finite element model was then developed and validated by a comparison with the experimental results. Based on experimental results and finite element analysis results, the relative effects of the hollow ratio of slab, the ratio of longitudinal reinforcement, the shear area of bent-up steel bars, and the arm length of welding section steel cross bridging were elucidated through parametric studies. This new slab-column connection showed better plastic deformation capacity while the bearing capacity was kept. Specimens with parallel tube fillers showed better seismic behavior than those of specimens with orthogonal tube fillers.

The mechanical properties of concrete and steel are seriously degraded under high temperature, so that reinforced concrete (RC) members after fire may not be able to satisfy the prescribed performance. In this study, 27 full-scale RC beams were carried out shear tests to investigate the shear behaviour after fire. A total of 20 beams were subjected to fire on three sides in accordance with ISO 834 standard fire curve, and the remaining 7 beams (which were not subjected to fire) were employed as a reference. The influences of fire time, stirrup ratio, shear span ratio, longitudinal reinforcement ratio, and preloading (40% loading level) were considered. The experimental results indicated that the shear failure mode of the RC specimens after fire exposure was similar to that of the reference specimens. Both the residual shear load bearing capacity and stiffness of the RC beams decreased after being subjected to fire. The loss of shear bearing capacity increased with the heating time. In addition, the ultimate load bearing capacity of specimens with stirrups subjected to the same fire exposure time decreased with an increasing shear span ratio.

To investigate the shear capacity of indirectly loaded reinforced concrete beams under and after fire exposure, load tests were conducted on eight full-scale specimens exposed to fire testing in a furnace chamber, and the effects of additional transverse reinforcement in the junction region between the primary and secondary beams on the shear capacity, fire resistance, failure modes and deflection were analysed. The results indicate that the slopes of the diagonal cracks in post-fire tested reinforced concrete beams without additional transverse reinforcement were shallower than those of a similar reference beam not exposed to fire, and that the ultimate capacities of reinforced concrete beams with additional transverse reinforcement decreased obviously after fire exposure. However, beams with additional transverse reinforcement exhibited increased fire resistance times and reduced strains in their reinforcement, indicating the benefit of conservatively providing such reinforcement. The findings of this study are expected to provide a reference for the improved fire-resistant design of indirectly loaded beams.

This article presents a staggered and out-of-plane connection between concrete-filled steel tubular column and reinforced concrete beam (SOC-TCB). SOC-TCB is taken from the basement roof joint of Suning center, which is a height of 341.85 m in China. In this joint system, the H-shaped steel brackets are welded with steel tube to transfer shear and moment. Moreover, the reinforcing bars are interrupted by steel tube and lapped with steel bracket. To investigate the seismic behavior of SOC-TCB, four types of SOC-TCBs were tested under reversal cyclic loading. The differences between specimens were staggered height and out-of-plane angle. Seismic performance was evaluated based on hysteretic behavior, failure mode, shear deformation, rotational deformation, and energy dissipation. The results showed that the shear deformation of joints was extremely small and the plastic hinges were formed at reinforced concrete beams. Due to insufficient anchorage length of longitudinal bars, anchoring failure was found in the reinforced concrete beams. However, SOC-TCB showed better seismic behavior as long as sufficient anchorage of longitudinal bars was ensured.

The hydrolysis process and mechanisms of unique as-prepared KCrO2 and K3CrO4 were systematically investigated. The characterization results of XRD, IR and SEM show that the hydrolysis reaction can be realized at a low reaction temperature of 80 °C and a reaction time of 24 h. Moreover, the greyish-green α-CrOOH with a hexagonal plate-like morphology and a large size of 10 μm is formed via the hydrolysis of the single-phase hexagonal KCrO2, while the green sol−gel of amorphous Cr(OH)3 with a lumpy aggregate morphology is generated through the hydrolysis of a cubic K3CrO4. It is a facile and rapid method to synthesize pure-phase chromium oxyhydroxide via the above hydrolysis.

This article proposes a new type of discrete connected precast reinforced concrete diaphragm floor system that consists of precast flat slabs and slab joint connectors. An experimental investigation of discrete connected new-type precast reinforced concrete diaphragm under a vertical distributed static load was conducted, and the effect of slab joint connectors on the load-bearing capacity was evaluated. Then, a finite element analysis of discrete connected new-type precast reinforced concrete diaphragm, precast reinforced concrete floors without slab connectors, and cast-in-situ reinforced concrete floor were performed to understand their working mechanism and determine the differences in load-bearing behavior. The results indicate that the load-bearing capacity and stiffness of discrete connected new-type precast reinforced concrete diaphragm increase considerably as the hairpin and cover plate hybrid slab joint connectors can efficiently connect adjacent precast slabs and enable them to work together under a vertical load by transmitting the shear and moment forces in the orthogonal slab laying direction. The deflection of discrete connected new-type precast reinforced concrete diaphragm in orthogonal slab laying direction is mainly caused by the opening deformation of the slab joint and the rotational deformation of the precast slabs. This flexural deformation feature can provide reference for establishing the bending stiffness analytical model of discrete connected new-type precast reinforced concrete diaphragm in orthogonal slab laying direction, which is vitally important for foundation of the vertical bearing capacity and deformation calculation method. The deflection and crack distribution patterns infer that the discrete connected new-type precast reinforced concrete diaphragm processes the deformation characteristic of two-way slab floor, which can provide a basis for the theoretical analysis of discrete connected new-type precast reinforced concrete diaphragm.

Conventional patterning methods for producing liquid metal (LM) electronic circuits, such as the template method, use chemical etching, which requires long cycle times, high costs, and multiple-step operations. In this study, a novel and reliable laser engraving micro-fabrication technology was introduced, which was used to fabricate personalized patterns of LM electronic circuits. First, by digitizing the pattern, a laser printing technology was used to burn a polyethylene (PE) film, where a polydimethylsiloxane (PDMS) or paper substrate was used to produce grooves. Then, the grooves were filled with LM and the PE film was removed; finally, the metal was packaged with PDMS film. The experimental results showed that the prepared LM could fabricate precise patterned electronic circuits, such as golden serpentine curves and Peano curves. The minimum width and height of the LM circuit were 253 μm and 200 μm, respectively, whereas the printed LM circuit on paper reached a minimum height of 26 μm. This LM flexible circuit could also be adapted to various sensor devices and was successfully applied to heart rate detection. Laser engraving micro-processing technologies could be used to customize various high-resolution LM circuit patterns in a short time, and have broad prospects in the manufacture of flexible electronic equipment.

In this work, iron-based metal organic frameworks (Fe-MOF) are used as a self-sacrifice beacon to produce Prussian blue (PB). Then, a dual-mode electrochemical-colorimetric biosensing platform for kanamycin (KAN) detection is established considering the prominent redox activity and blue color of PB. CoFe

Room-temperature liquid metal is a very ideal material for the design of catalytic materials. At low temperatures, the liquid metal enters the liquid state. It provides an opportunity to utilize the liquid phase in the catalysis, which is far superior to the traditional solid-phase catalyst. Aiming at the low performance and narrow application scope of the existing single-phase liquid metal catalyst, this paper proposed a type of liquid metal/metal oxide core-shell composite multi-metal catalyst. The Ga2O3 core-shell heterostructure was formed by chemical modification of liquid metals with different nano metals Cu/W/Mo/Ni, and it was applied to photocatalytic degrading organic contaminated raw liquor. The effects of different metal species on the rate of catalytic degradation were explored. The selectivity and stability of the LM/MO core-shell composite catalytic material were clarified, and it was found that the Ni-LM catalyst could degrade methylene blue and Congo red by 92% and 79%, respectively. The catalytic mechanism and charge transfer mechanism were revealed by combining the optical band gap value. Finally, we provided a theoretical basis for the further development of liquid metal photocatalytic materials in the field of new energy environments.

Background The objective of this study was to characterize hospitalized coronavirus disease 2019 (COVID-19) patients and describe their real-world treatment patterns and outcomes over time. Methods Adult patients hospitalized on May 1, 2020–December 31, 2020 with a discharge diagnosis of COVID-19 were identified from the Premier Healthcare Database. Patient and hospital characteristics, treatments, baseline severity based on oxygen support, length of stay (LOS), intensive care unit (ICU) utilization, and mortality were examined. Results The study included 295657 patients (847 hospitals), with median age of 66 (interquartile range, 54–77) years. Among each set of demographic comparators, the majority were male, white, and over 65. Approximately 85% had no supplemental oxygen charges (NSOc) or low-flow oxygen (LFO) at baseline, whereas 75% received no more than NSOc or LFO as maximal oxygen support at any time during hospitalization. Remdesivir (RDV) and corticosteroid treatment utilization increased over time. By December, 50% were receiving RDV and 80% were receiving corticosteroids. A higher proportion initiated COVID-19 treatments within 2 days of hospitalization in December versus May (RDV, 87% vs 40%; corticosteroids, 93% vs 62%; convalescent plasma, 68% vs 26%). There was a shift toward initiating RDV in patients on NSOc or LFO (68.0% [May] vs 83.1% [December]). Median LOS decreased over time. Overall mortality was 13.5% and it was highest for severe patients (invasive mechanical ventilation/extracorporeal membrane oxygenation [IMV/ECMO], 53.7%; high-flow oxygen/noninvasive ventilation [HFO/NIV], 32.2%; LFO, 11.7%; NSOc, 7.3%). The ICU use decreased, whereas mortality decreased for NSOc and LFO. Conclusions Clinical management of COVID-19 is rapidly evolving. This large observational study found that use of evidence-based treatments increased from May to December 2020, whereas improvement in outcomes occurred over this time-period.

To compare the characteristics of choroidal transmission in punctate inner choroidopathy (PIC) with or without choroidal neovascularization (CNV) and myopic CNV (mCNV) using spectral domain optical coherence tomography (SD-OCT). This retrospective observational case series includes 22 consecutive myopic patients (22 eyes) recruited from April 2016 until April 2018 who complained of acute blurring of vision and showed evidence of hyper-reflective material on SD-OCT imaging. Each patient underwent a comprehensive eye examination and imaging with fundus fluorescein angiography (FFA), SD-OCT, and SD-OCT angiography (SD-OCTA). Based on the results of SD-OCTA imaging and the color fundus imaging, the patients were divided into 2 groups: a group with myopic choroidal neovascularization (mCNV group, n = 10 eyes) and a group with PIC and no evidence of CNV at baseline (PIC group, n = 12 eyes). Four eyes diagnosed with PIC developed secondary PIC-CNV during follow-up. The characteristics of choroidal transmission in these eyes using SD-OCT imaging were compared. At baseline, none of the PIC lesions showed any evidence of blood flow within the lesions on OCTA imaging. However, all of the eyes with mCNV showed flow signals within the subretinal neovascularization on SD-OCTA and subretinal or intra-retinal fluid on SD-OCT imaging. These eyes with mCNV showed subretinal hyper-reflectivity associated with choroidal hypo-transmission accompanied by retinal pigment epithelium (RPE) and ellipsoid zone (EZ) disruption. In eyes with PIC inflammatory lesions, disruption of both the RPE and EZ were observed in 33% of the inflammatory lesions, and disruption of the EZ alone was observed in 67% of the lesions at the baseline. They all showed a hyper-reflective subretinal lesion located above RPE. Three cases (25%) showed evidence of choroidal hyper-transmission at the baseline, while the remaining had normal transmission within the first month after onset. Hyper-transmission then developed in all the lesions as the disease progressed. Four cases of PIC (33%) developed PIC-related CNV that showed choroidal hypo-transmission along with hyper-transmission with disruption of the RPE and EZ. In cases with PIC-related CNV, evidences of neovascularization on SD-OCTA imaging were all detected afterwards. No intra-retinal fluid was detected before secondary CNV occurred. SD-OCT imaging can noninvasively differentiate and track the progression of inflammatory lesions and myopic CNV by using the presence of choroidal hyper-transmission as a sign of just an inflammatory lesion and the presence hypo-transmission as a sign of a secondary CNV, which provides a convenient strategy for diagnosis and treatment of these lesions.

This paper reports the results of a seismic performance study of a precast shear wall with a new horizontal connection. The new connection is the rabbet-unbonded horizontal connection, which is composed of rabbets and unbonded rebar segments. The rabbets are used to improve the shear capacity and prevent slippage of the connection, and the unbonded rebar segments are used to improve the ductility and energy dissipation. Three specimens were tested with different parameters under cyclic quasi-static loading. The test results showed that the specimen with a larger unbonded level had a richer hysteresis curve, larger ductility, larger energy dissipation, and slightly smaller bearing capacity. Moreover, in relation to the stiffness degradation, in the initial stage, the specimen with a larger unbonded level had a smaller stiffness, whereas in the last stage, the stiffnesses were similar regardless of the unbonded level. A parameter analysis using a finite element model proved that the ductility and energy dissipation of a shear wall with the rabbet-unbonded horizontal connection increased with the unbonded length and level. In addition, when the axial compression ratio increased, the bearing capacity increased, but the load–displacement curves decreased more rapidly. It was concluded that the unbonded length and unbonded level could effectively improve the ductility and energy dissipation of a shear wall. However, they should not be too large under high pressure, and the design suggestions for the new connection need further research considering other factors.

IN BRIEF Chronic conditions such as diabetes are largely managed by primary care providers (PCPs), with significant patient self-management. This article describes the development, pilot testing, and fine-tuning of a Web-based digital health solution to help PCPs manage patients with cardiometabolic diseases during routine office encounters. It shows that such products can be successfully integrated into primary care settings when they address important unmet needs and are developed with input from end-users.

Effective seismic properties are a basic requirement in precast shear wall applications. Therefore, this study focuses on the evaluation and improvement of precast shear wall seismic properties using the new pore-forming grouted connector with welded closure confinement steels (NPGCS) developed in previous research. The NPGCS connector reliability was verified and the seismic properties of the NPGCS spatial structure model were evaluated by carrying out a low cyclic reversed lateral loads experimental test on the NPGCS precast shear wall spatial structure model containing superposed connecting beams and precast shear walls, which were selected from a practical high-rise precast residential building. According to the testing results of the crack distribution and component failure modes, the superposed connecting beam properties were weak, and damaged early in the shear failure mode, while the precast shear walls cracked after the steel bars in the superposed connecting beams yielded. Furthermore, the failure mode indicated that the NPGCS connection applied in this spatial model is reliable, while two new weak sections were proven to exist at the connector ends. Together with the precast joint interface slip, the dowel shear action is demonstrated to be harmful to the joint interface properties. Additional seismic parameters, namely capacity, ductility, stiffness and energy consumption, were used to complete the evaluation of the seismic properties of the NPGCS spatial structure model. Overall, although the NPGCS spatial model ductility is low, the strengths are high, leading to continued effective energy consumption properties, which indicates favourable seismic properties of the NPGCS spatial structural model.

Background Remdesivir (RDV) improved clinical outcomes among hospitalized patients with coronavirus disease 2019 (COVID-19) in randomized trials, but data from clinical practice are limited. Methods We examined survival outcomes for US patients hospitalized with COVID-19 between August and November 2020 and treated with RDV within 2 days of hospitalization vs those not receiving RDV during their hospitalization using the Premier Healthcare Database. Preferential within-hospital propensity score matching with replacement was used. Additionally, patients were also matched on baseline oxygenation level (no supplemental oxygen charges [NSO], low-flow oxygen [LFO], high-flow oxygen/noninvasive ventilation [HFO/NIV], and invasive mechanical ventilation/extracorporeal membrane oxygenation [IMV/ECMO]) and 2-month admission window and excluded if discharged within 3 days of admission (to exclude anticipated discharges/transfers within 72 hours, consistent with the Adaptive COVID-19 Treatment Trial [ACTT-1] study). Cox proportional hazards models were used to assess time to 14-/28-day mortality overall and for patients on NSO, LFO, HFO/NIV, and IMV/ECMO. Results A total of 28855 RDV patients were matched to 16687 unique non-RDV patients. Overall, 10.6% and 15.4% RDV patients died within 14 and 28 days, respectively, compared with 15.4% and 19.1% non-RDV patients. Overall, RDV was associated with a reduction in mortality at 14 days (hazard ratio [95% confidence interval]: 0.76 [0.70–0.83]) and 28 days (0.89 [0.82–0.96]). This mortality benefit was also seen for NSO, LFO, and IMV/ECMO at 14 days (NSO: 0.69 [0.57–0.83], LFO: 0.68 [0.80–0.77], IMV/ECMO: 0.70 [0.58–0.84]) and 28 days (NSO: 0.80 [0.68–0.94], LFO: 0.77 [0.68–0.86], IMV/ECMO: 0.81 [0.69–0.94]). Additionally, HFO/NIV RDV group had a lower risk of mortality at 14 days (0.81 [0.70–0.93]) but no statistical significance at 28 days. Conclusions RDV initiated upon hospital admission was associated with improved survival among patients with COVID-19. Our findings complement ACTT-1 and support RDV as a foundational treatment for hospitalized COVID-19 patients.

Background Remdesivir (RDV) reduced time to recovery and mortality in some subgroups of hospitalized patients in the NIAID ACTT-1 RCT compared to placebo. Comparative effectiveness data in clinical practice are limited. Methods Using the Premier Healthcare Database, we compared survival for adult non-mechanically ventilated hospitalized COVID-19 patients between Aug-Nov 2020 and treated with RDV within 2 days of hospitalization vs. those who did not receive RDV. Preferential within-hospital propensity score matching with replacement was used. Patients were matched on baseline O2 and 2-month admission period and were excluded if discharged within 3 days of RDV initiation (to exclude anticipated discharges/transfers within 72 hrs consistent with ACTT-1 study). Time to 14- and 28-day mortality was examined separately for patients on high-flow/non-invasive ventilation (NIV), low-flow, and no supplemental O2 using Cox Proportional Hazards models. Results RDV patients (n=27,559) were matched to unique non-RDV patients (n=15,617) (Fig 1). The two groups were balanced; median age 66 yrs and 73% white (RDV); 68 yrs and 74% white (non-RDV), and 55% male. At baseline, 21% required high-flow O2, 50% low-flow O2, and 29% no O2, overall. Mortality in RDV patients was 9.6% and 13.8% on days 14 and 28, respectively. For non-RDV patients, mortality was 14.0% and 17.3% on days 14 and 28, respectively. Kaplan-Meier curves for time to mortality are shown in Fig 2. After adjusting for baseline and clinical covariates, RDV patients on no O2 and low-flow O2 had a significantly lower risk of death within 14 days (no O2, HR: 0.69, 95% CI: 0.57—0.83; low-flow, HR: 0.67, 95% CI: 0.59—0.77) and 28 days (no O2, HR: 0.80, 95% CI: 0.68—0.94; low-flow, HR: 0.76, 95% CI: 0.68—0.86). Additionally, RDV patients on high-flow O2/NIV had a significantly lower risk of death within 14 days (HR: 0.81, 95% CI: 0.70—0.93); but not at 28 days (Fig 3). Fig 1. Study Population Fig 2. Kaplan-Meier curves among matched patients hospitalized for COVID-19, August-November 2020 Fig 3. Cox proportional hazard model* for time to mortality among matched patients hospitalized for COVID-19, August-November 2020 Conclusion In this large study of patients in clinical care hospitalized with COVID-19, we observed a significant reduction of mortality in RDV vs. non-RDV treated patients in those on no O2 or low-flow O2. Mortality reduction was also seen in patients on high-flow O2 at day 14, but not day 28. These data support the use of RDV early in the course of COVID-19 in hospitalized patients. Disclosures Essy Mozaffari, PharmD, MPH, MBA, Gilead Sciences (Employee, Shareholder) Aastha Chandak, PhD, Gilead Sciences (Other Financial or Material Support, Employee of Certara (contracted by Gilead to conduct this study)) Zhiji Zhang, MS, Gilead Sciences (Other Financial or Material Support, Employee of Certara (contracted by Gilead to conduct this study)) Shuting Liang, MPH, Gilead Sciences (Employee) Mark Thrun, MD, Gilead Sciences (Employee, Shareholder) Robert L. Gottlieb, MD, Eli Lilly (Scientific Research Study Investigator, Advisor or Review Panel member)Gilead Sciences (Scientific Research Study Investigator, Advisor or Review Panel member, Other Financial or Material Support, Gift in kind to Baylor Scott and White Research Institute for NCT03383419)GSK (Advisor or Review Panel member)Johnson and Johnson (Scientific Research Study Investigator)Kinevant (Scientific Research Study Investigator)Roche/Genentech (Scientific Research Study Investigator) Daniel R. Kuritzkes, MD, Abpro (Consultant)Atea (Consultant, Scientific Research Study Investigator)Decoy (Consultant)Gilead Sciences (Consultant, Grant/Research Support)GSK (Consultant)Janssen (Consultant)Merck (Consultant, Grant/Research Support)Novartis (Scientific Research Study Investigator)Rigel (Consultant)ViiV (Consultant, Grant/Research Support) Paul Sax, MD, Gilead Sciences (Consultant, Grant/Research Support)Janssen (Consultant)Merck (Consultant, Research Grant or Support)ViiV (Consultant, Research Grant or Support) David Wohl, MD, Gilead Sciences (Consultant, Grant/Research Support, Advisor or Review Panel member)Janssen (Consultant, Advisor or Review Panel member)Merck (Consultant, Grant/Research Support, Advisor or Review Panel member)ViiV (Consultant, Grant/Research Support, Advisor or Review Panel member) Roman Casciano, M.Eng, Gilead Sciences (Other Financial or Material Support, Employee of Certara (contracted by Gilead to conduct this study)) Paul Hodgkins, PhD, MSc, Gilead Sciences (Employee, Shareholder) Richard Haubrich, MD, Gilead Sciences (Employee, Shareholder)

Background To evaluate the effectiveness and safety of modified posterior scleral reinforcement in controlling the progression of myopia in patients with high myopia and provide reference information on surgical treatment for these patients.Methods The study included 32 patients (55 eyes) with high myopia who were treated with modified posterior scleral reinforcement and were followed up at 3 months, 6 months, 1 year and 2 years after the operation.The axial length, refractive error, best corrected visual acuity (BCVA) and fundus colour photographs after the operation were compared with those before the operation, and whether there were any complications was recorded.Results The axial length of the eye increased by 0.07 mm, 0.12 mm, 0.31 mm and 0.19 mm at 3 months, 6 months, 1 year and 2 years after the operation, respectively. The refractive error increased by 0.05 D, 0.28 D, 0.53 D and 0.50 D at 3 months, 6 months, 1 year and 2 years after the operation, respectively, and the differences were not significant (P > 0.05). There were no statistically significant changes in BCVA, but there was an upward trend. No severe complications occurred.Conclusion Modified posterior scleral reinforcement can effectively delay the worsening of the ocular axis and refractive error, without severe complications in the short term.