Soaring cases of coronavirus disease (COVID-19) are pummeling the global health system. Overwhelmed health facilities have endeavored to mitigate the pandemic, but mortality of COVID-19 continues to ...increase. Here, we present a mortality risk prediction model for COVID-19 (MRPMC) that uses patients' clinical data on admission to stratify patients by mortality risk, which enables prediction of physiological deterioration and death up to 20 days in advance. This ensemble model is built using four machine learning methods including Logistic Regression, Support Vector Machine, Gradient Boosted Decision Tree, and Neural Network. We validate MRPMC in an internal validation cohort and two external validation cohorts, where it achieves an AUC of 0.9621 (95% CI: 0.9464-0.9778), 0.9760 (0.9613-0.9906), and 0.9246 (0.8763-0.9729), respectively. This model enables expeditious and accurate mortality risk stratification of patients with COVID-19, and potentially facilitates more responsive health systems that are conducive to high risk COVID-19 patients.
•Mushrooms nutritional foods and source of compounds with medicinal properties.•We have updated latest date on contents of proximate composition and nutrition value.•Biodiversity of mushrooms make it ...possible to find more species of nutritional value.
In China, many species of edible wild-grown mushrooms are appreciated as food and also found use in traditional Chinese medicine. In this mini-review, for the first time, is summarized and discussed data available on chemical components of nutritional significance for wild-grown mushrooms collected from China. We aimed to update and discuss the latest data published on ash, fat, carbohydrates, fibre, proteins, essential amino acids and nonessential amino acids, some essential (P, K, Na, Ca, Mg, Fe, Mn, Zn, Cu) and toxic elements (As, Hg, Cd, Pb), vitamins (thiamine, riboflavin, niacin, tocopherol, vitamin D), flavour and taste compounds, antioxidants and also on less studied organic compounds (lectin, adustin, ribonuclease and nicotine) contents of wild-grown mushrooms.
Trigonal planar units with large polarizability anisotropy and high physicochemical stability are ideal structural units for exploring nonlinear optical (NLO) materials. Integrating the merits of two ...types of triangular‐like moieties, a family of second‐order NLO‐active hybrid halides, MATX (X = Cl (1), Br (2), and I (3)), are achieved. MATX crystallizes in a nonpolar space group of P6¯$P\overline 6 $2c but exhibits the optimal spatial arrangement and superior NLO performance. The low coordination planar trigonal AgX3 units enable segregation in layers of the three‐winged propeller‐like Me3TPA units. All of the layers are packed in a perfect parallel fashion, making the functional materials exhibit superior NLO performances, including the phase matchable behavior with strong SHG responses (6.2/1, 6.5/2, and 7.6/3 times that of potassium dihydrogen phosphate), large birefringence (0.232/1, 0.252/2 and 0.260/3 at 1064 nm), high laser damage threshold, wide transparent window, and easiness of crystal growth. The first‐principles calculations reveal that the coexistence of strong linear and nonlinear optical properties are ascribed to the synergistic effect of the trigonal moieties. This study points out a useful path for the rational design of excellent NLO materials.
Me3TPAAgX3X (X = Cl, Br or I) exhibits optimal planar alignment of two types of triangular‐like units and superior NLO performances, including the phase matchable behavior with strong second‐harmonic generation response, large birefringence, high LDT, wide band gap, and easiness of crystal growth.
Objective： This review aimed to provide a current recommendation to multidisciplinary physicians for early detection, diagnosis, and treatment of corticosteroid-induced osteonecrosis of the femoral ...head （ONFH） based on a comprehensive analysis of the clinical literature. Data Sources： For the purpose of collecting potentially eligible articles, we searched for articles in the PubMed, Cochrane Library, Embase, and CNKI databases up to February 2017, using the following key words： ＆quot;corticosteroid＆quot;, ＆quot;osteonecrosis of the femoral head＆quot;,＆quot;risk factors＆quot;, ＆quot;diagnosis＆quot;, ＆quot;prognosis＆quot;, and ＆quot;treatment＆quot;. Study Selection： Articles on relationships between corticosteroid and ONFH were selected for this review. Articles on the diagnosis, prognosis, and intervention of earlier-stage ONFH were also reviewed. Results： The incidence of corticosteroid-induced ONFH was associated with high doses of corticosteroids, and underlying diseases in certain predisposed individuals mainly occurred in the first 3 months of corticosteroid prescription. The enhanced awareness and minimized exposure to the established risk factors and earlier definitive diagnosis are essential for the success of joint preservation. When following up patients with ONFH, treatment should be started if necessary. Surgical treatment yielded better results than conservative therapy in earlier-stage ONFH. The ideal purpose of earlier intervention and treatment is permanent preservation of the femoral head without physical restrictions in daily living. Conclusions： Clinicians should enhance their precaution awareness of corticosteroid-induced ONFH. For high-risk patients, regular follow-up is very important in the 1st year after high-dose prescription of corticosteroids. Patients with suspected ONFH should be referred to orthopedists for diagnosis and treatment in its earlier stage to preserve the joint.
Quercetin is a polyphenol with multiple biological activities, and results of our preliminary study showed that it could shorten the immobility time of mice in the forced swimming test and tail ...suspending test. The aim of this study was to investigate its effects on the behavioral performance of lipopolysaccharide (LPS)-challenged rats and explore the potential mechanism. The results showed that intragastrical administration of quercetin (40 mg/kg) could improve the bodyweight gain of LPS-challenged rats, increase the saccharin preference index in the saccharin preference test and the novel arm preference index in the Y-maze, and decrease the immobility time in the FST. However, it showed no significant effect on the performance of LPS-challenged rats in the Morris water maze and the plasma concentrations of nesfatin-1, C-reactive protein (CRP), and IL-6. Results of western blot showed that the expression levels of BDNF, Copine 6, p-TrkB, and the triggering receptors expressed on myeloid cells (TREM) 1 were decreased in both the hippocampus and the prefrontal cortex (PFC) of LPS-challenged rats, while the expression of TREM2 was increased. The protein expression of synapsin-1 was decreased in the hippocampus without significant changes in the PFC. These imbalance protein expressions could be balanced by treatment with quercetin. The results suggested that quercetin could alleviate LPS-induced depression-like behaviors and impairment of learning and memory in rats, the mechanism of which might be involved with regulating the BDNF-related imbalance expression of Copine 6 and TREM1/2 in the hippocampus and the PFC.
Abstract
Stellar white-light flares are believed to play an essential role in the physical and chemical properties of the atmosphere of the surrounding exoplanets. Here we report an optical ...monitoring campaign on the nearby flaring system EI Cnc carried out by the Ground-based Wide Angle Camera (GWAC) and its dedicated follow-up telescope. A superflare, coming from the brighter component EI CncA, was detected and observed, in which four components are required to properly model the complex decay light curve. The lower limit of flare energy in the
R
− band is estimated to be 3.3 × 10
32
erg. A total of 27 flares are additionally detected from the GWAC archive data with a total duration of 290 hr. The inferred cumulative flare frequency distribution follows a quite shallow power-law function with a slope of
β
= − 0.50 ± 0.03 over the energy range between 10
30
and 10
33
erg, which reinforces the trend that stars cooler than M4 show enhanced superflare activity. The flares identified in EI Cnc enable us to extend the
τ
–
E
relationship previously established in the white-light superflares of solar-type stars down to an energy as low as ∼10
30
erg (i.e., by 3 orders):
τ
∝
E
0.42±0.02
, which suggests a common flare mechanism for stars with a type from M to solar-like and implies an invariant of
B
1/3
υ
A
in the white-light flares.
Body composition alterations may participate in the pathophysiological processes of type 2 diabetes (T2D). A sedentary lifestyle may be responsible for alterations of body composition and adverse ...consequences, but on which body composition of patients with T2D and to what extent the sedentary lifestyle has an effect have been poorly investigated.
We recruited 402 patients with T2D for this cross-sectional study. All patients received questionnaires to evaluate sedentary time and were further divided into three subgroups: low sedentary time (LST, < 4 h, n = 109), middle sedentary time (MST, 4-8 h, n = 129) and high sedentary time (HST, > 8 h, n = 164). Each patient underwent a dual energy X-ray absorptiometry (DXA) scan to detect body composition, which included body fat percentage (B-FAT), trunk fat percentage (T-FAT), appendicular skeletal muscle index (ASMI), lumbar spine bone mineral density (BMD) (LS-BMD), femoral neck BMD (FN-BMD), hip BMD (H-BMD) and total BMD (T-BMD). Other relevant clinical data were also collected.
With increasing sedentary time (from the LST to HST group), B-FAT and T-FAT were notably increased, while ASMI, LS-BMD, FN-BMD, H-BMD and T-BMD were decreased (p for trend < 0.01). After adjustment for other relevant clinical factors and with the LST group as the reference, the adjusted mean changes B (95% CI) in B-FAT, T-FAT, ASMI, LS-BMD, FN-BMD, H-BMD and T-BMD in the HST group were 2.011(1.014 to 3.008)%, 1.951(0.705 to 3.197)%, - 0.377(- 0.531 to - 0.223) kg/m
, - 0.083(- 0.124 to - 0.042) g/cm
, - 0.051(- 0.079 to - 0.024) g/cm
, - 0.059(- 0.087 to - 0.031) g/cm
and - 0.060(- 0.088 to - 0.033) g/cm
, p < 0.01, respectively.
A sedentary lifestyle may independently account for increases in trunk and body fat percentage and decreases in appendicular skeletal muscle mass and BMD of the lumbar spine, femoral neck, hip and total body in patients with T2D.
Skin wound therapy aims not only to restore skin protection but also to recover excitation functions through nerve regeneration. During the restoration of skin nerves, the recruitment of endogenous ...stem cells and promotion of neuronal regeneration on site work stepwise are foundations of in situ regeneration. However, current therapeutic systems usually execute each process separately, leading to limited regeneration and recovery of excitation functions. Herein, a novel self‐adaptive all‐in‐one delivery chip (G:P:Al‐Chip) is constructed that combines therapeutic protein release, gene delivery, and electrical conduction in a single microfluidic chip by 3D coaxial printing. G:P:Al‐Chip consists of an outer conductive hydrogel shell anchored with chemokine and an inner microchannel filled with enzyme‐initiated vector/plasmid DNAs microcomplexes. G:P:Al‐Chip delivers chemokine, functional plasmid DNAs, and promotes electrical conduction with a self‐adaptive program that significantly enhances the recruitment of endogenous mesenchymal stem cells and promotes neuronal regeneration. G:P:Al‐Chip is shown to enhance nerve regeneration with excitation functions within 23 days. G:P:Al‐Chip organizes recruitment and neuronal regeneration cues along with bioelectrical signal in one degradable chip for accelerated skin nerve regeneration.
An all‐in‐one delivery chip that combines protein release, gene delivery, and electrical conduction in a single microfluidic chip is developed via 3D coaxial printing. This chip organizes recruitment and neuronal regeneration cues for endogenous mesenchymal stem cells for in situ neuronal regeneration, providing a bottom‐up approach to regenerative biology.
The 2003 International Society of Nephrology/Renal Pathology Society (ISN/RPS) system for classifying patients with lupus nephritis was based on glomerular lesions exclusively, despite the fact that ...lupus nephritis affects all compartments of the kidney. Hence, we analyzed the tubulointerstitial lesions in patients with lupus nephritis within the different classes and subclasses of the 2003 ISN/RPS system. Among 313 patients from five centers in northern China with lupus nephritis, interstitial inflammatory cell infiltration, tubular atrophy, and interstitial fibrosis were severe in 170 patients with class IV, moderate in 55 with class III, and mild in 19 with class II and in 69 with class V disease, each with significance. The severity of tubulointerstitial lesions in classes IV-segmental and III was similar, whereas the score of interstitial inflammatory cell infiltration in patients with subclass IV-global was significantly higher than that in those with subclass IV-segmental. Interstitial fibrosis and tubular atrophy were each significantly more prominent in patients with both active and chronic lesions than in those with active lesions alone. The correlation coefficient ranged from 0.222 to 0.811 comparing glomerular and tubulointerstitial indices. In multivariate Cox hazard analysis of tubulointerstitial lesions, indices of interstitial infiltration, tubular atrophy, and interstitial fibrosis were confirmed as significant independent risk factors for renal outcome. Thus, we found that the 2003 ISN/RPS classification system of lupus nephritis, based on glomerular lesions, could also reflect related tubulointerstitial lesions. Hence, we suggest that the extent of tubulointerstitial lesions may be helpful in predicting renal outcome in patients with lupus nephritis.
The presence of multifocal tumors, developed either from intrahepatic metastasis (IM) or multicentric occurrence (MO), is a distinct feature of hepatocellular carcinoma (HCC). Immunogenomic ...characterization of multifocal HCC is important for understanding immune escape in different lesions and developing immunotherapy.
We combined whole-exome/transcriptome sequencing, multiplex immunostaining, immunopeptidomes, T cell receptor (TCR) sequencing and bioinformatic analyses of 47 tumors from 15 patients with HCC and multifocal lesions.
IM and MO demonstrated distinct clonal architecture, mutational spectrum and genetic susceptibility. The immune microenvironment also displayed spatiotemporal heterogeneity, such as less T cell and more M2 macrophage infiltration in IM and higher expression of inhibitory immune checkpoints in MO. Similar to mutational profiles, shared neoantigens and TCR repertoires among tumors from the same patients were abundant in IM but scarce in MO. Combining neoantigen prediction and immunopeptidomes identified T cell-specific neoepitopes and achieved a high verification rate in vitro. Immunoediting mainly occurred in MO but not IM, due to the relatively low immune infiltration. Loss of heterozygosity of human leukocyte antigen (HLA) alleles, identified in 17% of multifocal HCC, hampered the ability of major histocompatibility complex to present neoantigens, especially in IM. An integrated analysis of Immunoscore, immunoediting, TCR clonality and HLA loss of heterozygosity in each tumor could stratify patients into 2 groups based on whether they have a high or low risk of recurrence (p = 0.038).
Our study comprehensively characterized the genetic structure, neoepitope landscape, T cell profile and immunoediting status that collectively shape tumor evolution and could be used to optimize personalized immunotherapies for multifocal HCC.
Immunogenomic features of multifocal hepatocellular carcinoma (HCC) are important for understanding immune-escape mechanisms and developing more effective immunotherapy. Herein, comprehensive immunogenomic characterization showed that diverse genomic structures within multifocal HCC would leave footprints on the immune landscape. Only a few tumors were under the control of immunosurveillance, while others evaded the immune system through multiple mechanisms that led to poor prognosis. Our study revealed heterogeneous immunogenomic landscapes and immune-constrained tumor evolution, the understanding of which could be used to optimize personalized immunotherapies for multifocal HCC.
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•Immunogenomic discrepancies among multifocal HCC vary within patients and shape tumor evolutionary trajectories.•Immune escape involves HLA alterations, M2 macrophage infiltration, inhibitory ligands and immunoediting.•Immune context imprinted by genetics can exert selective pressures.•Immune evasion correlates with tumor regression and can predict postoperative recurrence.•Personalized immunotherapy strategies should be adopted for multifocal HCC to maximize efficacy.
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