We aim to evaluate the evolution differences in the incidence and case fatality rate (CFR) of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Delta and Omicron variants. The average ...incidence and CFRs were described between different countries. A gamma generalized linear mixed model (GLMM) was used to compare the CFRs of Delta and Omicron variants based on vaccination coverage. Totally, 50 countries were included for analyses. The incidence of coronavirus disease 2019 (COVID‐19) ranged from 0.16/100,000 to 82.95/100,000 during the Delta period and 0.03/100,000 to 440.88/100,000 during the Omicron period. The median CFRs were 8.56 (interquartile range IQR: 4.76–18.39) during the Delta period and 3.04 (IQR: 1.87–7.48) during the Omicron period, respectively. A total of 47 out of 50 countries showed decreased CFRs of the Omicron variant with the rate ratio ranging from 0.02 (95% confidence interval CI: 0.01–0.03) (in Cambodia) to 0.97 (95% CI: 0.87–1.08) (in Ireland). Gamma GLMM analysis showed that the decreased CFR was largely a result of the decreased pathogenicity of Omicron besides the increased vaccination coverage. The Omicron variant shows a higher incidence but a lower CFR around the world as a whole, which is mainly a result of the decreased pathogenicity by SARS‐CoV‐2's mutation, while the vaccination against SARS‐CoV‐2 still acts as a valuable measure in preventing people from death.
Cisplatin is the first and most widely used platinum-based chemotherapy drug and is the cornerstone agent in treating a broad spectrum of cancers. However, its clinical application is often limited ...by severe toxic side effects and drug resistance. Based on the discovered dissociative electron transfer mechanism of cisplatin, a novel combination of cisplatin with 9-(2-carboxyphenyl)-6-diethylamino-3-xanthenylidene-diethylammonium chloride (basic violet 10, BV10) is proposed to potentiate the chemotherapeutic effect of cisplatin. Here, we show that this combination enhances the anti-cancer effect of cisplatin in both in vitro cell lines and in vivo xenograft mouse models of cisplatin-sensitive and -resistant lung, ovarian and cervical cancers while introducing minimal additional toxic side effects. Furthermore, femtosecond time-resolved laser spectroscopic measurements demonstrate that cisplatin reacts with BV10 via an electron transfer mechanism. These results indicate that the combination of cisplatin with BV10 is promising for improving the chemotherapy of cancers with various extents of cisplatin resistance.
A copper‐catalyzed regio‐reversed asymmetric 3+2 cycloaddition of iminoesters with nitroolefins is disclosed for the first time. This method enables the facile synthesis of polysubstituted chiral ...pyrrolidines bearing at least one chiral quaternary center in high yields with excellent regio‐, diastereo‐, and enantioselectivity. The application of chiral P,S ligands and the unique effect of α‐aryl groups on the iminoesters are key to the success of this method. The practicality and versatility of the reaction are also demonstrated.
A copper‐catalyzed regio‐reversed asymmetric 3+2 cycloaddition of iminoesters with nitroolefins is reported. This method enables the facile synthesis of polysubstituted chiral pyrrolidines bearing at least one chiral quaternary center in high yields with excellent regio‐, diastereo‐, and enantioselectivity. The application of chiral P,S ligands and the unique effect of α‐aryl groups on the iminoesters are key to the success of this method.
Vaccination against coronavirus disease 2019 (COVID-19) has become an important public health solution. To date, there has been a lack of data on COVID-19 vaccination willingness, vaccine hesitancy, ...and vaccination coverage in China since the vaccine has become available.
We designed and implemented a cross-sectional, population-based online survey to evaluate the willingness, hesitancy, and coverage of the COVID-19 vaccine among the Chinese population. 8742 valid samples were recruited and classified as the vaccine-priority group (n = 3902; 44.6%) and the non-priority group (n = 4840; 55.4%).
The proportion of people’s trust in the vaccine, delivery system, and government were 69.0%, 78.0% and 81.3%, respectively. 67.1% of the participants were reportedly willing to accept the COVID-19 vaccination, while 9.0% refused it. 834 (35.5%) reported vaccine hesitancy, including acceptors with doubts (48.8%), refusers (39.4%), and delayers (11.8%). The current coverage was 34.4%, far from reaching the requirements of herd immunity. The predicted rate of COVID-19 vaccination was 64.9%, 68.9% and 81.1% based on the rates of vaccine hesitancy, willingness, and refusal, respectively.
The COVID-19 vaccine rate is far from reaching the requirements of herd immunity, which will require more flexible and comprehensive efforts to improve the population’s confidence and willingness to vaccinate. It should be highlighted that vaccination alone is insufficient to stop the pandemic; further efforts are needed not only to increase vaccination coverage but also to maintain non-specific prevention strategies.
This paper reveals a large and all-season ozone hole in the lower stratosphere over the tropics (30°N–30°S) existing since the 1980s, where an O3 hole is defined as an area of O3 loss larger than 25% ...compared with the undisturbed atmosphere. The depth of this tropical O3 hole is comparable to that of the well-known springtime Antarctic O3 hole, whereas its area is about seven times that of the latter. Similar to the Antarctic O3 hole, approximately 80% of the normal O3 value is depleted at the center of the tropical O3 hole. The results strongly indicate that both Antarctic and tropical O3 holes must arise from an identical physical mechanism, for which the cosmic-ray-driven electron reaction model shows good agreement with observations. The whole-year large tropical O3 hole could cause a great global concern as it can lead to increases in ground-level ultraviolet radiation and affect 50% of the Earth’s surface area, which is home to approximately 50% of the world’s population. Moreover, the presence of the tropical and polar O3 holes is equivalent to the formation of three “temperature holes” observed in the stratosphere. These findings will have significances in understanding planetary physics, ozone depletion, climate change, and human health.
Hepatitis B virus (HBV) infection has been declared an ongoing health threat, especially infections among children. We compared and updated the disease burden of HBV infection and the effectiveness ...of vaccination among children younger than 5 years to offer indications for hepatitis B prevention across the world. The country‐level data on the prevalence of hepatitis B surface antigen (HBsAg), the coverages of hepatitis B vaccine birth‐dose (HepB‐BD), three‐dose series (HepB3), income level, population density/size, and human development index were collected from open access databases including WHO, UNICEF, and World Bank. Comparison of the prevalence of HBsAg under 5 years old between 2015 and 2019 based on vaccination coverages was conducted by the gamma generalized linear mixed model. Globally, more than 6.3 million HBV infections were estimated in children under 5 years in 2019, compared to 10.1 million in 2015 within the 179 countries involved. The pooled average prevalence of HBsAg among children younger than 5 years decreased from 1.4% (95% confidence interval CI: 1.1–1.8) to 0.9% (95% CI: 0.7–1.2). The rate difference or rate ratio was −0.5% (95% CI: −0.6% to −0.3%) or 0.51(95% CI: 0.44–0.58), respectively. Countries from the African region or with lower income/population density/human development indexes bore the most significant disease burden of hepatitis B. Higher coverages of hepatitis B vaccine birth‐dose or primary series correlated with significant HBsAg prevalence decreases and much‐decreased ratio, independently. Hepatitis B prevention among children under 5 years has significantly been achieved while remaining the most life‐threatening disease burden, unequally distributed worldwide. The hepatitis B vaccination should be prioritized for all newborns, especially in those resource‐constrained countries or regions.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with an increasing case number and extensive geographical expansion, raising concerns locally and globally; ...however, the description of its clinical features needs to be addressed by large studies. We aimed to determine all the clinical features of SFTS in a large population of patients in an endemic area.
In this prospective observational study, data were collected on patients admitted to the People's Liberation Army Hospital in Xinyang, Henan Province, China, with laboratory-diagnosed SFTS. Demographic, clinical, laboratory, and treatment data were collected for each patient, and patients were followed up within 2 weeks after discharge or discontinuation of treatment. The association between each demographic, clinical, and laboratory variable with a fatal outcome was assessed. A clinical scoring model was designed for the early prediction of a fatal outcome, and the effect of treatment on outcome was analysed.
Between April 1, 2011, and Oct 31, 2017, 2096 patients with laboratory-confirmed SFTS were admitted. Mean age at admission was 61·4 years (SD 12·2) and 1239 (59%) patients were female. The case fatality rate (CFR) was 16·2% (95% CI 14·6–17·8). A higher risk was associated with being male (unadjusted odds ratio OR 1·45, 95% CI 1·15–1·83; p=0·002), older age (for a 10-year increase, unadjusted OR 1·82, 95% CI 1·62–2·04; p<0·0001), longer delay in admission (for every extra day taken before admission to hospital, unadjusted OR 1·18, 1·12–1·24; p<0·0001), presence of diarrhoea (adjusted OR 1·44, 1·12–1·87; p=0·005) or dyspnoea (adjusted OR 8·35, 5·97–11·69; p<0·0001), and development of haemorrhagic signs (adjusted OR 2·79, 95% CI 2·18–3·57; p<0·0001) or neurological symptoms (adjusted OR 30·26, 21·39–42·81; p<0·0001). Laboratory variables that were associated with death included abnormal concentrations of lactate dehydrogenase, aspartate aminotransferase, and blood urea nitrogen, and abnormal neutrophil percentage, which together with age and neurological symptoms were combined in the clinical scoring system. A total score of more than 8 was the optimal threshold to predict risk of death for patients who were evaluated within 6 days after symptom onset (area under the curve 0·879, 95% CI 0·855–0·902). For all participants, viraemia was a strong predictor of fatal outcome (all p<0·0001). Ribavirin therapy was effective in reducing CFR from 6·25% (15 of 240 participants) to 1·16% (two of 173 participants), but only in patients with a viral load below 1×106 copies per mL (hazard ratio 9·72, 95% CI 1·30–72·87; p=0·027).
The changing epidemiological features and high CFR of SFTS underscore the necessity of continued surveillance. Early prediction of fatal outcome can be attained by monitoring of clinical and laboratory data. Ribavirin should be applied early, with best results achieved before the viral load reaches 1 × 106 copies per mL.
National Natural Science Foundation of China.
...the added value for providing the tenofovir disoproxil fumarate prophylaxis before the 28th week of pregnancy until at least birth to prevent MTCT of HBV as it is recommended by WHO is not clear ...and might cause overtreatment.7 Third, this study used a single-arm approach to explore the effect of the study regimen on MTCT in a HBIg-free strategy, so we do not know the difference before and after the implementation of this algorithm, as well as between HBIg and HBIg-free strategy. ...it was not distinguishable whether the effect on MTCT after birth was caused by the HepB-BD vaccine or tenofovir disoproxil fumarate. ...this study is useful as evidence for those responsible for the formulation of policy regarding MTCT of HBV in LMICs.
There is long research interest in electron-induced reactions of halogenated molecules. It has been two decades since the cosmic-ray (CR) driven electron-induced reaction (CRE) mechanism for the ...ozone hole formation was proposed. The derived CRE equation with the stratospheric equivalent chlorine level and CR intensity as the only two variables has well reproduced the observed data of stratospheric O3 and temperatures over the past 40 years. The CRE predictions of 11-year cyclic variations of the Antarctic O3 hole and associated stratospheric cooling have also been well confirmed. Measured altitude profiles of the ozone and temperatures in Antarctic ozone holes provide convincing fingerprints of the CRE mechanism. A quantitative estimate indicates that the CRE-produced Cl atoms could completely deplete or even overkill the ozone in the CR-peak polar stratospheric region, consistent with the observed altitude profiles of the severest Antarctic ozone holes. After removing the natural CR effect, the hidden recovery in the Antarctic O3 hole since ∼1995 is clearly discovered, while the recovery of O3 loss at mid-latitudes is being delayed by ≥10 years. These results have provided strong evidence of the CRE mechanism. If the CR intensity keeps the current rising trend, the Antarctic O3 hole will return to the 1980 level by ∼2060, while the returning of the O3 layer at mid-latitudes to the 1980 level will largely be delayed or will not even occur by the end of this century. The results strongly indicate that the CRE mechanism must be considered as a key factor in evaluating the O3 hole.
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