Objective
To describe differences in outcomes between pregnant women with and without coronavirus dsease 2019 (COVID‐19).
Design
Prospective cohort study of pregnant women consecutively admitted for ...delivery, and universally tested via nasopharyngeal (NP) swab for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) using reverse transcription–polymerase chain reaction. All infants of mothers with COVID‐19 underwent SARS‐CoV‐2 testing.
Setting
Three New York City hospitals.
Population
Pregnant women >20 weeks of gestation admitted for delivery.
Methods
Data were stratified by SARS‐CoV‐2 result and symptomatic status, and were summarised using parametric and nonparametric tests.
Main outcome measures
Prevalence and outcomes of maternal COVID‐19, obstetric outcomes, neonatal SARS‐CoV‐2, placental pathology.
Results
Of 675 women admitted for delivery, 10.4% were positive for SARS‐CoV‐2, of whom 78.6% were asymptomatic. We observed differences in sociodemographics and comorbidities among women with symptomatic COVID‐10 versus asymptomatic COVID‐19 versus no COVID‐19. Caesarean delivery rates were 46.7% in symptomatic COVID‐19, 45.5% in asymptomatic COVID‐19 and 30.9% in women without COVID‐19 (P = 0.044). Postpartum complications (fever, hypoxia, readmission) occurred in 12.9% of women with COVID‐19 versus 4.5% of women without COVID‐19 (P < 0.001). No woman required mechanical ventilation, and no maternal deaths occurred. Among 71 infants tested, none were positive for SARS‐CoV‐2. Placental pathology demonstrated increased frequency of fetal vascular malperfusion, indicative of thrombi in fetal vessels, in women with COVID‐19 versus women without COVID‐19 (48.3% versus 11.3%, P < 0.001).
Conclusion
Among pregnant women with COVID‐19 at delivery, we observed increased caesarean delivery rates and increased frequency of maternal complications in the postpartum period. Additionally, intraplacental thrombi may have maternal and fetal implications for COVID‐19 remote from delivery.
Tweetable
COVID‐19 at delivery: more caesarean deliveries, postpartum complications and intraplacental thrombi.
Tweetable
COVID‐19 at delivery: more caesarean deliveries, postpartum complications and intraplacental thrombi.
This article includes Author Insights, a video available at https://vimeo.com/rcog/authorinsights16403
We report dissipative magnon-photon coupling caused by the cavity Lenz effect, where the magnons in a magnet induce a rf current in the cavity, leading to a cavity backaction that impedes the ...magnetization dynamics. This effect is revealed in our experiment as level attraction with a coalescence of hybridized magnon-photon modes, which is distinctly different from level repulsion with mode anticrossing caused by coherent magnon-photon coupling. We develop a method to control the interpolation of coherent and dissipative magnon-photon coupling, and observe a matching condition where the two effects cancel. Our work sheds light on the so-far hidden side of magnon-photon coupling, opening a new avenue for controlling and utilizing light-matter interactions.
Background
The aim of this study was to investigate the prevalence of epidemiologic and physician‐diagnosed pollen‐induced AR (PiAR) in the grasslands of northern China and to study the impact of the ...intensity and time of pollen exposure on PiAR prevalence.
Methods
A multistage, clustered and proportionately stratified random sampling with a field interviewer‐administered survey study was performed together with skin prick tests (SPT) and measurements of the daily pollen count.
Results
A total of 6043 subjects completed the study, with a proportion of 32.4% epidemiologic AR and 18.5% PiAR. The prevalence was higher in males than females (19.6% vs 17.4%, P = .024), but no difference between the two major residential and ethnic groups (Han and Mongolian) was observed. Subjects from urban areas showed higher prevalence of PiAR than rural areas (23.1% vs 14.0%, P < .001). Most PiAR patients were sensitized to two or more pollens (79.4%) with artemisia, chenopodium, and humulus scandens being the most common pollen types, which were similarly found as the top three sensitizing pollen allergens by SPT. There were significant regional differences in the prevalence of epidemiologic AR (from 18.6% to 52.9%) and PiAR (from 10.5% to 31.4%) among the six areas investigated. PiAR symptoms were positively associated with pollen counts, temperature, and precipitation (P < .05), but negatively with wind speed and pressure P < .05).
Conclusion
Pollen‐induced AR (PiAR) prevalence in the investigated region is extremely high due to high seasonal pollen exposure, which was influenced by local environmental and climate conditions.
Abstract
Mid-infrared (mid-IR) observations are powerful in identifying heavily obscured active galactic nuclei (AGN) that have weak emission in other wavelengths. Data from the Mid-Infrared ...Instrument (MIRI) on board the James Webb Space Telescope provides an excellent opportunity to perform such studies. We take advantage of the MIRI imaging data from the Cosmic Evolution Early Release Science Survey to investigate the AGN population in the distant universe. We estimate the source properties of MIRI-selected objects by utilizing spectral energy distribution (SED) modeling, and classify them into star-forming galaxies (SFs), SF-AGN mixed objects, and AGN. The source numbers of these types are 433, 102, and 25, respectively, from four MIRI pointings covering ∼9 arcmin
2
. The sample spans a redshift range of ≈0–5. We derive the median SEDs for all three source types, respectively, and publicly release them. The median MIRI SED of AGN is similar to the typical SEDs of hot dust-obscured galaxies and Seyfert 2s, for which the mid-IR SEDs are dominated by emission from AGN-heated hot dust. Based on our SED-fit results, we estimate the black hole accretion density (BHAD; i.e., total BH growth rate per comoving volume) as a function of redshift. At
z
< 3, the resulting BHAD agrees with the X-ray measurements in general. At
z
> 3, we identify a total of 27 AGN and SF-AGN mixed objects, leading to that our high-
z
BHAD is substantially higher than the X-ray results (∼0.5 dex at
z
≈ 3–5). This difference indicates MIRI can identify a large population of heavily obscured AGN missed by X-ray surveys at high redshifts.
GRB 130427A was extremely bright as a result of occurring at low redshift whilst the energetics were more typical of high-redshift gamma-ray bursts (GRBs). We collected well-sampled light curves at ...1.4 and 4.8 GHz of GRB 130427A with the Westerbork Synthesis Radio Telescope (WSRT); and we obtained its most accurate position with the European Very Long Baseline Interferometry Network (EVN). Our flux density measurements are combined with all the data available at radio, optical and X-ray frequencies to perform broad-band modelling in the framework of a reverse–forward shock model and a two-component jet model, and we discuss the implications and limitations of both models. The low density inferred from the modelling implies that the GRB 130427A progenitor is either a very low metallicity Wolf–Rayet star, or a rapidly rotating, low-metallicity O star. We also find that the fraction of the energy in electrons is evolving over time, and that the fraction of electrons participating in a relativistic power-law energy distribution is less than 15 per cent. We observed intraday variability during the earliest WSRT observations, and the source sizes inferred from our modelling are consistent with this variability being due to interstellar scintillation effects. Finally, we present and discuss our limits on the linear and circular polarization, which are among the deepest limits of GRB radio polarization to date.
Background
Elucidating the mechanism of the macrophage phagocytic response will improve our knowledge of host defence against Treponema pallidum.
Objective
To explore whether autophagy promotes ...T. pallidum phagocytosis and clearance via the NLRP3 inflammasome in macrophages.
Methods
The interactions between autophagy and phagocytosis and the role of NLRP3 in these processes in T. pallidum‐treated macrophages were investigated through experiments using human monocytic cell line (THP‐1)‐derived macrophages. Treponema pallidum clearance after phagocytosis was evaluated by inoculating rabbits with macrophage–treponeme mixtures.
Results
Activation of autophagy and phagocytosis in T. pallidum‐treated macrophages occurred in a dose‐ and time‐dependent manner. The percentage of spirochete‐positive macrophages (22.34% vs. 70.93%, P < 0.001) and spirochete internalization (MFI: 9.62 vs. 20.33, P < 0.001) were notably reduced by silencing Beclin1. Inoculation of macrophage–treponeme mixtures into rabbits showed a 3.00‐day delay in lesion development (17.55 ± 3.73 vs. 14.55 ± 1.99 days) and decreased lesion numbers 11 (36.7%) vs. 20 (66.7%) of 30; χ2 = 5.406, P = 0.020 in the control compared with the si‐Beclin1 group. Furthermore, silencing NLRP3 decreased the mRNA and protein levels of Beclin‐1 and LC3B mRNA: 49.86% and 43.02%; protein: 22.31% and 24.24%, respectively, differing significantly from the control group (P < 0.001) and reduced the percentage of spirochete‐positive macrophages (30.29% vs. 70.53%, P < 0.001) and spirochete internalization (MFI: 9.82 vs. 19.33, P < 0.001).
Conclusion
Treponema pallidum induces autophagy in macrophages to promote phagocytosis and clearance. The NLRP3 inflammasome modulates autophagy and phagocytosis in vitro. These data may be useful for understanding the host–pathogen relationship and establish the groundwork for strategies to combat syphilis.
Linked Commentary: N.H. Brockmeyer. J Eur Acad Dermatol Venereol 2020; 34: 1881. https://doi.org/10.1111/jdv.16837
Background
Allergen exposure chambers (AECs) are clinical facilities allowing for controlled exposure of subjects to allergens in an enclosed environment. AECs have contributed towards characterizing ...the pathophysiology of respiratory allergic diseases and the pharmacological properties of new therapies. In addition, they are complementary to and offer some advantages over traditional multicentre field trials for evaluation of novel therapeutics. To date, AEC studies conducted have been monocentric and have followed protocols unique to each centre. Because there are technical differences among AECs, it may be necessary to define parameters to standardize the AECs so that studies may be extrapolated for driving basic immunological research and for marketing authorization purposes by regulatory authorities.
Methods
For this task force initiative of the European Academy of Allergy and Clinical Immunology (EAACI), experts from academia and regulatory agencies met with chamber operators to list technical, clinical and regulatory unmet needs as well as the prerequisites for clinical validation.
Results
The latter covered the validation process, standardization of challenges and outcomes, intra‐ and interchamber variability and reproducibility, in addition to comparability with field trials and specifics of paediatric trials and regulatory issues.
Conclusion
This EAACI Position Paper aims to harmonize current concepts in AECs and to project unmet needs with the intent to enhance progress towards use of these facilities in determining safety and efficacy of new therapeutics in the future.
A theoretical black carbon (BC) aging model is developed to account for three typical evolution stages, namely, freshly emitted aggregates, BC coated by soluble material, and BC particles undergoing ...further hygroscopic growth. The geometric-optics surface-wave (GOS) approach is employed to compute the BC single-scattering properties at each aging stage, which are subsequently compared with laboratory measurements. Theoretical calculations are consistent with measurements in extinction and absorption cross sections for fresh BC aggregates with different BC sizes (i.e., mobility diameters of 155, 245, and 320 nm), with differences of ≤ 25 %. The measured optical cross sections for BC coated by sulfuric acid and for that undergoing further hygroscopic growth are generally captured (differences < 30 %) by theoretical calculations using a concentric core-shell structure, with an overestimate in extinction and absorption of the smallest BC size and an underestimate in scattering of the largest BC size. We find that the absorption and scattering cross sections of fresh BC aggregates vary by 20–40 and 50–65 %, respectively, due to the use of upper (1.95–0.79i) and lower (1.75–0.63i) bounds of BC refractive index, while the variations are < 20 % in absorption and < 50 % in scattering in the case of coated BC particles. Sensitivity analyses of the BC morphology show that the optical properties of fresh BC aggregates are more sensitive to fractal dimension than primary spherule size. The absorption and scattering cross sections of coated BC particles vary by more than a factor of 2 due to different coating structures. We find an increase of 20–250 % in absorption and a factor of 3–15 in scattering during aging, significantly depending on coating morphology and aging stages. This study suggests that an accurate estimate of BC radiative effects requires the incorporation of a dynamic BC aging process that accounts for realistic coating structures in climate models.
We aimed to characterize kinetics of non-treponamal antibody titres during the natural course of syphilis and explore their roles in monitoring syphilis treatment efficacy.
Sixty New Zealand white ...male rabbits were challenged with Nichols or Amoy Treponema pallidum strains, and the rapid plasma reagin (RPR) test was performed to quantify non-treponemal antibody titres during the infection course. Viable T. pallidum in the challenged rabbits was assessed with rabbit infectivity tests.
The RPR titres of the Nichols or Amoy strain between no benzathine penicillin G (BPG) and BPG treatment subgroups displayed a similar trend: first ascending and then descending. Compared with baseline, the proportions of fourfold decline in RPR titres in the Nichols or Amoy group presented a similar result on days 30, 60 and 180 between the no BPG and BPG treatment subgroups (0%, 0/5; 80%, 4/5; 100%, 5/5; vs. 0%, 0/5; 80%, 4/5; 100%, 5/5; p 0.999; 0%, 0/5; 80%, 4/5; 80%, 4/5; vs. 40%, 2/5; 100%, 5/5; 100%, 5/5; p 0.098, respectively). Compared with the maximum baseline titre, the proportion of fourfold decline in PRR titre also showed a similar result in the two groups on days 30, 60 and 180 between the no BPG and the BPG treatment subgroups (0%, 0/5; 100%, 5/5; 100%, 5/5, vs. 40%, 2/5; 100%, 5/5; 100%, 5/5; p 0.129; 0%, 0/5; 100%, 5/5; 100%, 5/5, vs. 80%, 4/5; 100%, 5/5; 100%, 5/5; p 0.091, respectively. Moreover, regardless of whether the RPR titres presented a fourfold decline, viable T. pallidum could be detected in untreated rabbits' lymph nodes at 30, 60 and 180 days post infection, while viable T. pallidum was not detected in any of the treated rabbits' lymph nodes.
The RPR titre increased and then decreased (even became negative) during the natural course of syphilis, similar to that seen after BPG treatment. The RPR tetre is thus a questionable indicator of syphilis treatment efficacy.
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