PLA2G12A protects against diet-induced obesity and insulin resistance by enhancing energy expenditure and clearance of circulating triglycerides.

Secreted phospholipase A2s are involved in the development of obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease, which have become serious and growing health concerns worldwide. Integration of genome-wide association study and gene co-expression networks analysis showed that the secreted phospholipase A2 group XIIA (PLA2G12A) may participate in hepatic lipids metabolism. Nevertheless, the role of PLA2G12A in lipid metabolism and its potential mechanism remain elusive. Here, we used AAV9 vector carrying human PLA2G12A gene to exogenously express hPLA2G12A in the liver of mice. We demonstrated that the overexpression of hPLA2G12A resulted in a significant decrease in serum lipid levels in wild-type mice fed with chow diet or high-fat diet (HFD). Moreover, hPLA2G12A treatment protected against diet-induced obesity and insulin resistance in mice fed a HFD. Notably, we found that hPLA2G12A treatment confers protection against obesity and hyperlipidemia independent of its enzymatic activity, but rather by increasing physical activity and energy expenditure. Furthermore, we demonstrated that hPLA2G12A treatment induced upregulation of ApoC2 and Cd36 and downregulation of Angptl8, which contributed to the increase in clearance of circulating triglycerides and hepatic uptake of fatty acids without affecting hepatic de novo lipogenesis, very low-density lipoprotein secretion, or intestinal lipid absorption. Our study highlights the potential of PLA2G12A gene therapy as a promising approach for treating obesity, insulin resistance and T2DM.

Bone age assessment based on three-dimensional ultrasound and artificial intelligence compared with paediatrician-read radiographic bone age: protocol for a prospective, diagnostic accuracy study.

INTRODUCTION: Radiographic bone age (BA) assessment is widely used to evaluate children's growth disorders and predict their future height. Moreover, children are more sensitive and vulnerable to X-ray radiation exposure than adults. The purpose of this study is to develop a new, safer, radiation-free BA assessment method for children by using three-dimensional ultrasound (3D-US) and artificial intelligence (AI), and to test the diagnostic accuracy and reliability of this method. METHODS AND ANALYSIS: This is a prospective, observational study. All participants will be recruited through Paediatric Growth and Development Clinic. All participants will receive left hand 3D-US and X-ray examination at the Shanghai Sixth People's Hospital on the same day, all images will be recorded. These image related data will be collected and randomly divided into training set (80% of all) and test set (20% of all). The training set will be used to establish a cascade network of 3D-US skeletal image segmentation and BA prediction model to achieve end-to-end prediction of image to BA. The test set will be used to evaluate the accuracy of AI BA model of 3D-US. We have developed a new ultrasonic scanning device, which can be proposed to automatic 3D-US scanning of hands. AI algorithms, such as convolutional neural network, will be used to identify and segment the skeletal structures in the hand 3D-US images. We will achieve automatic segmentation of hand skeletal 3D-US images, establish BA prediction model of 3D-US, and test the accuracy of the prediction model. ETHICS AND DISSEMINATION: The Ethics Committee of Shanghai Sixth People's Hospital approved this study. The approval number is 2022-019. A written informed consent will be obtained from their parent or guardian of each participant. Final results will be published in peer-reviewed journals and presented at national and international conferences. TRIAL REGISTRATION NUMBER: ChiCTR2200057236.

Assessment of chemotherapy resistance changes in human colorectal cancer xenografts in rats based on MRI histogram features.

Purpose: We investigated the value of magnetic resonance imaging (MRI) histogram features, a non-invasive method, in assessing the changes in chemoresistance of colorectal cancer xenografts in rats. Methods: A total of 50 tumor-bearing mice with colorectal cancer were randomly divided into two groups: control group and 5-fluorouracil (5-FU) group. The MRI histogram characteristics and the expression levels of p53 protein and MRP1 were obtained at 24 h, 48 h, 72 h, 120 h, and 168 h after treatment. Results: Sixty highly repeatable MRI histogram features were obtained. There were 16 MRI histogram parameters and MRP1 resistance protein differences between groups. At 24 h after treatment, the MRI histogram texture parameters of T2-weighted imaging (T2WI) images (10%, 90%, median, energy, and RootMeanSquared) and D images (10% and Range) were positively correlated with MRP1 (r = 0.925, p = 0.005). At 48 h after treatment, histogram texture parameters of apparent diffusion coefficient (ADC) images (Energy) were positively correlated with the presence of MRP1 resistance protein (r = 0.900, p = 0.037). There was no statistically significant difference between MRI histogram features and p53 protein expression level. Conclusions: MRI histogram texture parameters based on T2WI, D, and ADC maps can help to predict the change of 5-FU resistance in colorectal cancer in the early stage and provide important reference significance for clinical treatment.

The global burden of lower respiratory infections attributable to respiratory syncytial virus in 204 countries and territories, 1990-2019: findings from the Global Burden of Disease Study 2019.

AIMS: The purpose of this study is to investigate the global epidemiological characteristics of lower respiratory infections (LRI) burden attributable to respiratory syncytial virus (RSV) from 1990 to 2019. MATERIALS AND METHODS: We used the recent Global Burden of Disease Study (GBD) 2019 to systematically evaluate the current burden and temporal trend of LRI burden attributable to RSV by global, age, sex, geographic location, and socio-economic status. RESULTS: Globally, the disability-adjusted life years (DALYs) cases of LRI attributable to RSV dropped from an estimated 39,964,488 [95% uncertainty interval (UI): 16,825, 572 to 68,800,553] in 1990 to 14,956,514 (95%UI: 6,271,751 to 25,910,753) in 2019 and estimated death cases droped from 541,172 (95%UI:226,614 to 958,596) to 338,495 (95%UI:126,555 to 667,109) from1990 to 2019. Similarly, age-standardized DALYs rate of LRI attributable to RSV decreased from an estimated 646.2 (95%UI: 276.9 to 1121.5) in 1990 to 218.3 (95%UI:92.1 to 376.8) in 2019 and estimated age-standardized deaths rate decreased from 10.3 (95%UI:4.1 to 18.5) to 4.8 (95%UI:1.8 to 9.3) between 1990 and 2019. In 2019, the highest age-standardized DALYs and death rates of LRI attributable to RSV were seen in the lower SDI regions, children and old people. From 1990 to 2019, age-standardized DALYs and death rates of LRI attributable to RSV decreased with increasing SDI. CONCLUSIONS: In this study, we found that the LRI burden attributable to RSV decreased significantly from 1990 to 2019. However, the lower SDI regions, children and old people urgently require cost-effective interventions to prevent and reduce the LRI burden attributable to RSV.

Gender Differences in Migrant Workers Health in China.

Objectives: This study aimed to explore the distribution and differences in the health status of migrant workers in China by gender and age. In addition, it investigated the causes of health inequalities among them. Methods: This paper analyzes the differences in health status across age groups for migrant workers of different genders based on the data from the China Migrant Dynamic Survey in 2018. It also empirically assesses how education level and health insurance impact gender-related health inequalities. Results: The results suggest that female migrant workers in China have significantly lower health levels than males. Furthermore, these differences in health are exacerbated with age. This disparity may be attributed to lower participation in social insurance participation and less educational attainment among female migrant workers than their male counterparts. Conclusion: The government should take effective practical measures to increase the social insurance participation rate of female migrant workers. Moreover, investing in female education to reduce health inequality among migrant workers is essential.

How does trade policy uncertainty affect China's economy and energy?

Facing increasing trade policy uncertainty, deeply understanding the impacts of trade policy shocks on the economy and energy is of vital realistic importance for China to respond to these shocks, strengthen economic resilience, and promote high-quality development. This study develops an integrating input-output model with economy and energy, and evaluates the extreme effects of trade policy uncertainty on the macro-economy, industry development, and energy consumption in China, based on bottom-line thinking. The results are shown as follows. Firstly, under extreme scenarios, trade restriction policies would harm China's economy with a maximum GDP decline of 5.65%. However, China's countermeasures against trade restrictions could reduce economic losses by an average of 2.07%. Secondly, the industries would be hit by trade policy uncertainty in varying degrees. Trade policy uncertainty would strike the textile and apparel industry, machinery industry and other manufacturing 7.64% greater than other industries on average. Thirdly, under extreme scenarios, trade restriction policies would decrease China's energy consumption with a maximum drop of 6.91%; China's countermeasures against this could raise energy consumption by an average of 2.46%. Fourth, the fossil energy consumption reduced by trade policy uncertainty would be 3.95% more than the non-fossil energy consumption on average.

Helicobacter pylori Infection Combined with OLGA and OLGIM Staging Systems for Risk Assessment of Gastric Cancer: A Retrospective Study in Eastern China.

Purpose: Helicobacter pylori (H. pylori) infection is a high-risk factor for gastric cancer (GC). The main aim of this study was to evaluate the effect of H. pylori on gastritis staging systems and the value of H. pylori combined with gastritis staging systems in predicting GC risk. Patients and Methods: This study enrolled 609 patients with gastric atrophy (GA) and 527 patients with gastric intestinal metaplasia (GIM), who were graded by the OLGA and OLGIM staging systems, respectively. Each individual underwent serum pepsinogen (PG) test, H. pylori detection and questionnaire investigation. We did a real-world retrospective follow-up survey for them in April 2022. Results: Compared with H. pylori-negative patients, H. pylori-positive patients had higher serum PGs/gastrin-17 (G-17) levels and lower PGR levels, regardless of OLGA/OLGIM stages I-II or III-IV. Furthermore, eight patients with atrophic gastritis who progressed to GC were previously in OLGA stages III-IV and OLGIM stages II-IV. The average duration of this process was 2.19±1.03 years. Logistic regression analysis indicated that PGI and H. pylori infection were independent risk factors of individuals with OLGA stages III-IV. Age and PGR were independent risk factors of patients with OLGIM stages III-IV. PGI and PGR had good clinical diagnostic values for OLGA stages III-IV and OLGIM stages III-IV, respectively. Conclusion: Patients with OLGA/OLGIM stages III-IV should undergo endoscopic surveillance regardless of H. pylori infection. H. pylori-positive patients with OLGIM stage II also have a high risk of GC. H. pylori combined with PGI and PGR is helpful to evaluate the severity of chronic gastritis.

Assessment of the status quo of social responsibility performance of inclusive kindergartens: Evidence from China.

China is determined to accomplish universal preschool education by asking the kindergartens to participate in social responsibility programs. This study intends to assess the level of participation of inclusive kindergartens in social responsibility programs. This study uses the Delphi expert method, integrated ISO26000 International Standard Guidelines for Social Responsibility, CSR (Corporate Social Responsibility) Scale, and the characteristics of the preschool education industry to construct a social responsibility evaluation model for inclusive kindergartens. It includes five dimensions (responsibility management, customer responsibility, employee responsibility, social service, and organizational responsibility) to show the social responsibility status of kindergartens. Data was collected from 832 respondents from 27 provinces, cities, and regions in China. This study reveals that the overall performance of social responsibility of inclusive kindergarten (3.67) is better, while organization responsibility (3.91) shows the highest performance. In comparison, customer (3.63) and staff responsibility (3.63) deliver average performance, and responsibility management (3.56) offers lower performance. The statistical analysis shows that the nature of kindergartens, whether inclusive or not, the number of classes, years of establishment, the distribution area, and performance are different. Kindergartens should have certain social values, including specific behaviors and participating in social activities in the spirit of social service. They should ensure preschool teacher's professional and vocational development through multiple subjects' synergetic governance. In addition to fulfilling the teachers' social responsibility and professional development, the findings can put forward the cooperation with the government, social organizations, and kindergartens to improve teachers' professional quality and social responsibility.

Assessment of multiple subjects' synergetic governance in vocational education.

Synergetic governance is a practical approach to ensure quality in the teaching-learning process at multi-dimensional perspectives. This study intends to explore the potential of a synergetic governance approach in the vocational education system. A systematic literature review has been done by applying the PRISMA approach. The last 21 years' literature has been analyzed, and a synergetic governance model has been developed. This study reveals that the synergetic governance of education deals with integrating all available resources to enhance development by meeting the demands of market, society, and nation as a new paradigm. An effective vocational education system requires the participation of all related stakeholders in the governance system. This study has developed an "intervention-approach-synergy-integration" mechanism to show how the education elements are connected to each other. The study reveals that the major synergetic elements are openness, equilibrium, dynamism and cooperation. To ensure synergetic governance, these elements should be integrated with an educational institution, market, public, society, state and private organization. It argues that the synergetic governance of these related components can reduce the demand and supply gap of quality vocational graduates in the industry - academy sectors. This study recommends incorporating multi-subjects' synergetic governance to expedite the marketable quality of vocational education.

Depression in systemic lupus erythematosus: Modifiable or inheritable? a two-sample mendelian randomization study.

Observational studies have found increased incidence of depression, the leading cause of disability worldwide, in patients with systemic lupus erythematosus (SLE). However, it is not clear whether the association was genetically inheritable or caused by modifiable risk factors, such as socioeconomic factors. We investigated the causal relationship between genetically predicted SLE and depression by two-sample Mendelian randomization analysis. Single nucleotide polymorphisms (SNPs) associated with SLE were selected as instrumental variables (IVs) from a genome-wide association study (GWAS) of 14,267 European-ancestry participants. A large GWAS of depression (180,866 European-ancestry participants) and another GWAS of major depressive disorder (MDD) (173,005 European-ancestry participants) were selected as outcomes. Then we estimated the effects of IVs on the odds of depression or MDD by using the inverse-variance weighted (IVW) meta-analysis method (random-effects), which had a power of 90% to detect 4% increase of depression in SLE. Interestingly, genetically predicted SLE decreased the odds of depression [odds ratio (OR): 0.995; 95% CI: 0.990-0.999; p = 0.025] and MDD [odds ratio (OR): 0.985; 95% CI: 0.975-0.996; p = 0.009], indicating increased depression in SLE was not due to inheritable risk factors.

Deep Learning-Based Automatic Detection of ASPECTS in Acute Ischemic Stroke: Improving Stroke Assessment on CT Scans.

(1) Background: The Alberta Stroke Program Early CT Score (ASPECTS) is a standardized scoring tool used to evaluate the severity of acute ischemic stroke (AIS) on non-contrast CT (NCCT). Our aim in this study was to automate ASPECTS. (2) Methods: We utilized a total of 258 patient images with suspected AIS symptoms. Expert ASPECTS readings on NCCT were used as ground truths. A deep learning-based automatic detection (DLAD) algorithm was developed for automated ASPECTS scoring based on 168 training patient images using a convolutional neural network (CNN) architecture. An additional 90 testing patient images were used to evaluate the performance of the DLAD algorithm, which was then compared with ASPECTS readings on NCCT as performed by physicians. (3) Results: The sensitivity, specificity, and accuracy of DLAD for the prediction of ASPECTS were 65%, 82%, and 80%, respectively. These results demonstrate that the DLAD algorithm was not inferior to radiologist-read ASPECTS on NCCT. With the assistance of DLAD, the individual sensitivity of the ER physician, neurologist, and radiologist improved. (4) Conclusion: The proposed DLAD algorithm exhibits a reasonable ability for ASPECTS scoring on NCCT images in patients presenting with AIS symptoms. The DLAD algorithm could be a valuable tool to improve and accelerate the decision-making process of front-line physicians.

Hybrid Adjusting Variables-Dependent Event-Based Finite-Time State Estimation for Two-Time-Scale Markov Jump Complex Networks.

This article investigates the problem of dynamic event-triggered finite-time H∞ state estimation for a class of discrete-time nonlinear two-time-scale Markov jump complex networks. A hybrid adjusting variables-dependent dynamic event-triggered mechanism (DETM) is proposed to regulate the releases of measurement outputs of a node to a remote state estimator. Such a DETM contains both an additive dynamically adjusting variable (DAV) and a multiplicative adaptively adjusting variable. The aim is to design a DETM-based mode-dependent state estimator, which guarantees that the resultant error dynamics is stochastically finite-time bounded with H∞ performance. By constructing a mode-dependent Lyapunov function with multiple DAVs and a singular perturbation parameter associated with time scales, a matrix-inequalities-based sufficient condition is derived, the feasible solutions of which facilitate the design of the parameters of the state estimator. The validity of the designed state estimator and the superiority of the devised DETM are verified by two examples. It is verified that the devised DETM is capable of saving network resources and simultaneously improving the estimation performance.

Assessment of Preschool's Inclusive Participation in Social Responsibility Program Under Institutional Pressure: Evidence From China.

China set the goal of expanding early childhood education (ECE) in 2018, by encouraging the development of public interest kindergartens (PIK) to provide high-quality, low-cost preschool services to the general public. This is in response to the challenges of accessibility, affordability, and accountability besetting China's current ECE system. However, the transition toward PIK has been slow due to various complex problems, including the lackluster willingness of ECE providers to become PIK. To better understand the challenges leading to low participation, this study explores the external pressures affecting ECE providers and evaluates the external factors that influence their level of social responsibility. A stratified-random sampling questionnaire survey solicited responses from 832 ECE personnel representing 261 kindergartens from across China. Our findings suggest that institutional pressure has a positive effect on social responsibility and inclusive participation. We also found that institution visibility positively regulates the relationship between institutional pressure and social responsibility. At the same time, the level of environmental perception positively governs the relationship between social responsibility and participation willingness. Kindergartens should have certain social values, including assuming certain behaviors and participating in social activities in the spirit of social service and ensure multiple subjects' synergetic governance.

Blockchain and Fog Computing in IoT-Driven Healthcare Services for Smart Cities.

Nowadays, technology has been evolving rapidly. Due to the consequent impact of smart technologies, it becomes a ubiquitous part of life. These technologies have led to the emergence of smart cities that are geographic areas driven by advanced information and communication technologies. In the context of smart cities, IoT, blockchain, and fog computing have been found as the significant drivers of smart initiates. In this recognition, the present study is focused on delineating the impact and potential of blockchain, IoT, and fog computing on healthcare services in the context of smart cities. In pursuit of this objective, the study has conducted a systematic review of literature that is most relevant to the topic of the paper. In order to select the most relevant and credible articles, the researcher has used PRISMA and AMSTAR that have culminated in the 10 most relevant articles for the present study. The findings revealed that IoT, blockchain, and fog computing had become drivers of efficiency in the healthcare services in smart cities. Among the three technologies, IoT has been found to be widely incorporated. However, it is found to be lacking in terms of cost efficiency, data privacy, and interoperability of data. In this recognition, blockchain technology and fog computing have been found to be more relevant to the healthcare sector in smart cities. Blockchain has been presented as a promising technology for ensuring the protection of private data, creating a decentralized database, and improving the interoperability of data while fog computing has been presented as the promising technology for low-cost remote monitoring, reducing latency and increasing efficiency.

Operating Performance Improvement Based on Prediction and Grade Assessment for Sintering Process.

Sintering is the preproduction process of ironmaking, whose products are the basis of ironmaking. How to improve the operating performance of the iron ore sintering process has always been a problem that operators are committed to solve. An operating performance improvement method based on prediction and grade assessment is presented in this article. First, considering the data distribution characteristics of the process, a performance index prediction model based on the Gaussian process regression is built, in which the mutual information analysis method is used to select the inputs of the performance index prediction model. Then, the operating performance grade is assessed by a threshold division method. Next, the operating performance grade guides the control of the burn-through point to improve the operating performance. Finally, experimental verification is performed based on the actual running data. The results show that the proposed method has high prediction accuracy, and it is also significant in improving the operating performance. Therefore, this approach provides an effective solution to predict and improve operating performance.

Usefulness of New Shear Wave Elastography Technique for Noninvasive Assessment of Liver Fibrosis in Patients with Chronic Hepatitis B: A Prospective Multicenter Study.

PURPOSE: To explore the usefulness of liver stiffness measurements (LSMs) by sound touch elastography (STE) and sound touch quantification (STQ) in chronic hepatitis B (CHB) patients for staging fibrosis. METHODS: This prospective multicenter study recruited normal volunteers and CHB patients between May 2018 and October 2019. The volunteers underwent LSM by STE and supersonic shear imaging (SSI) or by STQ and acoustic radiation force impulse imaging (ARFI). CHB patients underwent liver biopsy and LSM by both STE/STQ. The areas under the receiver operating characteristic curves (AUCs) for staging fibrosis were calculated. RESULTS: Overall, 97 volunteers and 524 CHB patients were finally eligible for the study. The successful STE and STQ measurement rates were both 100 % in volunteers and 99.4 % in CHB patients. The intraclass correlation coefficients (ICCs) for the intra-observer stability of STE and STQ (0.94; 0.90) were similar to those of SSI and ARFI (0.95; 0.87), respectively. STE and STQ showed better accuracy than the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) (AUC: 0.87 vs 0.86 vs 0.73 vs 0.77) in staging cirrhosis. However, both STE and STQ were not superior to APRI and FIB-4 in staging significant fibrosis (AUC: 0.76 vs 0.73 vs 0.70 vs 0.71, all P-values > 0.05). CONCLUSION: STE and STQ are convenient techniques with a reliable LSM value. They have a similar diagnostic performance and are superior to serum biomarkers in staging cirrhosis in CHB patients.

Copper ions binding regulation for the high-efficiency biodegradation of ciprofloxacin and tetracycline-HCl by low-cost permeabilized-cells.

Cu2+ plays a decisive role for the bio-oxidation in the active center of laccase. In the fermentation-purified process, the loss of Cu2+ reduces the activity and the high cost limits the application of laccase. In this study, a fermentation-permeabilization combined process were developed which based on the regulation of Cu2+ binding time to produce the permeabilized-cells containing laccase, in which Cu2+ can enter the cells freely to greatly improve the laccase activity and reduce the immobilization cost by about 19 times. So, the permeabilized-cells is suitable for biodegradation of antibiotic pollution in the environment, which was applied for the biodegradation of ciprofloxacin (CIP) and tetracycline-HCl (TCH) and the degradation efficiency reached 95.42% and 98.73%, respectively, with low ecotoxicity of the degradation products. Finally, the degradation mechanism was analyzed theoretically by molecular docking. Therefore, this study provided a low-cost, eco-friendly, and widely applicable method for organic pollutants removal.

Assessment of immunotherapy response in intracranial malignancy using semi-automatic segmentation on magnetic resonance images.

Objective: To explore multi-aspect radiologic assessment of immunotherapy response in intracranial malignancies based on a semi-automatic segmentation technique, and to explore volumetric thresholds with good performance according to RECIST 1.1 thresholds. Methods: Patients diagnosed with intracranial malignancies and treated with immunotherapy were included retrospectively. In all MR images, target lesions were measured using a semi-automatic segmentation technique that could intelligently generate visual diagrams including RECIST 1.1, total volume, and max. 3D diameter. The changes in parameters were calculated for each patient after immunotherapy. The ROC curve was used to analyze the sensitivity and specificity of the size change of the legion. This was useful to find new volumetric thresholds with better efficiency in response assessment. The changes in total volume were assessed by conventional volumetric thresholds, while RECIST 1.1 thresholds were for the max. 3D diameter. A chi-square test was used to compare the concordance and diagnostic correlation between the response assessment results of the three criteria. Results: A total of 20 cases (average age, 58 years; range, 23 to 84 years) and 58 follow-up MR examinations after immunotherapy were included in the analysis. The P-value of the chi-square test between RECIST 1.1 and total volume is 0 (P <0.05), same as that in RECIST 1.1 and max. 3D diameter. The kappa value of the former two was 0.775, and the kappa value for the latter two was 0.742. The above results indicate a significant correlation and good concordance for all three criteria. In addition, we also found that the volumetric assessment had the best sensitivity and specificity for the immunotherapy response in intracranial malignancies, with a PR threshold of -64.9% and a PD threshold of 21.4%. Conclusions: Radiologic assessment of immunotherapy response in intracranial malignancy can be performed by multiple criteria based on semi-automatic segmentation technique on MR images, such as total volume, max. 3D diameter and RECIST 1.1. In addition, new volumetric thresholds with good sensitivity and specificity were found by volumetric assessment.

The Impacts of COVID-19 on China's Economy and Energy in the Context of Trade Protectionism.

In the current context of rising trade protectionism, deeply understanding the impacts of COVID-19 on economy and energy has important practical significance for China to cope with external shocks in an uncertain environment and enhance economic resilience. By constructing an integrated economic and energy input-output model including the COVID-19 shock, this paper assesses the impacts of COVID-19 on China's macro-economy and energy consumption in the context of trade protectionism. The results are shown as follows. First, in the context of protectionism, the outbreak of COVID-19 in China would cause a 2.2-3.09% drop in China's GDP and a 1.56-2.48% drop in energy consumption, while adverse spillovers from global spread of COVID-19 would reduce its GDP by 2.27-3.28% and energy consumption by 2.48-3.49%. Second, the negative impacts of domestic outbreak on China's construction, non-metallic mineral products, and services would be on average 1.29% higher than those on other industries, while the impacts of global spread of COVID-19 on export-oriented industries such as textiles and wearing apparel would be on average 1.23% higher than other industries. Third, the effects of two wave of the pandemic on China's fossil energy consumption would be on average 1.44% and 0.93% higher than non-fossil energy consumption, respectively.

Temporal variations in the severity of COVID-19 illness by race and ethnicity.

INTRODUCTION: Early reports highlighted racial/ethnic disparities in the severity of COVID-19 seen across the USA; the extent to which these disparities have persisted over time remains unclear. Our research objective was to understand temporal trends in racial/ethnic variation in severity of COVID-19 illness presenting over time. METHODS: We conducted a retrospective cohort analysis using longitudinal data from Cedars-Sinai Medical Center, a high-volume health system in Southern California. We studied patients admitted to the hospital with COVID-19 illness from 4 March 2020 through 5 December 2020. Our primary outcome was COVID-19 severity of illness among hospitalised patients, assessed by racial/ethnic group status. We defined overall illness severity as an ordinal outcome: hospitalisation but no intensive care unit (ICU) admission; admission to the ICU but no intubation; and intubation or death. RESULTS: A total of 1584 patients with COVID-19 with available demographic and clinical data were included. Hispanic/Latinx compared with non-Hispanic white patients had higher odds of experiencing more severe illness among hospitalised patients (OR 2.28, 95% CI 1.62 to 3.22) and this disparity persisted over time. During the initial 2 months of the pandemic, non-Hispanic blacks were more likely to suffer severe illness than non-Hispanic whites (OR 2.02, 95% CI 1.07 to 3.78); this disparity improved by May, only to return later in the pandemic. CONCLUSION: In our patient sample, the severity of observed COVID-19 illness declined steadily over time, but these clinical improvements were not seen evenly across racial/ethnic groups; greater illness severity continues to be experienced among Hispanic/Latinx patients.