The outcome and related risk factors of unvaccinated patients with end-stage kidney disease during the Omicron pandemic: a multicentre retrospective study.

OBJECTIVES: The study aims to identify the outcome and the related factors of unvaccinated patients with end-stage kidney disease during the Omicron pandemic. DESIGN: A multicentre retrospective study of patients with end-stage kidney disease undergone maintenance haemodialysis (HD) in China. SETTING: 6 HD centres in China. PARTICIPANTS: A total of 654 HD patients who tested positive for SARS-CoV-2 were ultimately included in the study. OUTCOME MEASURES: The primary outcomes of interest were adverse outcomes, including hospitalisation due to COVID-19 and all-cause mortality. RESULTS: The average age of the patients was 57 years, with 33.6% of them being over 65 years. Among the patients, 57.5% were male. During the follow-up period, 158 patients (24.2%) experienced adverse outcomes, and 93 patients (14.2%) died. The majority of patients (88/158) developed adverse outcomes within 30 days, and most deaths (77/93) occurred within 1 month. An advanced multivariable Cox regression analysis identified that adverse outcomes were associated with various factors while all-cause mortality was related to advanced age, male gender, high levels of C reactive protein (CRP) and low levels of prealbumin. The Kaplan-Meier curves demonstrated significantly higher all-cause mortality rates in the older, male, high CRP and low prealbumin subgroups. CONCLUSIONS: Among unvaccinated HD patients with confirmed Omicron infections, various factors were found to be linked to adverse outcomes. Notably, age, sex, CRP and prealbumin had a substantial impact on the risk of all-cause mortality.

Effects of dietary supplementation with heat-killed Lactobacillus acidophilus on growth performance, digestive enzyme activity, antioxidant capacity, and inflammatory response of juvenile large yellow croaker (Larimichthys crocea).

A ten-week culture trial in juvenile large yellow croaker (Larimichthys crocea) (10.80 ± 0.10 g) was conducted to assess the impact of supplementing heat-killed Lactobacillus acidophilus (HLA) on growth performance, intestinal digestive enzyme activity, antioxidant capacity and inflammatory response. Five iso-nitrogenous (42% crude protein) and iso-lipidic (12% crude lipid) experimental feeds with different levels of HLA (0.0%, 0.1%, 0.2%, 0.4%, or 0.8%) were prepared. They were named FO (control group), HLA0.1, HLA0.2, HLA0.4 and HLA0.8, respectively. The results indicated that HLA addition had no impact on survival (P > 0.05). In this experiment, the final body weight, weight gain rate and specific growth rate showed a quadratic regression trend, initially increasing and subsequently decreasing with the increasing in HLA levels, and attained the peak value at 0.2% HLA supplemental level (P < 0.05). In contrast to the control group, in terms of digestive ability, amylase, lipase and trypsin exhibited a notable linear and quadratic pattern, demonstrating a substantial increase when 0.1%-0.2% HLA was added in the diets (P < 0.05). Notably, elevated levels of catalase (CAT) activity, superoxide dismutase (SOD) activity, and total antioxidant capacity (T-AOC) were observed in the liver when adding 0.1%-0.2% HLA, and the level of malondialdehyde (MDA) was significantly decreased and the liver exhibited a notable upregulation in the mRNA expression levels of nrf2, cat, sod2, and sod3 (P < 0.05). Additionally, the mRNA levels of genes associated with tight junctions in the intestines (zo-1, zo-2 and occludin) exhibited a significant upregulation when 0.2% HLA was added in the feed (P < 0.05). Furthermore, the levels of mRNA expression for proinflammatory genes in the intestines including tnf-α, il-1ß, il-6 and il-8 exhibited a quadratic regression trend, characterized by an initial decline followed by subsequent growth (P < 0.05). Meanwhile, the levels of mRNA expression for genes linked to anti-inflammatory responses in the intestines (including il-10, tgf-ß, and arg1) exhibited a quadratic regression pattern, initially increasing and subsequently decreasing (P < 0.05). Compare with the control group, the levels of tnf-α, il-1ß and il-8 expression were notably downregulated in all HLA addition groups (P < 0.05). When 0.2% HLA was added, the expression levels of il-10, tgf-ß and arg1 in the intestinal tract were markedly increased (P < 0.05). Overall, the supplementation of 0.2% HLA in the feed has been shown to enhance the growth performance. The enhancement was attributed to HLA's capacity to improve antioxidant function, intestinal barrier integrity, and mitigate inflammatory responses. This research offers a scientific foundation for the utilization of HLA in aquaculture.

High-efficient subwavelength structure engineered grating couplers for 2-µm waveband high-speed data transmission.

The 2-µm waveband is becoming an emerging window for next-generation high-speed optical communication. To enable on-chip high-speed data transmission, improving the signal-to-noise ratio (SNR) by suppressing the coupling loss of a silicon chip is critical. Here, we report grating couplers for TE and TM polarized light at the 2-µm waveband. With a single-step fully etched process on the 340 nm silicon-on-insulator (SOI) platform, the devices experimentally demonstrate high coupling efficiency of -4.0 dB and 1-dB bandwidth of 70 nm for the TE polarized light, while -4.5 dB coupling efficiency and 58 nm 1-dB bandwidth for the TM polarized light. For comprehensive performance, both of them are among the best grating couplers operating in the 2-µm waveband so far. We also demonstrate 81Gbps high-speed on-chip data transmission using pulse amplitude modulation 8-level (PAM-8) signals.

Effectiveness of vaccination in reducing hospitalization and mortality rates in dialysis patients with Omicron infection in China: A single-center study.

The impact of vaccination on the outcomes of dialysis patients with Omicron infections in China remains unknown. This study aimed to examine the relationship between vaccination and hospitalization as well as all-cause mortality. We included patients who had undergone maintenance hemodialysis (HD) for at least three months at our center. The follow-up period spanned from December 2022 to February 2023. We assessed the connections between vaccination and hospitalization as well as all-cause mortality using univariable and multivariable logistic regression models. Receiver operating characteristic (ROC) curves were used to assess the diagnostic accuracy for hospitalization and all-cause mortality. Ultimately, a total of 427 HD patients with confirmed SARS-CoV-2 infections were included. The patients had a mean age of 54 years, and 59.4% of them were male. Prior to the investigation, 108 patients had received vaccinations, with 81 of them having completed or received booster vaccinations. Throughout the follow-up period, 81 patients were admitted to the hospital, and 39 patients died. Multivariable logistic regression revealed that vaccination significantly decreased all-cause mortality (OR 0.25, 95% CI 0.07-1.94, P = .04). Moreover, completed or booster vaccinations were effective in reducing the hospitalization rate (OR 0.41, 95%CI 0.17-0.99, P = .047). It is noteworthy that both unvaccinated and vaccinated individuals experienced mild symptoms, and the hospitalization rates were relatively low in both groups. Despite the reduced pathogenicity of Omicron compared to previous strains in dialysis patients, both vaccinated and unvaccinated, vaccination still provides benefits for improving the prognosis.

Visit-to-visit ultrafiltration volume variability predicts all-cause mortality in patients receiving hemodialysis.

PURPOSE: Little is known about the effect of visit-to-visit ultrafiltration volume (UV) variability on the outcome. In this study, we investigated the association between visit-to-visit UV variability and all-cause mortality in patients receiving hemodialysis (HD). METHODS: We consecutively enrolled patients who received maintenance HD in our center from March 2015 to March 2021. UV variability was defined using standard deviation (UVSD) and coefficient of variation (UVCV) (standard deviation divided by the mean). The relationship between UV variability and all-cause mortality was assessed using univariate and multivariate Cox proportional hazard regression models. Receiver operating characteristic curves were used to evaluate the predictive abilities of UVSD and UVCV for short-term and long-term survival rates. RESULTS: A total of 283 HD patients were included. The mean age was 57.54 years, and 53% were males. Follow-up was done for a median of 3.38 years (IQR 1.83-4.78). During the follow-up period, 73 patients died. Cox proportional hazards models indicated that UVSD and UVCV (higher versus lower) were positively associated with all-cause mortality (p=.003 and p<.001, respectively), while in multivariable-adjusted models, only higher UVCV remained significantly associated with all-cause mortality in patients receiving HD (HR 2.55 (95% CI 1.397-4.654), p=.002). Moreover, subgroup analyses showed that the predictive performance of UVCV was more accurate among older patients, males and patients with comorbidities. CONCLUSIONS: Visit-to-visit UV variability, especially UVCV, is a helpful indicator for predicting all-cause mortality in patients receiving HD, especially for older patients, males and those with comorbidities.

Subwavelength structure engineered passband filter for the 2-µm wave band.

In this work, we experimentally demonstrate a passband filter for the 2-µm wave band on the silicon-on-insulator platform. The device consists of a strip waveguide and an apodized subwavelength-structured waveguide. Fabricated on a 340-nm-thick silicon membrane, the proposed passband filter shows a 3-dB bandwidth of 16-33 nm, a high sidelobe suppression ratio (SLSR) of 24 dB, and a low insertion loss (IL) of 0.4 dB.

The Impact Resistance and Mechanical Properties of Recycled Aggregate Concrete with Hooked-End and Crimped Steel Fiber.

The utilization of recycled coarse aggregate (RCA) from construction and demolition waste (CDW) is a sustainable solution to protect the fragile natural environment and save the diminishing natural resources. The current study was aimed at exploring the impact resistance and mechanical properties of recycled aggregate concrete (RAC) affected by hooked-end steel fiber (HF) and crimped steel fiber (CF). Fifteen concrete mixtures considering different RCA substitution ratio, steel fiber dosage, and steel fiber shapes were designed. Meanwhile, a statistical analysis method-based Weibull distribution was introduced to evaluate the variations of impact test results, presented using a reliability function. Lastly, the microstructural morphologies of interfacial transition zones at the cement paste/aggregate and cement paste/fiber interfaces were observed using a scanning electron microscope (SEM). The experimental results showed that the impact resistance and mechanical properties mildly decreased with the increase in substitution ratio of RCA, whereas they conclusively increased with the increase in steel fiber content. Steel fiber recycled aggregate concrete (SFRAC) with 1.5% steel fiber content had the best impact resistance, and its initial cracking times and final failure times were 3.25-4.75 and 8.78-29.08 times those of plain RAC, respectively. HF has better impact resistance than CF. The SEM observations of microstructures indicated that the hardened cement paste of natural aggregate concrete (NAC) was more compact than that of RAC. Steel fiber had a better connection with the cement paste interface than that of aggregate and cement paste owing to better thermal conductivity. This research could be a guide for SFRAC as a structural material in practical engineering, steering the construction industry toward the circular economy.

[Progress in mechanism of formation of neutrophil extracellular traps: Review].

Neutrophils play their roles via phagocytosis, degranulation and producing reactive oxygen species(ROS). Moreover, a new reaction mechanism of neutrophils producing neutrophil extracellular traps (NETs) has been reported. NETs take part in the innate immune responses. The formation of NETs is called NETosis, which belongs to programmed cell death. NETs could be formed in response to neutrophils activation by a series of processes, including ROS production, neutrophil elastase (NE) and myeloperoxidase (MPO) transportation to nucleus, histones modification, chromatin decoagulation, and membrane breakage. This process is called NADPH-dependent NETosis. In addition, peptidyl arginine deiminase 4 (PAD4) is needed for NADPH-independent NETosis. Furthermore, NETs can also be rapidly formed. Herein, we mainly reviewed the mechanism of NETosis.

[Chronic effects of low-dose hydrochlorothiazide in patients with mild to moderate essential hypertension].

OBJECTIVE: To investigate the chronic efficacy of low-dose hydrochlorothiazide (HCTZ) in patients with mild-to-moderate hypertension. METHODS: After a 2-weeks placebo run-in period, 232 patients with mild or moderate hypertension were recruited and received HCTZ (12.5 mg once daily) therapy for one year. Patient compliance and blood pressure were monitored and serum BUN, Cr, glucose, electrolytes, and lipids were measured before, 6 weeks and 1 year after treatment. RESULTS: (1) Reduction of SBP, DBP and MAP were more significantly at 1 year [(10.45 +/- 17.28) mm Hg, (8.45 +/- 11.06) mm Hg, (9.12 +/- 10.88) mm Hg] than that at 6 weeks post therapy [(6.01 +/- 16.05) mm Hg, (2.90 +/- 10.33) mm Hg, (3.94 +/- 10.68) mm Hg, all P < 0.05]. Blood pressure were reduced to normal in 35.1% patients at 1 year and in 20.3% patients at 6 weeks (P < 0.05). (2) No patient developed diabetes mellitus or hypokalemia during therapy while the serum uric acid at 1 year post therapy was significantly higher than that at before therapy (P < 0.05). CONCLUSION: The study indicates that low dose HCTZ is an effective and safe antihypertensive agent for patients with mild-to-moderate hypertension and uric acid changes during therapy need to be monitored.