Puerarin Alleviates Experimental Autoimmune Thyroiditis by Regulating Macrophages.

Hashimoto's thyroiditis (HT) is the most common organ-specific autoimmune disease, predominantly affecting women. Although the pathogenesis of HT is incompletely understood, some studies have found that macrophage polarization plays a role. Puerarin is a soy isoflavone compound that has anti-inflammatory and immunomodulatory effects and regulates macrophage immune activity. This study aimed to verify the therapeutic effect of puerarin on HT and explored its regulatory effect on macrophage polarization imbalance in HT. Through bioinformatics analysis and molecular biology methods, it was found that macrophages increased significantly in HT patients and model mice. Immunological staining showed that puerarin intervention could reduce tissue inflammatory cell infiltration. Molecular biological examination displayed that puerarin could inhibit local and systemic inflammation levels, and the expression of marker thyroglobulin and thyroid peroxidase Abs. In vivo experimental results indicated that puerarin regulated macrophage polarity and reduced inflammatory damage, possibly by inhibiting the pyroptosis signaling pathway. In vivo macrophage clearance experiments demonstrated that puerarin relied on macrophages to exert its mechanism of action in treating HT. The results of this study indicate that macrophages are important mediators in the development of HT, and puerarin can regulate macrophage polarity and inflammatory status to provide thyroid tissue protection, which provides a new idea for the treatment of HT.

Distinct compositions and functions of circulating microbial DNA in the peripheral blood compared to fecal microbial DNA in healthy individuals.

The crucial function of circulating microbial DNA (cmDNA) in peripheral blood is gaining recognition because of its importance in normal physiology and immunity in healthy individuals. Evidence suggests that cmDNA in peripheral blood is derived from highly abundant, translocating gut microbes. However, the associations with and differences between cmDNA in peripheral blood and the gut microbiome remain unclear. We collected blood, urine, and fecal samples from volunteers to compare their microbial information via 16S rDNA sequencing. The results revealed that, compared with gut microbial DNA, cmDNA in peripheral blood was associated with reduced diversity and a distinct microbiota composition. The cmDNA in the blood reflects the biochemical processes of microorganisms, including synthesis, energy conversion, degradation, and adaptability, surpassing that of fecal samples. Interestingly, cmDNA in blood showed a limited presence of DNA from anaerobes and gram-positive bacteria, which contrast with the trend observed in fecal samples. Furthermore, analysis of cmDNA revealed traits associated with mobile elements and potential pathologies, among others, which were minimal in stool samples. Notably, cmDNA analysis indicated similarities between the microbial functions and phenotypes in blood and urine samples, although greater diversity was observed in urine samples. Source Tracker analysis suggests that gut microbes might not be the main source of blood cmDNA, or a selective mechanism allows only certain microbial DNA into the bloodstream. In conclusion, our study highlights the composition and potential functions associated with cmDNA in peripheral blood, emphasizing its selective presence; however, further research is required to elucidate the mechanisms involved.IMPORTANCEOur research provides novel insights into the unique characteristics and potential functional implications of circulating microbial DNA (cmDNA) in peripheral blood. Unlike other studies that analyzed sequencing data from fecal or blood microbiota in different study cohorts, our comparative analysis of cmDNA from blood, urine, and fecal samples from the same group of volunteers revealed a distinct blood-specific cmDNA composition. We discovered a decreased diversity of microbial DNA in blood samples compared to fecal samples as well as an increased presence of biochemical processes microbial DNA in blood. Notably, we add to the existing knowledge by documenting a reduced abundance of anaerobes and gram-positive bacteria in blood compared to fecal samples according to the analysis of cmDNA and gut microbial DNA, respectively. This observation suggested that a potential selective barrier or screening mechanism might filter microbial DNA molecules, indicating potential selectivity in the translocation process which contrasts with the traditional view that cmDNA primarily originates from random translocation from the gut and other regions. By highlighting these differences, our findings prompt a reconsideration of the origin and role of cmDNA in blood circulation and suggest that selective processes involving more complex biological mechanisms may be involved.

Puerarin alleviates sleep disorders in aged mice related to repairing intestinal mucosal barrier.

More and more evidence suggests that puerarin, a potential remedy for gut inflammation, may have an ameliorative effect on sleep disturbances. However, the relationship between puerarin and sleep disruption has not been extensively researched. This study aims to explore the role and mechanisms of puerarin in improving sleep disorders. We established a light-induced sleep disorder model in mice and assessed the effects of puerarin on cognitive behavior using open field and water maze tests. Pathological detection demonstrated that sleep disturbances resulted in observable damage to the liver, lung, and kidney. Puerarin reversed multi-organ damage and inflammation. Further, puerarin activated paneth cells, resulting in increased lysozyme and TGF-ß production, and stimulating intestinal stem cell proliferation. Puerarin also effectively inhibited the expression of F4/80, iNOS, TNF-α, and IL-1ß in the small intestine, while it increased Chil3, CD206, and Arg-1 levels. Moreover, puerarin treatment significantly decreased P-P65, TLR4, Bcl-xl, and cleaved caspase-3 protein levels while increasing barrier protein levels, including ZO-1, Occludin, Claudin 1 and E-cadherin suggesting a reduction in inflammation and apoptosis in the gut. Overall, puerarin diminished systemic inflammation, particularly intestinal inflammation, and enhanced intestinal barrier integrity in mice with sleep disorders. Our findings suggest a potential new therapeutic pathway for sleep disorders.

Synthesis and Biological Evaluation of Novel 2-Amino-1,4-Naphthoquinone Amide-Oxime Derivatives as Potent IDO1/STAT3 Dual Inhibitors with Prospective Antitumor Effects.

Indoleamine-2,3-dioxygenase 1 (IDO1) and signal transducer and activator of transcription 3 (STAT3) have emerged as significant targets in the tumor microenvironment for cancer therapy. In this study, we synthesized three novel 2-amino-1,4-naphthoquinone amide-oxime derivatives and identified them as dual inhibitors of IDO1 and STAT3. The representative compound NK3 demonstrated effective binding to IDO1 and exhibited good inhibitory activity (hIDO1 IC50 = 0.06 µM), leading to its selection for further investigation. The direct interactions between compound NK3 and IDO1 and STAT3 proteins were confirmed through surface plasmon resonance analysis. A molecular docking study of compound NK3 revealed key interactions between NK3 and IDO1, with the naphthoquinone-oxime moiety coordinating with the heme iron. In the in vitro anticancer assay, compound NK3 displayed potent antitumor activity against selected cancer cell lines and effectively suppressed nuclear translocation of STAT3. Moreover, in vivo assays conducted on CT26 tumor-bearing Balb/c mice and an athymic HepG2 xenograft model revealed that compound NK3 exhibited potent antitumor activity with low toxicity relative to 1-methyl-L-tryptophan (1-MT) and doxorubicin (DOX). Overall, these findings provided evidence that the dual inhibitors of IDO1 and STAT3 may offer a promising avenue for the development of highly effective drug candidates for cancer therapy.

ASCL2 induces an immune excluded microenvironment by activating cancer-associated fibroblasts in microsatellite stable colorectal cancer.

Proficient mismatch repair or microsatellite stable (pMMR/MSS) colorectal cancers (CRCs) are vastly outnumbered by deficient mismatch repair or microsatellite instability-high (dMMR/MSI-H) tumors and lack a response to immune checkpoint inhibitors (ICIs). In this study, we reported two distinct expression patterns of ASCL2 in pMMR/MSS and dMMR/MSI-H CRCs. ASCL2 is overexpressed in pMMR/MSS CRCs and maintains a stemness phenotype, accompanied by a lower density of tumor-infiltrating lymphocytes (TILs) than those in dMMR/MSI CRCs. In addition, coadministration of anti-PD-L1 antibodies facilitated T cell infiltration and provoked strong antitumor immunity and tumor regression in the MC38/shASCL2 mouse CRC model. Furthermore, overexpression of ASCL2 was associated with increased TGFB levels, which stimulate local Cancer-associated fibroblasts (CAFs) activation, inducing an immune-excluded microenvironment. Consistently, mice with deletion of Ascl2 specifically in the intestine (Villin-Cre+, Ascl2 flox/flox, named Ascl2 CKO) revealed fewer activated CAFs and higher proportions of infiltrating CD8+ T cells; We further intercrossed Ascl2 CKO with ApcMin/+ model suggesting that Ascl2-deficient expression in intestinal represented an immune infiltrating environment associated with a good prognosis. Together, our findings indicated ASCL2 induces an immune excluded microenvironment by activating CAFs through transcriptionally activating TGFB, and targeting ASCL2 combined with ICIs could present a therapeutic opportunity for MSS CRCs.

Three-dimensional stability analysis of tunnel face based on unified strength theory.

The impact of cyclic footage and intermediate principal stress on the stability of the tunnel-face area are analyzed in this study using the theory of limit analysis. The study introduces the unified strength theory and proposes three-dimensional logarithmic spiral failure modes with corresponding velocity fields. The influence of various parameters on the tunnel-face area stability is analyzed, and it is found that when the internal friction angle is less than 30°, the internal friction angle parameters should be improved first to enhance stability, while when the internal friction angle is greater than 30°, cohesion should be prioritized. When using the double shear uniform strength theory in the tunnel-face area, the intermediate principal stress can improve the stability of the tunnel face. Results show that Mohr-Coulomb criterion calculations are conservative in the good surrounding ground, but no similar conclusion has been obtained for the poor surrounding ground, and specific problems must be analyzed during construction.

A burns and COVID-19 shared stress responding gene network deciphers CD1C-CD141- DCs as the key cellular components in septic prognosis.

Differential body responses to various stresses, infectious or noninfectious, govern clinical outcomes ranging from asymptoma to death. However, the common molecular and cellular nature of the stress responsome across different stimuli is not described. In this study, we compared the expression behaviors between burns and COVID-19 infection by choosing the transcriptome of peripheral blood from related patients as the analytic target since the blood cells reflect the systemic landscape of immune status. To this end, we identified an immune co-stimulator (CD86)-centered network, named stress-response core (SRC), which was robustly co-expressed in burns and COVID-19. The enhancement of SRC genes (SRCs) expression indicated favorable prognosis and less severity in both conditions. An independent whole blood single-cell RNA sequencing of COVID-19 patients demonstrated that the monocyte-dendritic cell (Mono-DC) wing was the major cellular source of SRC, among which the higher expression of the SRCs in the monocyte was associated with the asymptomatic COVID-19 patients, while the quantity-restricted and function-defected CD1C-CD141-DCs were recognized as the key signature which linked to bad consequences. Specifically, the proportion of the CD1C-CD141-DCs and their SRCs expression were step-wise reduced along with worse clinic conditions while the subcluster of CD1C-CD141-DCs from the critical COVID-19 patients was characterized of IFN signaling quiescence, high mitochondrial metabolism and immune-communication inactivation. Thus, our study identified an expression-synchronized and function-focused gene network in Mono-DC population whose expression status was prognosis-related and might serve as a new target of diagnosis and therapy.

Learning adaptability facilitates self-regulated learning at school: the chain mediating roles of academic motivation and self-management.

Studies have demonstrated that learning adaptability has emerged as an important factor for students' utilization of self-regulated learning for successful learning, but how this association occurred is not clear yet. This study aimed to clarify the mechanism of the relationship between learning adaptability and self-regulated learning by investigating the chain mediating roles of academic motivation and self-management of 787 junior high school students under the "double reduction" background. The results showed that (1) learning adaptability had significant positive effects on junior high school students' self-regulated learning and (2) academic motivation and self-management played independent and accumulative mediating roles in the relationship between learning adaptability and self-regulated learning. These findings help to understand how to support students in successfully coping with the new challenges brought by educational reform and promote effective adjustment to challenges, including the "double reduction." The key contribution of this study is to provide new insights into the literature that academic motivation and self-management separately and sequentially mediate the learning adaptability, self-regulated learning links, and learning adaptability is effective driver of self-regulated learning in the population of junior high school students.

369Fabrication of 3D gel-printed ß-tricalcium phosphate/titanium dioxide porous scaffolds for cancellous bone tissue engineering.

Human bone is composed of cortical bone and cancellous bone. The interior portion of natural bone is cancellous with a porosity of 50%-90%, but the outer layer is made of dense cortical bone, of which porosity was not higher than 10%. Porous ceramics were expected to be research hotspot in bone tissue engineering by virtue of their similarity to the mineral constituent and physiological structure of human bone. However, it is challenging to utilize conventional manufacturing methods to fabricate porous structures with precise shapes and pore sizes. Three-dimensional (3D) printing of ceramics is currently the latest research trend because it has many advantages in the fabrication of porous scaffolds, which can meet the requirements of cancellous bone strength, arbitrarily complex shapes, and individualized design. In this study, ß-tricalcium phosphate (ß-TCP)/titanium dioxide (TiO2) porous ceramics scaffolds were fabricated by 3D gel-printing sintering for the first time. The chemical constituent, microstructure, and mechanical properties of the 3D-printed scaffolds were characterized. After sintering, a uniform porous structure with appropriate porosity and pore sizes was observed. Besides, biological mineralization activity and biocompatibility were evaluated by in vitro cell assay. The results demonstrated that the incorporation of TiO2 (5 wt%) significantly improved the compressive strength of the scaffolds, with an increase of 283%. Additionally, the in vitro results showed that the ß-TCP/TiO2 scaffold had no toxicity. Meanwhile, the adhesion and proliferation of MC3T3-E1 cells on scaffolds were desirable, revealing that the ß-TCP/TiO2 scaffolds can be used as a promising candidate for repair scaffolding in orthopedics and traumatology.

Discovery of novel sulfonamide chromone-oxime derivatives as potent indoleamine 2,3-dioxygenase 1 inhibitors.

A series of chromone-oxime derivatives containing piperazine sulfonamide moieties were designed, synthesized and evaluated for their inhibitory activities against IDO1. These compounds displayed moderate to good inhibitory activity against IDO1 with IC50 values in low micromolar range. Among them, compound 10m bound effectively to IDO1 with good inhibitory activities (hIDO1 IC50 = 0.64 µM, HeLa IDO1 IC50 = 1.04 µM) and were selected for further investigation. Surface plasmon resonance analysis confirmed the direct interaction between compound 10m and IDO1 protein. Molecular docking study of the most active compound 10m revealed key interactions between 10m and IDO1 in which the chromone-oxime moiety coordinated to the heme iron and formed several hydrogen bonds with the porphyrin ring of heme and ALA264, consistent with the observation by UV-visible spectra that 10m induced a Soret peak shift from 403 to 421 nm. Moreover, compound 10m exhibited no cytotoxicity at its effective concentration in MTT assay. Consistently, in vivo assays results demonstrated that 10m displayed potent antitumor activity with low toxicity in CT26 tumor-bearing Balb/c mice, in comparison with 1-methyl-l-tryptophan (1-MT) and 4-amino-N-(3-chloro-4-fluorophenyl)-N'-hydroxy-1,2,5-oxadiazole-3-carboximidamide (IDO5L). In brief, the results suggested that chromone-oxime derivatives containing sulfonamide moieties might serve as IDO1 inhibitors for the development of new antitumor agents.

Common Driving Forces of Provincial-Level Greenhouse Gas and Air Pollutant Emissions in China.

By developing a filtering framework and a sector-level multi-regional input-output structural decomposition model, this study identifies key common emission sources, motivation sources, and inter-provincial emission flows of both GHGs and air pollutants and reveals the key driving forces of changes in different emissions from 2012 to 2017. Results show that key common emission sources are electricity sector, non-metallic mineral products, and smelting and processing of metals in Shandong and Hebei. However, key common motivation sources are the construction sectors in Guangdong, Henan, Jiangsu, Zhejiang, and Shandong. The key inflow regions include Guangdong and Zhejiang and key outflow regions include Jiangsu and Hebei. The emission reductions are attributed to the emission intensity effect of the construction sector; contrastingly, the emission increase is from the investment scale of the construction sector. Here, Jiangsu could be a key target for future emission reduction because of its high absolute emissions and low past reduction. The scale of investment in construction might be a significant factor in reducing emissions in Shandong and Guangdong. Henan and Zhejiang could concentrate on sound new building planning and resource recycling.

Parent-Adolescent Conflict, Peer Victimization, and Internet Gaming Disorder Among Chinese Adolescents: The Moderating Effect of OXTR Gene rs53576 Polymorphism.

Despite growing evidence that parent-adolescent conflict positively correlates with Internet gaming disorder (IGD) among adolescents, its underlying mediating and moderating mechanisms have yet to be thoroughly examined. Based on the social development model and gene-environment interaction perspective, this study investigates whether the indirect association of parent-adolescent conflict, which impacts adolescent IGD through peer victimization, was moderated by the oxytocin receptor (OXTR) gene rs53576 polymorphism. Overall, 673 Chinese adolescents (Meanage = 12.81 years; SD = 0.48 years; 54% boys) were included in this study. The participants completed questionnaires concerning parent-adolescent conflict, peer victimization, and IGD, and genomic DNA was extracted from each participant's saliva and buccal cells. The findings indicated that peer victimization mediated the link between parent-adolescent conflict and IGD among adolescents. The OXTR gene rs53576 polymorphism also moderated this indirect link. Specifically, the indirect effect of parent-adolescent conflict on adolescent IGD through peer victimization was significant for adolescents with AA homozygotes. However, it was non-significant for adolescents with GA and GG genotypes. This research simultaneously considers the roles of family, peers, and genetics in adolescent IGD. Furthermore, it provides beneficial information to customize interventions for adolescent IGD prevention.

Anti-inflammatory effect of miR-125a-5p on experimental optic neuritis by promoting the differentiation of Treg cells.

Methylprednisolone pulse treatment is currently used for optic neuritis. It can speed visual recovery, but does not improve the ultimate visual outcomes. Recent studies have reported that miR-125a-5p has immunomodulatory effects on autoimmune diseases. However, it remains unclear whether miR-125a-5p has effects on optic neuritis. In this study, we used adeno-associated virus to overexpress or silence miR-125a-5p in mice. We found that silencing miR-125a-5p increased the latency of visual evoked potential and aggravated inflammation of the optic nerve. Overexpression of miR-125a-5p suppressed inflammation of the optic nerve, protected retinal ganglion cells, and increased the percentage of Treg cells. Our findings show that miR-125a-5p exhibits anti-inflammatory effects through promoting the differentiation of Treg cells.

Performance of rural practitioners of endoscopic cleaning and disinfection on the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers / 中华消化内镜杂志

Objective:To evaluate the performance of rural practitioners of endoscopic cleaning and disinfection participating in the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers and to analyze the influencing factors.Methods:The questionnaires for skill assessment were designed based on the skill scheme and clinical practice of the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China, and the App Early diagnosis, Early treatment was used as the examination platform. The practitioners in 539 county hospitals from 25 provinces participating in the program in 2019 were assessed for techniques and skills for endoscopic cleaning and disinfection and the excellence rate was calculated. Multivariate logistic regression model was used to analyze the influencing factors for the examination. Results:A total of 1 671 endoscopic cleaning and disinfection practitioners participated in the assessment with the score of 73.41±16.60. The passing rate was 85.82%, and the excellence rate was 44.94%. Among all questions, the correct rate of "opportunistic screening flow chart" was the highest (98.21%), and that of "the evaluation index for mass screening" was the lowest (57.89%). The multivariate logistic regression analysis showed that the excellence rate was high in practitioners who had a bachelor degree or above ( OR=1.627,95% CI:1.319-2.007, P<0.001), the career for 5 to <15 years (5 to <10 years: OR=1.329,95% CI:1.045-1.689, P=0.020; 10 to <15 years: OR=1.384,95% CI:1.026-1.867, P=0.033), working in eastern and central regions (eastern regions: OR=3.476,95% CI:2.368-5.103, P<0.001;central regions: OR=4.028,95% CI:2.679-6.057, P<0.001) and with full understanding of the screening scheme ( OR=1.547,95% CI:1.246-1.921, P<0.001) . Conclusion:Practitioners on the Early Diagnosis and Treatment Program for Upper Gastrointestinal Cancers in rural China have mastered the basic screening scheme and skills for endoscopic cleaning and disinfection. The education background, duration of the career, area and understanding of screening scheme are influencing factors for the excellence rate of endoscopic cleaning and disinfection.

Thoughts on the course construction of Brain Functional Imaging for postgraduates majoring in biomedical engineering / 中华医学教育探索杂志

Based on the summary and reflection of the existing course construction content, this paper redesigns the course teaching to Brain Functional Imaging and forms a new curriculum construction scheme, including improving the professional teachers' ability of the teaching team by means of "internal training" + "external introduction", building an online and offline integrated teaching mode by combining online teaching resources such as course website with offline teaching (such as literature guidance, classroom discussion, comprehensive experimental design, etc.), and designing comprehensive experiments related to Electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS), which is driven by scientific research projects, based on the scientific research experimental platform of the teaching and research department. This construction scheme is of great significance for improving the teaching quality of the course, stimulating the learning interest of graduate students, and cultivating the comprehensive application and practical innovation ability of graduate students' brain imaging technology. And it also provides the reference for the further construction of the course and teaching reform in the future.

Application of "Flipped Classroom" in comprehensive experiment teaching of Digital Signal Processing for biomedical engineering specialty / 中华医学教育探索杂志

"Flipped Classroom" is a new kind of "student-centered" teaching model, which can give full play to the advantages of both sides of teaching and learning. According to this teaching model, we redesigned the teaching process, in which the students studied by themselves and built their own knowledge system. Moreover, each of them took part in three stages of experimental design including digital signal collection, analysis and processing in groups. Results have shown that this model can fully stimulate students' learning interest, not only helps students to deepen understanding of digital signal processing theory knowledge, but also strengthen the ability of autonomous learning and team collaboration. The teaching model maybe have certain reference function in comprehensive experiment teaching of Digital Signal Processing course for biomedical engineering specialty.

Microfluidic chip and mass spectrometry-based detection of bacterial antimicrobial resistance and study of antimicrobial resistance mechanism / 中国药科大学学报

@#Bacterial antimicrobial resistance (AMR) is a globally serious problem that threatens public health security.Misuse and abuse of antibiotics cannot achieve the effect of treating bacterial infectious diseases, but will trigger the SOS response of bacteria, exacerbating the evolution of bacterial AMR and the spread of resistant bacteria.This article focuses on antibiotic-resistant bacteria, briefly introduces the pathogenesis of bacterial AMR and SOS response, and systematically summarizes the determination and mechanism study of bacterial AMR based on microfluidics and mass spectrometry.This article provides theoretical basis for AMR-related drug target mining and new drug development, aiming to develop new methods for rapid detection of bacterial AMR and new methods for bacteria inhibition, and promote the diagnosis and treatment of clinical bacteria infectious diseases.

An Economy-wide Analysis of the Energy and Environmental Impacts of International Trade Policy Adjustments for Chemical Industry in China.

In China, the proportion of energy consumption and carbon emissions embodied in international trade in chemical industry is high. It is important to consider how international trade policy adjustments in chemical industry will affect the economy and environment so as to achieve the goal of carbon intensity. This study investigates the impact of international trade policy adjustments. We adopt a computable general equilibrium model to simulate the impacts of trade policy adjustment. The result shows all adjustment plans cause economic losses. All plans will promote energy structure toward cleaner. All plans reduce CO2 emissions and energy consumption but cannot realize the carbon intensity and energy intensity target. The adjustment of tariff policy in basic raw materials sector should be smaller than that of other sectors. Raising the export tariff is the best policy choice for achieving the carbon intensity target, but other low-carbon policies should be introduced. In particular, protection measures should be taken for the energy industry.

Impact of COVID-19 on global burn care.

BACKGROUND: Worldwide, different strategies have been chosen to face the COVID-19-patient surge, often affecting access to health care for other patients. This observational study aimed to investigate whether the standard of burn care changed globally during the pandemic, and whether country´s income, geographical location, COVID-19-transmission pattern, and levels of specialization of the burn units affected reallocation of resources and access to burn care. METHODS: The Burn Care Survey is a questionnaire developed to collect information on the capacity to provide burn care by burn units around the world, before and during the pandemic. The survey was distributed between September and October 2020. McNemar`s test analyzed differences between services provided before and during the pandemic, χ2 or Fisher's exact test differences between groups. Multivariable logistic regression analyzed the independent effect of different factors on keeping the burn units open during the pandemic. RESULTS: The survey was completed by 234 burn units in 43 countries. During the pandemic, presence of burn surgeons did not change (p = 0.06), while that of anesthetists and dedicated nursing staff was reduced (<0.01), and so did the capacity to manage patients in all age groups (p = 0.04). Use of telemedicine was implemented (p < 0.01), collaboration between burn centers was not. Burn units in LMICs and LICs were more likely to be closed, after adjustment for other factors. CONCLUSIONS: During the pandemic, most burn units were open, although availability of standard resources diminished worldwide. The use of telemedicine increased, suggesting the implementation of new strategies to manage burns. Low income was independently associated with reduced access to burn care.