Multiple venous thromboembolisms in a pregnant patient carrying a novel mutation in SERPINC1 (p.M313T) that causes a transient antithrombin deficiency: a case report.

BACKGROUND: Congenital antithrombin deficiency is an autosomal dominant disease that results in deep venous thrombosis and pulmonary embolism, which is mainly caused by mutations in the antithrombin gene (SERPINC1). Since SERPINC1 is highly susceptible to alterations, severe structural and functional changes that promote thrombosis may occur. Clinical presentations vary from different alterations. We report a pregnant case with novel mutation in SERPINC1 presenting transient antithrombin deficiency and multiple venous thromboembolisms. CASE PRESENTATION: We report a case of a 36-year-old pregnant patient who was diagnosed with congenital antithrombin deficiency for carrying a novel heterozygous mutation, NM_000488:exon5:c.T9 38 C:p. M313T in SERPINC1 presenting transient antithrombin deficiency and multiple venous thromboembolisms. Thrombolytic with alteplase and anticoagulant therapies with low-molecular-weight heparin and warfarin were administrated. After confirming the genetic analysis and the termination of pregnancy, rivaroxaban was administrated, and the thrombosis reduced. CONCLUSIONS: Our study enriched the mutation database of SERPINC1 gene, provided some new theoretical basis for gene diagnosis and genetic counseling of patients with transient antithrombin deficiency. While it still needs for subsequent exploration of molecular pathogenesis.

Global characteristics and trends in research on Candida auris.

Introduction: Candida auris, a fungal pathogen first reported in 2009, has shown strong resistance to azole antifungal drugs and has caused severe nosocomial outbreaks. It can also form biofilms, which can colonize patients' skin and transmit to others. Despite numerous reports of C. auris isolation in various countries, many studies have reported contradictory results. Method: A bibliometric analysis was conducted using VOSviewer to summarize research trends and provide guidance for future research on controlling C. auris infection. The analysis revealed that the United States and the US CDC were the most influential countries and research institutions, respectively. For the researchers, Jacques F. Meis published the highest amount of related articles, and Anastasia P. Litvintseva's articles with the highest average citation rate. The most cited publications focused on clade classification, accurate identification technologies, nosocomial outbreaks, drug resistance, and biofilm formation. Keyword co-occurrence analysis revealed that the top five highest frequencies were for 'drug resistance,' 'antifungal susceptibility test,' 'infection,' 'Candida auris,' and 'identification.' The high-frequency keywords clustered into four groups: rapid and precise identification, drug resistance research, pathogenicity, and nosocomial transmission epidemiology studies. These clusters represent different study fields and current research hotspots of C. auris. Conclusion: The bibliometric analysis identified the most influential country, research institution, and researcher, indicating current research trends and hotspots for controlling C. auris.

Microstructure and Mechanical Properties of TA2/Q235 Laser Weld Joint with Copper Interlayer.

For the dissimilar metal welding needs of TA2 titanium and Q235 steel, preliminary trials were conducted using laser welding methods, and the results showed that the addition of a copper interlayer and the bias of the laser beam toward the Q235 side allowed for an effective connection. The welding temperature field was simulated using the finite element method, and the optimum offset distance of 0.3 mm was obtained. Under the optimized parameters, the joint had good metallurgical bonding. Further SEM analysis showed that the microstructure of the bonding area between the weld bead and Q235 was a typical fusion weld pattern, while that of the bonding area between the weld bead and TA2 was in brazing mode. The microhardness of the cross-section showed complex fluctuations; the microhardness of the weld bead center was higher than that of the base metal due to the formation of a mixture microstructure of copper and dendritic Fe phases. The copper layer not involved in the weld pool mixing had almost the lowest microhardness. The highest microhardness was found at the bonding site of TA2 and the weld bead, mainly due to the formation of an intermetallic layer with a thickness of about 100 µm. Further detailed analysis revealed that the compounds included Ti2Cu, TiCu and TiCu2, showing a typical peritectic morphology. The tensile strength of the joint was approximately 317.6 MPa, reaching 82.71% of that of the Q235 and 75.44% of the TA2 base metal, respectively. The fracture occurred in the unmixed copper layer.

Development and validation of a nomogram to predict failure of 14-day negative nucleic acid conversion in adults with non-severe COVID-19 during the Omicron surge: a retrospective multicenter study.

BACKGROUND: With the variability in emerging data, guidance on the isolation duration for patients with coronavirus disease 2019 (COVID-19) due to the Omicron variant is controversial. This study aimed to determine the predictors of prolonged viral RNA shedding in patients with non-severe COVID-19 and construct a nomogram to predict patients at risk of 14-day PCR conversion failure. METHODS: Adult patients with non-severe COVID-19 were enrolled from three hospitals of eastern China in Spring 2022. Viral shedding time (VST) was defined as either the day of the first positive test or the day of symptom onset, whichever was earlier, to the date of the first of two consecutively negative PCR tests. Patients from one hospital (Cohort I, n = 2033) were randomly grouped into training and internal validation sets. Predictors of 14-day PCR conversion failure were identified and a nomogram was developed by multivariable logistic regression using the training dataset. Two hospitals (Cohort II, n = 1596) were used as an external validation set to measure the performance of this nomogram. RESULTS: Of the 2033 patients from Cohort I, the median VST was 13.0 (interquartile range: 10.0‒16.0) days; 716 (35.2%) lasted > 14 days. In the training set, increased age [per 10 years, odds ratio (OR) = 1.29, 95% confidence interval (CI): 1.15‒1.45, P < 0.001] and high Charlson comorbidity index (OR = 1.25, 95% CI: 1.08‒1.46, P = 0.004) were independent risk factors for VST > 14 days, whereas full or boosted vaccination (OR = 0.63, 95% CI: 0.42‒0.95, P = 0.028) and antiviral therapy (OR = 0.56, 95% CI: 0.31‒0.96, P = 0.040) were protective factors. These predictors were used to develop a nomogram to predict VST > 14 days, with an area under the ROC curve (AUC) of 0.73 in the training set (AUC, 0.74 in internal validation set; 0.76 in external validation set). CONCLUSIONS: Older age, increasing comorbidities, incomplete vaccinations, and lack of antiviral therapy are risk factors for persistent infection with Omicron variant for > 14 days. A nomogram based on these predictors could be used as a prediction tool to guide treatment and isolation strategies.

Family Subjective Socioeconomic Status and University Students' Online Shopping Addiction: A Gender-Based Analysis.

Online shopping addiction has surged among today's university students. Previous studies have focused on individual and network factors, whereas neglecting family-related roles. This study examined the relationship between subjective socioeconomic status (SSES) and university students' online shopping addiction (OSA) using the life course model of consumer behavior, and explored the chain-mediating role of vanity and materialism, and the moderating role of gender. We surveyed 635 students from two universities in Henan Province, China, using self-administered scales and questionnaires assessing subjective SES (SSES), OSA, materialism, and vanity. The results showed that SSES is negatively associated with OSA. Materialism played a mediating role, whereas vanity and vanity-materialism played a suppressing role between SSES and OSA. A direct relationship between SSES and OSA was found only in men, whereas the indirect path of SSES-vanity-materialism-OSA was found only in women. These results enable better recognition and understanding of the family's role, including family economic status, in university students' gender-specific OSA. They also advance the understanding of the transmission mechanism between family economic status and university students' OSA and promote better recognition and awareness of the family's role in university students' gender-specific OSA.

Photoinduced Ion-Pair Inner-Sphere Electron Transfer-Reversible Addition-Fragmentation Chain Transfer Polymerization.

Photoredox-mediated reversible deactivation radical polymerization (RDRP) is a promising method of precise synthesis of polymers with diverse structures and properties. However, its mechanism mainly based on the outer-sphere electron transfer (OSET) leads to stringent requirements for an efficient photocatalyst. In this paper, the zwitterionic organoboranes [L2B]+X- are prepared and applied in reversible addition-fragmentation chain transfer (RAFT) polymerization with the photoinduced ion-pair inner-sphere electron transfer (IP-ISET) mechanism. The ion-pair electron transfer mechanism and the formation of the radical [L2B]• are supported by electron paramagnetic resonance (EPR) radical capture experiments, 1H/11B NMR spectroscopy, spectroelectrochemical spectroscopy, transient absorption spectroscopy, theoretical calculation, and photoluminescence quenching experiments. Photoluminescence quenching experiments show that when [CTA]/[[L2B]+] ≥ 0.6, it is static quenching because of the in situ formation of [L2B]+[ZCS2]-, the real catalytic species. [L2B]+[C3H7SCS2]- is synthesized, and its photoluminescence lifetime is the same as the lifetime in the static quenching experiment, indicating the formation of [L2B]+[ZCS2]- in polymerization and the IP-ISET mechanism. The matrix-assisted laser desorption ionization time-of-flight mass (MALDI-TOF MS) spectra show that the structure of [C3H7SCS2] was incorporated into the polymer, indicating that ion-pair electron transfer occurs in catalytic species. The polymerization shows high catalytic activity at ppb catalyst loading, a wide range of monomers, excellent tolerance in the presence of 5 mol % phenolic inhibitors, and the synthesis of ultrahigh-molecular-weight polymers. This protocol with the IP-ISET mechanism exhibits a value in the development of new organic transformations and polymerization methods.

Family Socioeconomic Status and Attention Deficit/Hyperactivity Disorder in Preschool Children: The Mediating Role of Executive Function.

This study aimed to explore the relationship between family socioeconomic status (SES) and attention deficit/hyperactivity disorder (ADHD) symptoms in preschool children and the mediating role of executive function (EF). A total of 361 parents of preschool children were surveyed using the self-reported Family Situation Questionnaire, the Child Executive Functioning Inventory, and the Child Strengths and Difficulties Questionnaire. The results revealed that (1) there were significant pairwise correlations between SES, EF and its dimensions, and ADHD, except for a non-significant correlation between SES and regulation ability; (2) after controlling for preschool children's age and sex, SES directly predicted preschoolers' ADHD and EF partially mediated the association between SES and ADHD; and (3) among the EF dimensions, working memory and inhibitory ability significantly mediated the association between SES and ADHD, whereas the mediating effect of regulatory ability was not significant. These results suggest that SES can affect the ADHD of preschoolers both directly and through EF, especially through working memory and inhibitory ability. This supports the family stress model and family investment model of the relationship between SES and the development of children to some extent, and provides a reference for the early prevention of ADHD in children with low SES.

CD56dim NK Cell is an Important Factor in T Cell Depletion of cART-Treated AIDS Patients.

Purpose: To investigate factors involved in T-cell depletion in combination antiretroviral therapy (cART)-treated human immunodeficiency virus 1 (HIV-1)-positive patients. Patients and Methods: 29 HIV-1-positive patients were enrolled. The CD4+, CD8+ T cell subsets and CD56dim NK cells were detected by flow cytometry. The concentrations of cytokines were measured by enzyme-linked immunosorbent assay. Extraction, amplification, and viral load quantification of specimens were performed using the Roche Cobas Ampliprep/Cobas TaqMan HIV-1 test. Results: Compared with IR group, the total number of red blood cells (RBCs) and lymphocytes (LCs) in INR group was significantly reduced, and there was a significant positive correlation between the number of RBCs and that of LCs. The overall production rates of T cells-related cytokines were lower in INR group. However, the cell-surface expression of programmed death-1 (PD-1) on CD4+ T and CD8+ T cells were markedly elevated in INR group. Moreover, it was found that the proportion and the killing ability of CD56dim NK cells significantly increased in INR patients, and significantly correlated with apoptosis of T lymphocytes. Conclusion: A poor immune reconstitution in HIV-positive patients might result from multiple factors, including bone marrow suppression, high PD-1 expression on the surface of CD4+ T cells, and over-activation of T and NK cells. Besides, the activity of NK cells and RBCs count might be important auxiliary indicators for immune reconstitution and provided a reliable guidance for developing strategies to improve immune reconstitution.

COVID-19 vaccines in patients with decompensated cirrhosis: a retrospective cohort on safety data and risk factors associated with unvaccinated status.

BACKGROUND: Safety data reported from the large-scale clinical trials of the coronavirus disease 2019 (COVID-19) vaccine are extremely limited in patients with decompensated cirrhosis. The vaccination campaign in this specific population could be difficult due to uncertainty about the adverse events following vaccination. We aimed to assessed the COVID-19 vaccination rate, factors associated with unvaccinated status, and the adverse events following vaccination in patients with decompensated cirrhosis. METHODS: This is a retrospective study from Ruijin Hospial (Shanghai, China) on an ongoing prospective cohort designed for long-term survival analysis of decompensated cirrhotic patients who recovered from decompensating events or acute-on-chronic liver failure (ACLF) between 2016 and 2018. We assessed the COVID-19 vaccination rate, the number of doses, type of vaccine, safety data, patient-reported reasons for remaining unvaccinated, factors associated with unvaccinated status, and the adverse events of COVID-19 vaccine. Binary logistic regression was used for identifying factors associated with unvaccinated status. RESULTS: A total of 229 patients with decompensated cirrhosis without previous SARS-CoV-2 infection participated (mean age, 56 ± 12.2 years, 75% male, 65% viral-related cirrhosis). Mode of decompensation were grade II‒III ascites (82.5%), gastroesophageal varices bleeding (7.9%), hepatic encephalopathy (7.9%). Eighty-five participants (37.1%) received at least one dose of vaccination (1 dose: n = 1, 2 doses: n = 65, 3 doses: n = 19) while 62.9% remained unvaccinated. Patient-reported reasons for remaining unvaccinated were mainly fear of adverse events (37.5%) and lack of positive advice from healthcare providers (52.1%). The experience of hepatic encephalopathy (OR = 5.61, 95% CI: 1.24-25.4) or ACLF (OR = 3.13, 95% CI: 1.12-8.69) and post-liver transplantation status (OR = 2.47, 95% CI: 1.06-5.76) were risk factors of remaining unvaccinated independent of residential areas. The safety analysis demonstrated that 75.3% had no adverse events, 23.6% had non-severe reactions (20% injection-site pain, 1.2% fatigue, 2.4% rash) and 1.2% had a severe event (development of acute decompensation requiring hospitalization). CONCLUSIONS: Patients with decompensated cirrhosis in eastern China are largely remained at unvaccinated status, particularly those with previous episodes of ACLF or hepatic encephalopathy and liver transplantation recipients. Vaccination against COVID-19 in this population is safe.

Clinical and virological course of patients with coronavirus disease 2019 in Jiangsu province, China: a retrospective, multi-center cohort study.

BACKGROUND: The clinical and virological course of patients with coronavirus disease 2019 (COVID-19) are lacking. We aimed to describe the clinical and virological characteristics of COVID-19 patients from 10 designated hospitals in 10 cities of Jiangsu province, China. The factors associated with the clearance of SARS-CoV-2 were investigated. METHODS: A total of 328 hospitalized patients with COVID-19 were retrospectively recruited. The epidemiological, clinical, laboratory, radiology and treatment data were collected. The associated factors of SARS-CoV-2 clearance were analyzed. RESULTS: The median duration of hospitalization was 16.0 days (interquartile range [IQR] 13.0-21.0 days). On multivariate Cox regression analysis, age > 60 years (hazard ratio [HR] 0.643, 95% confidence interval [CI] 0.454-0.911, P = 0.013) was associated with the delayed SARS-CoV-2 clearance, while the atomized inhalation of interferon α-2b could improve the clearance of SARS-CoV-2 (HR, 1.357, 95% CI 1.050-1.755, P = 0.020). Twenty-six (7.9%) patients developed respiratory failure and 4 (1.2%) patients developed ARDS. Twenty (6.1%) patients were admitted to the ICU, while no patient was deceased. CONCLUSIONS: Our study found that age > 60 years was associated with the delayed SARS-CoV-2 clearance, while treated with atomized inhalation of interferon α-2b could promote the clearance of SARS-CoV-2.

LncRNA HOTAIR Promotes LPS-Induced Inflammation and Apoptosis of Cardiomyocytes via Lin28-Mediated PDCD4 Stability.

Sepsis is one of the primary causes of death in intensive care units. Recently, increasing evidence has identified lncRNA HOTAIR is involved in septic cardiomyopathy. However, the potential mechanism underlying HOTAIR on septic cardiomyopathy is still unknown. H9C2 cells were treated with lipopolysaccharide (LPS) after transfection with sh-HOTAIR, sh-Lin28, pcDNA3.1-HOTAIR, and pcDNA3.1-PDCD4. qRT-PCR was used to examine the level of HOTAIR, Lin28, PDCD4, and sepsis-related inflammatory cytokines. Flow cytometric analysis was applied to detect cell apoptosis. The interaction between Lin28 and HOTAIR or PDCD4 was verified by RNA pull-down and RIP assay. HOTAIR levels were interfered by AAV9-sh-HOTAIR in LPS-induced septic cardiomyopathy mice. ELISA analysis was used to evaluate TNF-α, IL-6, and IL-1ß level. Western blot was used to detect the expression of LIN28 and PDCD4 in mouse cardiomyocytes. Echocardiography was used to evaluate the cardiac function. In our study, knockdown of HOTAIR inhibited LPS-induced inflammation and H9C2 cells apoptosis. HOTAIR promoted LPS-induced inflammatory response and apoptosis of H9C2 cells by enhancing PDCD4 stability. RNA pull-down and RIP assay exhibited that Lin28, a highly conserved RNA-binding protein, was combined with HOTAIR and PDCD4. The in vivo experiments verified that the HOTAIR knockdown alleviated the cardiac function injury and secretion of inflammatory factors caused by sepsis. In conclusion, our findings supported that the HOTAIR/Lin28/PDCD4 axis serves as a critical regulator of sepsis, which may open a new direction for the development of sepsis therapeutic.

RF Thermal Plasma Synthesis of Ultrafine ZrB2-ZrC Composite Powders.

Ultrafine ZrB2-ZrC composite powders were synthesized via a radiofrequency (RF) thermal plasma process. Numerical simulation and thermodynamic analysis were conducted to predict the synthesis process, and experimental work was performed accordingly to demonstrate its feasibility. The as-prepared samples were characterized by XRD, FESEM, particle size analyzer, nitrogen/oxygen analyzer, Hall flowmeter, and the Brunner-Emmet-Teller (BET) measurements. The thermodynamic analysis indicated that ZrB2 was preferentially generated, rather than ZrC, and numerical simulation revealed that the solid raw materials could disperse well in the gaseous reactants, and experimental work showed that free carbon particles were easily removed from the products and the elements of Zr, B, C, and O exhibited a uniform distribution. Finally, ZrB2-ZrC composite powders with a particle size of about 100 nm were obtained, the surface area of which was 32.15 m2/g and the apparent density was 0.57 g/cm3.

Analysis of volume management by comparing between critical care ultrasound examination and pulse indicator cardiac output in patients with septic shock.

OBJECTIVE: To investigate volume management by comparing between critical care ultrasound examination and pulse indicator cardiac output (PICCO) in patient with septic shock. METHODS: Patients with septic shock during July 2017 and June 2018 were included. Inferior Vena Cava (IVC), total end-diastolic volume index (GEDI), central venous pressure (CVP), lactic acid and oxygenation index were measured by ultrasound. First, the accuracy difference of IVC, GEDI and CVP estimation capacity was compared. According to the changes of IVCmin, IVCmax, and GEDI, they were divided into 5 groups to compare the differences of lactic acid and oxygenation index between the groups and the correlation of lactate and Oxygenation index (PaO2/FiO2) between IVC and GEDI was analyzed. The correlation of lactate and PaO2/FiO2 between B lines and extravascular pulmonary water index (ELWI) was noted. RESULTS: The accuracy of IVC and GEDI in volume estimation was greater than 75%, significantly higher than that of CVP (53.3%) (P<0.05). The correlation results showed that GEDI was significantly correlated with IVCmax and IVCmin (P<0.05), while there was a significant correlation between b-line area and oxygenation index, ELWI and lactic acid, ELWI and oxygenation index (P<0.05). IVCmin, IVCmax and GEDI were respectively divided into 5 groups for comparing the difference between lactic acid and oxygenation. It was found that there were significant differences between the two indicators of IVCmin in different groups (P>0.05). The oxygenation index of the group ≤IVCmax was significantly lower than that of the group 0.5 ≤IVCmax < 1.0cm (P<0.05). The oxgenation indexes of groups 500≤GEDI < 600mL/m2; 600≤GEDI < 700mL/m2. 700≤GEDI < 800mL/m2 were significantly higher than that of group 0 < GEDI < 500mL/m2 (P<0.05). CONCLUSIONS: Critical care ultrasound examination and PICCO are better methods than in volume management, but PICCO is more individualized, and PICCO in patients with valvular heart disease is not recommended.

Light Trapping in Single Elliptical Silicon Nanowires.

Light trapping in single nanowires (NWs) is of vital importance for photovoltaic applications. However, circular NWs (CNWs) can limit their light-trapping ability due to high geometrical symmetry. In this work, we present a detailed study of light trapping in single silicon NWs with an elliptical cross-section (ENWs). We demonstrate that the ENWs exhibit significantly enhanced light trapping compared with the CNWs, which can be ascribed to the symmetry-broken structure that can orthogonalize the direction of light illumination and the leaky mode resonances (LMRs). That is, the elliptical cross-section can simultaneously increase the light path length by increasing the vertical axis and reshape the LMR modes by decreasing the horizontal axis. We found that the light absorption can be engineered via tuning the horizontal and vertical axes, the photocurrent is significantly enhanced by 374.0% (150.3%, 74.1%) or 146.1% (61.0%, 35.3%) in comparison with that of the CNWs with the same diameter as the horizontal axis of 100 (200, 400) nm or the vertical axis of 1000 nm, respectively. This work advances our understanding of how to improve light trapping based on the symmetry breaking from the CNWs to ENWs and provides a rational way for designing high-efficiency single NW photovoltaic devices.

Off-Resonant Absorption Enhancement in Single Nanowires via Graded Dual-Shell Design.

Single nanowires (NWs) are of great importance for optoelectronic applications, especially solar cells serving as powering nanoscale devices. However, weak off-resonant absorption can limit its light-harvesting capability. Here, we propose a single NW coated with the graded-index dual shells (DSNW). We demonstrate that, with appropriate thickness and refractive index of the inner shell, the DSNW exhibits significantly enhanced light trapping compared with the bare NW (BNW) and the NW only coated with the outer shell (OSNW) and the inner shell (ISNW), which can be attributed to the optimal off-resonant absorption mode profiles due to the improved coupling between the reemitted light of the transition modes of the leak mode resonances of the Si core and the nanofocusing light from the dual shells with the graded refractive index. We found that the light absorption can be engineered via tuning the thickness and the refractive index of the inner shell, the photocurrent density is significantly enhanced by 134% (56%, 12%) in comparison with that of the BNW (OSNW, ISNW). This work advances our understanding of how to improve off-resonant absorption by applying graded dual-shell design and provides a new choice for designing high-efficiency single NW photovoltaic devices.

Clinical Features of Patients With COVID-19 With Nonalcoholic Fatty Liver Disease.

Previous studies reported that coronavirus disease 2019 (COVID-19) was likely to result in liver injury. However, few studies investigated liver injury in patients with COVID-19 with chronic liver diseases. We described the clinical features in patients with COVID-19 with nonalcoholic fatty liver disease (NAFLD). Confirmed patients with COVID-19 from hospitals in 10 cities of Jiangsu Province, China, were retrospectively included between January 18, 2020, and February 26, 2020. The hepatic steatosis index (HSI) was used to defined NAFLD. A total of 280 patients with COVID-19 were enrolled. Eighty-six (30.7%) of 280 patients with COVID-19 were diagnosed as NAFLD by HSI. One hundred (35.7%) patients presented abnormal liver function on admission. The median alanine aminotransferase (ALT) levels (34.5 U/L vs. 23.0 U/L; P < 0.001) and the proportion of elevated ALT (>40 U/L) (40.7% vs. 10.8%; P < 0.001) were significantly higher in patients with NAFLD than in patients without NAFLD on admission. The proportion of elevated ALT in patients with NAFLD was also significantly higher than patients without NAFLD (65.1% vs. 38.7%; P < 0.001) during hospitalization. Multivariate analysis showed that age over 50 years (odds ratio [OR], 2.077; 95% confidence interval [CI], 1.183, 3.648; P = 0.011) and concurrent NAFLD (OR, 2.956; 95% CI, 1.526, 5.726; P = 0.001) were independent risk factors of ALT elevation in patients with COVID-19, while the atomized inhalation of interferon α-2b (OR, 0.402; 95% CI, 0.236, 0.683; P = 0.001) was associated with a reduced risk of ALT elevation during hospitalization. No patient developed liver failure or death during hospitalization. The complications and clinical outcomes were comparable between patients with COVID-19 with and without NAFLD. Conclusion: Patients with NAFLD are more likely to develop liver injury when infected by COVID-19. However, no patient developed severe liver-related complications during hospitalization.

Clinical findings of patients with coronavirus disease 2019 in Jiangsu province, China: A retrospective, multi-center study.

Limited data are available for clinical characteristics of patients with coronavirus disease 2019 (COVID-19) outside Wuhan. This study aimed to describe the clinical characteristics of COVID-19 and identify the risk factors for severe illness of COVID-19 in Jiangsu province, China. Clinical data of hospitalized COVID-19 patients were retrospectively collected in 8 hospitals from 8 cities of Jiangsu province, China. Clinical findings of COVID-19 patients were described and risk factors for severe illness of COVID-19 were analyzed. By Feb 10, 2020, 202 hospitalized patients with COVID-19 were enrolled. The median age of patients was 44.0 years (interquartile range, 33.0-54.0). 55 (27.2%) patients had comorbidities. At the onset of illness, the common symptoms were fever (156 [77.2%]) and cough (120 [59.4%]). 66 (32.7%) patients had lymphopenia. 193 (95.5%) patients had abnormal radiological findings. 11 (5.4%) patients were admitted to the intensive care unit and none of the patients died. 23 (11.4%) patients had severe illness. Severe illness of COVID-19 was independently associated with body mass index (BMI) ≥ 28 kg/m2 (odds ratio [OR], 9.219; 95% confidence interval [CI], 2.731 to 31.126; P<0.001) and a known history of type 2 diabetes (OR, 4.326; 95% CI, 1.059 to 17.668; P = 0.041). In this case series in Jiangsu Province, COVID-19 patients had less severe symptoms and had better outcomes than the initial COVID-19 patients in Wuhan. The BMI ≥ 28 kg/m2 and a known history of type 2 diabetes were independent risk factors of severe illness in patients with COVID-19.

A "MOF-Protective-Pyrolysis" Strategy for the Preparation of Fe-N-C Catalysts and the Role of Fe, N, and C in the Oxygen Reduction Reaction in Acidic Medium.

M-N-C electrocatalysts for the oxygen reduction reaction (ORR) have been considered as the most promising alternatives to precious metal catalysts. However, the catalytic activity of M-N-C especially in an acidic medium is still unable to meet the practical requirement, and the corresponding ORR mechanism also remains unclear. Herein, an "MOF-protective-pyrolysis" strategy was adopted to synthesize an Fe-N-C catalyst (P-FeMOF@ZIF-8) with Fe-N4 as the predominant Fe species. The P-FeMOF@ZIF-8 displays high catalytic activity in both acidic and alkaline mediums. The experimental results further reveal the different importance of the Fe species in different mediums. Based on the results, a distinct mechanism of the ORR the in acidic medium was proposed, where the synergistic effect of the Fe-N4 site and carbon in improving the kinetics of the ORR were well explained. The findings and the corresponding perspective may provide a new guidance for the design of highly efficient ORR electrocatalysts.

Modeling and Selection of RF Thermal Plasma Hot-Wall Torch for Large-Scale Production of Nanopowders.

Fouling is a great problem that significantly affects the continuous operation for large-scale radio-frequency (RF) thermal plasma synthesizing nanopowders. In order to eliminate or weaken the phenomenon, numerical simulations based on FLUENT software were founded to investigate the effect of operation parameters, including feeding style of central gas and sheath gas, on plasma torches. It is shown that the tangential feeding style of central gas brings serious negative axial velocity regions, which always forces the synthesized nanopowders to "back-mix", and further leads to the fouling of the quartz tube. Moreover, it is shown that sheath gas should be tangentially fed into the plasma reactor to further eliminate the gas stream's back-mixing. However, when this feeding style is applied, although the negative axial velocity region is decreased, the plasma gas and kinetic energy of the vapor phase near the wall of the plasma reactor are less and lower, respectively; as a result, that plasma flame is more difficult to be arced. A new plasma arcing method by way of feeding gun instead of torch wall was proposed and put in use. The fouling problem has been well solved and plasma arcing is well ensured, and as a result, the experiment on large-scale production of nanopowders can be carried out for 8 h without any interruption, and synthesized Si and Al2O3 nanopowders exhibit good dispersion and sphericity.

Synthesis of Metallic Nanocrystals: From Noble Metals to Base Metals.

Metallic nanocrystals exhibit superior properties to their bulk counterparts because of the reduced sizes, diverse morphologies, and controllable exposed crystal facets. Therefore, the fabrication of metal nanocrystals and the adjustment of their properties for different applications have attracted wide attention. One of the typical examples is the fabrication of nanocrystals encased with high-index facets, and research on their magnified catalytic activities and selections. Great accomplishment has been achieved within the field of noble metals such as Pd, Pt, Ag, and Au. However, it remains challenging in the fabrication of base metal nanocrystals such as Ni, Cu, and Co with various structures, shapes, and sizes. In this paper, the synthesis of metal nanocrystals is reviewed. An introduction is briefly given to the metal nanocrystals and the importance of synthesis, and then commonly used synthesis methods for metallic nanocrystals are summarized, followed by specific examples of metal nanocrystals including noble metals, alloys, and base metals. The synthesis of base metal nanocrystals is far from satisfactory compared to the tremendous success achieved in noble metals. Afterwards, we present a discussion on specific synthesis methods suitable for base metals, including seed-mediated growth, ligand control, oriented attachment, chemical etching, and Oswald ripening, based on the comprehensive consideration of thermodynamics, kinetics, and physical restrictions. At the end, conclusions are drawn through the prospect of the future development direction.