Profiles of Cough and Associated Risk Factors in Nonhospitalized Individuals With SARS-CoV-2 Omicron Variant Infection: Cross-Sectional Online Survey in China.

BACKGROUND: Cough is a common symptom during and after COVID-19 infection; however, few studies have described the cough profiles of COVID-19. OBJECTIVE: The aim of this study was to investigate the prevalence, severity, and associated risk factors of severe and persistent cough in individuals with COVID-19 during the latest wave of the Omicron variant in China. METHODS: In this nationwide cross-sectional study, we collected information of the characteristics of cough from individuals with infection of the SARS-CoV-2 Omicron variant using an online questionnaire sent between December 31, 2022, and January 11, 2023. RESULTS: There were 11,718 (n=7978, 68.1% female) nonhospitalized responders, with a median age of 37 (IQR 30-47) years who responded at a median of 16 (IQR 12-20) days from infection onset to the time of the survey. Cough was the most common symptom, occurring in 91.7% of participants, followed by fever, fatigue, and nasal congestion (68.8%-87.4%). The median cough visual analog scale (VAS) score was 70 (IQR 50-80) mm. Being female (odds ratio [OR] 1.31, 95% CI 1.20-1.43), having a COVID-19 vaccination history (OR 1.71, 95% CI 1.37-2.12), current smoking (OR 0.48, 95% CI 0.41-0.58), chronic cough (OR 2.04, 95% CI 1.69-2.45), coronary heart disease (OR 1.71, 95% CI 1.17-2.52), asthma (OR 1.22, 95% CI 1.02-1.46), and gastroesophageal reflux disease (GERD) (OR 1.21, 95% CI 1.01-1.45) were independent factors for severe cough (VAS>70, 37.4%). Among all respondents, 35.0% indicated having a productive cough, which was associated with risk factors of being female (OR 1.44, 95% CI 1.31-1.57), having asthma (OR 1.84, 95% CI 1.52-2.22), chronic cough (OR 1.44, 95% CI 1.19-1.74), and GERD (OR 1.22, 95% CI 1.01-1.47). Persistent cough (>3 weeks) occurred in 13.0% of individuals, which was associated with the risk factors of having diabetes (OR 2.24, 95% CI 1.30-3.85), asthma (OR 1.70, 95% CI 1.11-2.62), and chronic cough (OR 1.97, 95% CI 1.32-2.94). CONCLUSIONS: Cough is the most common symptom in nonhospitalized individuals with Omicron SARS-CoV-2 variant infection. Being female, having asthma, chronic cough, GERD, coronary heart disease, diabetes, and a COVID-19 vaccination history emerged as independent factors associated with severe cough, productive cough, and persistent cough.

Sputum Transcriptomics Reveals FCN1+ Macrophage Activation in Mild Eosinophilic Asthma Compared to Non-Asthmatic Eosinophilic Bronchitis.

PURPOSE: Eosinophilic asthma (EA) and non-asthmatic eosinophilic bronchitis (EB) share similar eosinophilic airway inflammation. Unlike EA, EB did not present airway hyperresponsiveness or airflow obstruction. We aimed to compare the mechanism underlying the different manifestations between EA and EB via sputum transcriptomics analysis. METHODS: Induced-sputum cells from newly physician-diagnosed EA, EB patients, and healthy controls (HCs) were collected for RNA sequencing. RESULTS: Bulk RNA sequencing was performed using sputum cells from patients with EA (n = 18), EB (n = 15) and HCs (n = 28). Principal component analysis revealed similar gene expression patterns in EA and EB. The most differentially expressed genes in EB compared with HC were also shared by EA, including IL4, IL5 IL13, CLC, CPA3, and DNASE1L3. However, gene set enrichment analysis showed that the signatures regulating macrophage activation were enriched in EA compared to EB. Sputum cells were profiled using single-cell RNA sequencing. FABP4+ macrophages, SPP1+ macrophages, FCN1+ macrophages, dendritic cells, T cells, B cells, mast cells, and epithelial cells were identified based on gene expression profiling. Analysis of cell-cell communication revealed that interactions between FCN1+ macrophages and other cells were higher in EA than in EB. A wealth of transforming growth factor beta (TGF-ß) and vascular endothelial growth factor (VEGF) interactions between FCN1+ macrophages and other cells have been shown in EA. The gene expression levels of EREG, TGFBI, and VEGFA in FCN1+ macrophages of EA were significantly higher than those of EB. Furthermore, signatures associated with the response to TGF-ß, cellular response to VEGF stimulus and developmental cell growth were enriched in FCN1+ macrophages of EA compared to those of EB. CONCLUSIONS: FCN1+ macrophage activation associated with airway remodeling processes was upregulated in EA compared to that in EB, which may contribute to airway hyperresponsiveness and airflow obstruction.

Can fiscal decentralization and farmers' use of internent be the route to the digitalization performance in China? A novel approach towards unlocking the role of online marketing behavior and performance of agricultural products.

It is believed that the respondents' disadvantageous positions and the information asymmetry that exists between them are the bottlenecks that contribute to the stagnation of trades and the poor revenue that respondents receive from agro-products. Digitalization and fiscal decentralization both play an important part in helping to increase the information literacy of respondents who live in rural areas. The purpose of this study is to investigate the theoretical effects that the digital revolution has had on environmental behavior and performance, and it also analyzes the part that digitalization plays in the process of fiscal decentralization. This study investigates the impact that farmers' usage of the Internet has on their information literacy, online sales behavior, and online sales performance using research data collected from 1338 farmers in China primarily produce pears. Primary data was collected and utilized to develop a structural equation model, using the partial least squares (PLS) and bootstrapping methods; according to the findings, the use of the Internet by farmers has a significant positive effect on the improvement of their information literacy, and it will promote their online sales of pear through the improvement of their information literacy. The results show that the use of the Internet by farmers will improve the online sales performance of pear due to the improvement of farmers' information literacy.

Clinical characteristics of protracted bacterial bronchitis in adults.

There are few data regarding adult protracted bacterial bronchitis (PBB). This study aimed to delineate the clinical features of PBB and evaluate their potential diagnostic value in adults. We recruited 55 adult patients with PBB and selected randomly 220 patients with non-PBB as control. A diagnosis of PBB was considered if patients had a cough lasting ≥3 weeks, no abnormalities of chest computed tomography, positive bacterial culture in sputum and/or response well to oral moxifloxacin for 1-4 weeks. The clinical manifestations and laboratory investigations were compared between PBB patients and non-PBB patients. Of the 55 patients with PBB, approximately three-fifths (34, 61.8%) were females with a median age of 46.0 years, which were similar to that of patients with non-PBB. We observed a shorter cough duration in PBB than non-PBB (median 3.0 versus 24.0 months, p < 0.001). Compared to non-PBB patients, PBB patients had higher incidences of productive cough, yellow phlegm and a sensation of mucus in the throat (SMIT) (all p < 0.001). Sputum neutrophils and lymphocytes were markedly elevated in PBB patients than non-PBB patients (both p = 0.004). Bacterial pathogens were detected in eight (28.6%) of 28 cases with PBB. The multivariate analyses showed yellow phlegm, productive cough, SMIT, increased sputum lymphocytes (≥2.3%) and cough duration ≤8.5 months with moderate sensitivity (50.9-81.8%) and moderate-high specificity (60.5-94.4%) for determining PBB. In summary, adults with PBB are characterized by productive cough, yellow phlegm, SMIT and neutrophilic airway inflammation. These cough features and increased sputum lymphocytes may be useful to indicate PBB.

Association of short-term exposure to air pollution with emergency visits for respiratory diseases in children.

Ambient air pollutants are health hazards to children. This study comprised 773,504 emergency department visits (EDVs) at 0-14 years of age with respiratory diseases in southern China. All air pollutants were positively associated with EDVs of total respiratory diseases, especially pneumonia. NO2, PM10, and PM2.5 had intraday effects and cumulative effects on asthma EDVs. The effect of SO2, PM10, and PM2.5 on pneumonia EDVs was stronger in girls than in boys. The effect of NO2 on acute upper respiratory tract infection EDVs was greater in children aged 0-5 years old; however, the effect of PM10 on acute upper respiratory tract infection EDVs was greater in the 6-14 years group. In a two-pollutant model, NO2 was associated with bronchitis and pneumonia, and PM10 was associated with acute upper respiratory tract infection. In this time-series study, NO2 and PM10 were risk indicators for respiratory diseases in children.

Prevalence and risk factors for postinfectious cough in discharged patients with coronavirus disease 2019 (COVID-19).

Background: Cough is one of the most common symptoms of coronavirus disease 2019 (COVID-19). However, the prevalence of persistent cough in recovered patients with COVID-19 during a longer follow-up remained unknown. This study aims to investigate the prevalence, and risk factors for postinfectious cough in COVID-19 patients after discharge. Methods: We conducted a follow-up study for 129 discharged patients with laboratory-confirmed COVID-19 in two large hospitals located in Hubei Province, China from January 2020 to December 2020. Baseline demographics, comorbidities and smoking history were extracted from the medical record. Current symptoms and severity were recorded by a uniform questionnaire. Spirometry, diffuse function and chest computed tomography (CT) were performed on part of patients who were able to return to the outpatient department at follow-up. Results: The median (interquartile range) follow-up time was 8.1 (7.9-8.5) months after discharge. The mean (standard deviation) age was 51.5 (14.9) years and 57 (44.2%) were male. A total of 27 (20.9%) patients had postinfectious cough (>3 weeks), 6 patients (4.7%) had persistent cough by the end of follow-up, including 3 patients with previous chronic respiratory diseases or current smoking. Other symptoms included dyspnea (6, 4.7%), sputum (4, 3.1%), fatigue (4, 3.1%), and anorexia (4, 3.1%) by the end of follow-up. Thirty-six of 41 (87.8%) patients showed impaired lung function or diffuse function, and 39 of 50 (78.0%) patients showed abnormal CT imaging. Patients with postinfectious cough demonstrated more severe and more frequent cough during hospitalization (P<0.001), and more chronic respiratory diseases (P=0.01). In multivariate logistic regression analysis, digestive symptoms during hospitalization [odds ratio (OR) 2.95, 95% confidence interval (CI): 1.10-7.92] and current smoking (OR 6.95, 95% CI: 1.46-33.14) were significantly associated with postinfectious cough of COVID-19. Conclusions: A small part of patients developed postinfectious cough after recovery from COVID-19, few patients developed chronic cough in spite of a higher proportion of impaired lung function and abnormal lung CT image. Current smoking and digestive symptoms during hospitalization were risk factors for postinfectious cough in COVID-19.

The spectrum, clinical features and diagnosis of chronic cough due to rare causes.

BACKGROUND: Chronic cough has many diverse causes, including common and uncommon causes. There are few comprehensive reports on rare causes of chronic cough. The purpose of this study is to determine the etiological distribution, clinical features, and diagnostic value of special examinations in patients with rare causes of chronic cough. METHODS: A retrospective analysis of patients with chronic cough who underwent medical history taking, full examination, and etiological treatment over a 13-year period was conducted. Causes of chronic cough with a prevalence of less than 3% were defined as rare causes. RESULTS: A total of 1,554 patients were enrolled, and 39 causes of chronic cough were identified. Among them, 1,055 cases were due to common causes, whereas 235 cases were due to rare causes; the causes involved 7 bodily systems. The top five rare causes were protracted bacterial bronchitis, somatic cough syndrome, diffuse panbronchiolitis, obstructive sleep apnea syndrome (OSAS), and interstitial lung disease, accounting for 67.2% of all rare causes. Among 235 patients with rare causes, causes in 90 (38.3%) patients were detected by chest high-resolution computed tomography (HRCT), in 44 (18.7%) patients by bronchoscopy/nasopharyngoscopy, and in 21 (8.9%) patients by pulmonary spirometry and diffusing capacity testing. CONCLUSIONS: Among the 31 rare causes of chronic cough in this cohort, the top five were protracted bacterial bronchitis, somatic cough syndrome, diffuse panbronchiolitis, OSAS, and interstitial lung disease. Special examinations, such as chest HRCT and bronchoscopy, should be considered after excluding common causes of chronic cough.

Public health initiatives from hospitalized patients with COVID-19, China.

BACKGROUND: Since December 2019, when it first occurred in Wuhan, China, coronavirus disease 2019 (COVID-19) has spread rapidly worldwide via human-to-human transmission. We aimed to describe the epidemiological and demographic features of COVID-19 outside Wuhan. METHODS: A single-center case series of 136 consecutive (from January 16 to February 17, 2020) patients with confirmed COVID-19 hospitalized in The First People's Hospital of Jingzhou, China, was retrospectively analyzed. Outcomes were followed up until February 19, 2020. RESULTS: Of the 136 patients (median age, 49 years; interquartile range [IQR], 33-63 years; range, 0.3-83 years), 91 (67%) had been to Wuhan or contacted persons from Wuhan. Forty-five (33.1%) were familial clusters. The median incubation period was 6 days (IQR: 4-11 days). All children had an exact exposure history, family members with COVID-19, and "Mild/Moderate" symptoms at admission. Among the 64 elderly patients, 14 (21.9%) had no exposure history, and 43 (67.2%) had a chronic illness. All 11 (8.1%) "Severe/very severe" illness at onset cases and 5 (3.7%) fatal cases were elderly patients. The duration from symptom onset to admission was positively correlated with the duration from symptom onset to endpoint. Overall, patients with a longer incubation period had more severe outcomes. CONCLUSION: As high-risk susceptible groups, strong protection should be implemented for children and the elderly. Universal screening should be performed for people with a clear exposure history, even lacking apparent symptoms. Given the rapid progression of COVID-19, people should be admitted quickly following symptom onset.

Randomized controlled clinical effectiveness of adjunct 660-nm light-emitting diode irradiation during non-surgical periodontal therapy.

BACKGROUND/PURPOSE: The irradiation of 660-nm light-emitting diodes (LEDs) has exhibited potential to accelerate oral wound healing and prevent periodontal breakdown in rodents. This study was to evaluate the clinical effectiveness of 660-nm LEDs during non-surgical periodontal therapy (NSPT). METHODS: Nineteen patients with at least one periodontitis-involved tooth in three quadrants received NSPT, and three protocols of LED light irradiation, including LED light irradiation from initial clinical assessment (T0) until the completion of scaling and root planning (T1) (LED01), LED light irradiation from T1 until re-evaluation (T2) (LED02), and no LED light irradiation (control treatment), were randomly assigned to respective quadrant. Clinical parameters were assessed at T0 and T2, and such biomarkers as IL-1ß and MMP-8 from gingival crevicular fluid were assessed at T0, T1, and T2. RESULTS: At T2, all examined sites exhibited significantly reduced probing pocket depth (PD), clinical attachment level (CAL), gingival bleeding index, plaque score, and visual analog scale. In the sites with greatest initial PD and CAL, LED01 and LED02 significantly reduced PD and CAL compared with the control treatment. IL-1ß and MMP-8 were reduced in all groups at T1 and T2, and the reduction of MMP-8 was the most notable in LED01. CONCLUSION: LED light irradiation during or after scaling and root planing assisted in the recovery of periodontium and can be used as an adjunct treatment during NSPT, specifically for sites with severe periodontal breakdown.

A cobalt-pyrrole coordination compound as high performance cathode catalyst for direct borohydride fuel cells.

Pyrrole and cobalt nitrate were used as nitrogen and metal sources respectively to synthesize a dinitratobis(polypyrrole)cobalt(ii) (Co(polypyrrole)2(NO3)2) adduct as the precursor of a Co-pyrrole/MPC catalyst. Pyrrole has the capability of polymerization and coordination with Co(ii). Taking this advantage, the Co(polypyrrole)2(NO3)2 coordination can form a long-chain structure with abundant and robust Co-N bonds, contributing to significantly increased catalytic sites in the product catalyst. As a result, the obtained Co-pyrrole/MPC (MPC = macroporous carbon) catalyst exhibited high ORR catalytic activity in alkaline media and excellent performance in direct borohydride fuel cell (DBFC). A peak power density up to 325 mW cm-2 was achieved at ambient condition, outperforming the commercialized Pt/XC-72 benchmark containing 28.6 wt% Pt. The construction of long-chain coordination precursor was verified playing a key role in the electrochemical improvement of Co-pyrrole/MPC catalyst in DBFC.

Erratum: The association between human papillomavirus presence and epidermal growth factor receptor mutations in Asian patients with non-small cell lung cancer.

[This corrects the article DOI: 10.21037/tlcr.2018.03.16.].

The association between human papillomavirus presence and epidermal growth factor receptor mutations in Asian patients with non-small cell lung cancer.

BACKGROUND: The etiology of non-small cell lung cancer (NSCLC) in non-smoker patients remains largely unknown. It has been widely proved that human papillomavirus (HPV) participates in the development of various cancers. Epidermal growth factor receptor (EGFR) mutation patients represent a large portion of non-smokers with NSCLC. We performed this meta-analysis to determine whether HPV infection in NSCLC tissue is associated with EGFR mutations compared with HPV negative controls. METHODS: Online databases were searched up to June 30th 2017. We included studies in which HPV detection was based on polymerase chain reaction (PCR) methods. Random effects model was used in data synthesis and the relative effects were presented as odds ratio (OR) with 95% confidence intervals (CIs). RESULTS: Finally, four eligible studies with a total of 498 patients from Asian countries were identified and included. The general EFGR mutation positive rate was 38.2% among all patients, and the HPV DNA detection rate (HPV subtype being involved: 16, 18, 33 and 58) was 35.3%. The presence of EGFR mutation was significantly higher in HPV-positive patients compared with HPV-negative controls (52% vs. 31%; OR =2.41, 95% CI: 1.21 to 4.77; P=0.012), with moderate heterogeneity among studies (I2=59%; P=0.062). CONCLUSIONS: Our results suggest that HPV infection is associated with EGFR mutations in NSCLC, at least in Asian populations. Further efforts should be made on exploring the potential mechanism and the prognostic character of HPV/EGFR positive NSCLC patient.

Three-Dimensional Versus Two-Dimensional Video-Assisted Endoscopic Surgery: A Meta-analysis of Clinical Data.

BACKGROUND: There have been no studies to systematically evaluate the two display (3D vs. 2D) systems regarding both laparoscopic and thoracoscopic surgeries in clinical settings; thus, we conducted one to evaluate the safety and efficacy of different visualization systems (two-dimensional and three-dimensional) during endoscopic surgery (laparoscopy or thoracoscopy) in clinical settings. METHODS: A comprehensive search of online databases was performed. Perioperative outcomes were synthesized. Cumulative meta-analysis was performed to evaluate the temporal trend of pooled outcomes. Specific subgroups (laparoscopy vs. thoracoscopy, prospective vs. retrospective study, malignant vs. benign diseases) were examined. Meta-regression was conducted to explore the source of heterogeneity. RESULTS: Twenty-three articles were considered in this analysis, of which 7 were thoracoscopic and 16 were laparoscopic surgeries. A total of 2930 patients were recorded, of which 1367 underwent 3D video-assisted surgery and 1563 underwent 2D display. Overall, significantly shorter operating time (SMD -0.69; p = <0.001), less blood loss (SMD -0.26; p = 0.028) and shorter hospital stays (SMD -0.16; p = 0.016) were found in the 3D display group. Meanwhile, the perioperative morbidity (OR 0.92; p = 0.487), retrieved lymph nodes (SMD 0.09; p = 0.081), drainage duration (SMD -0.15; p = 0.105) and drainage volume (SMD 0.00; p = 0.994) were similar between the two groups. Comparison of the overall outcomes in each subset showed consistency in all groups. CONCLUSIONS: This up-to-date meta-analysis reveals that the 3D display system is superior to the 2D system in clinical settings with significantly shorter operating time, less blood loss and shorter hospital stay. These findings suggest that, in laparoscopic or thoracoscopic surgeries, 3D endoscopic system is preferable when condition permits. Future efforts should be made on decreasing the side effects of 3D display and increasing its cost-effectiveness.

Identification of differentially expressed genes and biological pathways in bladder cancer.

The purpose of the present study was to identify key genes and investigate the related molecular mechanisms of bladder cancer (BC) progression. From the Gene Expression Omnibus database, the gene expression dataset GSE7476 was downloaded, which contained 43 BC samples and 12 normal bladder tissues. GSE7476 was analyzed to screen the differentially expressed genes (DEGs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed for the DEGs using the DAVID database, and a protein­protein interaction (PPI) network was then constructed using Cytoscape software. The results of the GO analysis showed that the upregulated DEGs were significantly enriched in cell division, nucleoplasm and protein binding, while the downregulated DEGs were significantly enriched in 'extracellular matrix organization', 'proteinaceous extracellular matrix' and 'heparin binding'. The results of the KEGG pathway analysis showed that the upregulated DEGs were significantly enriched in the 'cell cycle', whereas the downregulated DEGs were significantly enriched in 'complement and coagulation cascades'. JUN, cyclin­dependent kinase 1, FOS, PCNA, TOP2A, CCND1 and CDH1 were found to be hub genes in the PPI network. Sub­networks revealed that these gene were enriched in significant pathways, including the 'cell cycle' signaling pathway and 'PI3K­Akt signaling pathway'. In summary, the present study identified DEGs and key target genes in the progression of BC, providing potential molecular targets and diagnostic biomarkers for the treatment of BC.

Identification and validation of a novel major QTL for harvest index in rice (Oryza sativa L.).

BACKGROUND: Harvest index (HI) in rice is defined as the ratio of grain yield (GY) to biomass (BM). Although it has been demonstrated that HI is significantly related to yield and is considered as one of the most important traits in high-yielding rice breeding, HI-based high-yielding rice breeding is difficult due to its polygenic nature and insufficient knowledge on the genetic basis of HI. Therefore, searching for rice varieties with high HI and mapping genes associated with high HI can facilitate marker-assisted breeding for high HI in rice. RESULTS: Yuexiangzhan, a popular indica cultivar with good reputation of high HI was crossed with Shengbasimiao, an indica cultivar with lower HI to develop a recombinant inbred line population, and QTL mapping for HI and its component traits was conducted. In total, five QTLs for HI, three QTLs for GY, and six QTLs for BM were detected in two-year experiments. Among the three GY QTLs, one co-located with the HI QTL on chromosome 8, while the other two co-located with the two tightly-linked BM QTLs on chromosome 3. The co-located QTLs in each of the chromosomal regions produced additive effects in the same direction. Particularly, the HI QTL on chromosome 8, qHI-8, could be detected across two years and explained 42.8% and 44.5% of the phenotypic variation, respectively. The existence of qHI-8 was confirmed by the evaluation of the near isogenic lines derived from a residual heterozygous line, and this QTL was delimitated to a 1070 kb interval by substitution mapping. CONCLUSION: In the present study, the detected GY QTLs overlapped with both HI QTL and BM QTL, suggesting a positive relationship between GY and HI or BM, respectively. With an understanding of the genetic basis for grain yield, harvest index and biomass, it is possible to achieve higher yield through enhancing HI and BM by pyramiding the favorable alleles for the two traits via marker-assisted selection (MAS). As qHI-8 has a large phenotypic effect on HI and expresses stably in different environments, it provides a promising target for further genetic characterization of HI and MAS of high HI in rice breeding.

[Research progress of non-biological meshes for breast reconstruction].

Objective: To review the application progress of non-biological meshes for breast reconstruction (BR). Methods: The related home and abroad researches in BR were reviewed and summarized. Results: Non-biological meshes can be divided into degradable and nondegradable. The former has many types, whether its degradation rate can match with the grow rate of repair tissue will significantly affect the wound healing and tissue intergradation. TiLOOP, on behalf of the latter, has a good postoperative performance due to its nano TiO 2 layer, lightness and flexibility. Non-biological meshes have been gradually used to cover and fix implant in BR. Compared with biological meshes, non-biological meshes are cheaper and have a more positive postoperative performance generally, but definite comparison can't be concluded due to the limited data. Conclusion: As non-biological meshes are applied to BR preliminarily, their effectiveness are still needed to be observed further.

Filarial granuloma of the female breast: a histopathological study of 131 cases.

One hundred and thirty-one filarial granulomas of the female breast are described. The histopathological features, including a number of cross-sections of worms, ratio of female to male worms, and the frequency of degenerating worms were studied. Filarial granuloma of the female breast is common in eastern China, and adult worms and microfilariae should be sought in all unexplained granulomas of the breast.