Hematopoietic stem cell transplantation activity in China 2020-2021 during the SARS-CoV-2 pandemic: a report from the Chinese Blood and Marrow Transplantation Registry Group.

Between 2020 and 2021, 31,525 hematopoietic stem cell transplantations (HSCTs) were reported to the Chinese Blood and Marrow Transplantation Registry Group (CBMTRG) throughout mainland China. In this report, we describe the activity and current trends for HSCT in China during the SARS-CoV-2 pandemic. In 2020, a total of 13,415 cases of HSCT were reported from 166 transplant teams, and 75% (10,042 cases) were allogeneic HSCTs. In 2021, a total of 18,110 cases of HSCT were reported from 174 transplant teams, and 70% (12,744 cases) were allogeneic HSCTs. Haploidentical donor (HID) transplantation accounted for 63% (7977 cases) of allogeneic HSCTs in 2021. The most common indications for allogeneic HSCT for malignant disease were acute myeloid leukemia (AML) (37%) and acute lymphoblastic leukemia (ALL) (23%), and the largest proportion of nonmalignant disease comprised aplastic anemia (AA) (13%). The PB stem cell source accounted for 41% of HIDs and 75% of MSDs. The BuCy-based regimen (57%) was the most popular conditioning regimen for allogeneic HSCT, followed by the BuFlu-based regimen (28%) and TBI-based regimen (11%). This survey provides comprehensive information about the current activities and might benefit clinical physicians' decision planning for HSCT.

Etiology, clinical features, infection control and therapy of SARS-CoV-2 Omicron variant

The Omicron variant of SARS-CoV-2 is a new variant of concern after Alpha, Beta, Gamma and Delta variants. The amino acid mutations in the viral antigens, especially in the receptor binding region (RBD) of spike protein, were significantly more than those of other variants, which lead to the significant increase of infectivity, transmissibility and immune escape of Omicron variant. In addition, those spike mutations impaired the protective effect of vaccination. When compared to the infection of other variants, the latency of Omicron variant infection was significantly shortened, and the pathogenicity decreased markedly, which is in consistence with the fact that the vast majority of infected individuals showed no symptoms or only mild disease. Exacerbations in patients infected by Omicron variant were often associated with the progress of underlying disease. Early detection and medical isolation of infected persons, careful personal protection measures to cut off transmission routes, and active vaccination to protect susceptible people are key measures to prevent the spread of Omicron variant epidemic. A small number of patients infected with Omicron variant may develop so-called long COVID-19, post-COVID-19 syndrome, or post-COVID-19 condition, which means that long-term follow-up is needed in those patients. Effective anti-Omicron variant therapy can shorten the course of infection, promote the recovery from infection, and also contribute to the control of infection. Therefore, the development of antiviral drugs with ideal cost-benefit ratio and convenient administration is one of the research hotspot in the future.

Structural Attacks and Defenses for Flow-Based Microfluidic Biochips.

Flow-based microfluidic biochips (FMBs) have seen rapid commercialization and deployment in recent years for point-of-care and clinical diagnostics. However, the outsourcing of FMB design and manufacturing makes them susceptible to susceptible to malicious physical level and intellectual property (IP)-theft attacks. This work demonstrates the first structure-based (SB) attack on representative commercial FMBs. The SB attacks maliciously decrease the heights of the FMB reaction chambers to produce false-negative results. We validate this attack experimentally using fluorescence microscopy, which showed a high correlation ( R2 = 0.987) between chamber height and related fluorescence intensity of the DNA amplified by polymerase chain reaction. To detect SB attacks, we adopt two existing deep learning-based anomaly detection algorithms with  âˆ¼ 96% validation accuracy in recognizing such deliberately introduced microstructural anomalies. To safeguard FMBs against intellectual property (IP)-theft, we propose a novel device-level watermarking scheme for FMBs using intensity-height correlation. The countermeasures can be used to proactively safeguard FMBs against SB and IP-theft attacks in the era of global pandemics and personalized medicine.

Di-(2-ethylhexyl) Phthalate Triggers Proliferation, Migration, Stemness, and Epithelial-Mesenchymal Transition in Human Endometrial and Endometriotic Epithelial Cells via the Transforming Growth Factor-ß/Smad Signaling Pathway.

Di-(2-ethylhexyl) phthalate (DEHP) is a frequently used plasticizer that may be linked to the development of endometriosis, a common gynecological disorder with a profound impact on quality of life. Despite its prevalence, vital access to treatment has often been hampered by a lack of understanding of its pathogenesis as well as reliable disease models. Recently, epithelial-mesenchymal transition (EMT) has been suggested to have a significant role in endometriosis pathophysiology. In this study, we found that DEHP treatment enhanced proliferation, migration, and inflammatory responses, along with EMT and stemness induction in human endometrial and endometriotic cells. The selective transforming growth factor-ß (TGF-ß) receptor type 1/2 inhibitor LY2109761 reversed the DEHP-induced cell proliferation and migration enhancement as well as the increased expression of crucial molecules involved in inflammation, EMT, and stemness, indicating that DEHP-triggered phenomena occur via the TGF-ß/Smad signaling pathway. Our study clearly defines the role of DEHP in the etiology and pathophysiological mechanisms of endometriosis and establishes an efficient disease model for endometriosis using a biomimetic 3D cell culture technique. Altogether, our data provide novel etiological and mechanistic insights into the role of DEHP in endometriosis pathogenesis, opening avenues for developing novel preventive and therapeutic strategies for endometriosis.

PaO2/FiO2 and IL-6 are risk factors of mortality for intensive care COVID-19 patients.

To identify the risk factors of mortality for the coronavirus disease 19 (COVID-19) patients admitted to intensive care units (ICUs) through a retrospective analysis. The demographic, clinical, laboratory, and chest imaging data of patients admitted to the ICU of Huoshenshan Hospital from February 10 to April 10, 2020 were retrospectively analyzed. Student's t-test and Chi-square test were used to compare the continuous and categorical variables, respectively. The logistic regression model was employed to ascertain the risk factors of mortality. This retrospective study involved 123 patients, including 64 dead and 59 survivors. Among them, 57 people were tested for interleukin-6 (IL-6) (20 died and 37 survived). In all included patients, the oxygenation index (PaO2/FiO2) was identified as an independent risk factor (odd ratio [OR] = 0.96, 95% confidence interval [CI]: 0.928-0.994, p = 0.021). The area under the curve (AUC) was 0.895 (95% CI: 0.826-0.943, p < 0.0001). Among the patients tested for IL-6, the PaO2/FiO2 (OR = 0.955, 95%CI: 0.915-0.996, p = 0.032) and IL-6 (OR = 1.013, 95%CI: 1.001-1.025, p = 0.028) were identified as independent risk factors. The AUC was 0.9 (95% CI: 0.791-0.964, p < 0.0001) for IL-6 and 0.865 (95% CI: 0.748-0.941, p < 0.0001) for PaO2/FiO2. PaO2/FiO2 and IL-6 could potentially serve as independent risk factors for predicting death in COVID-19 patients requiring intensive care.

Bull and bear markets during the COVID-19 pandemic.

The COVID-19 pandemic has caused severe disruption worldwide. We analyze the aggregate U.S. stock market during this period, including implications for both short and long-horizon investors. We identify bull and bear market regimes including their bull correction and bear rally components, demonstrate our model's performance in capturing periods of significant regime change, and provide weekly forecasts that improve risk management and investment decisions. An investment strategy that uses out-of-sample forecasts for market states outperforms a buy and hold strategy during the pandemic by a wide margin, both in terms of annualized returns and Sharpe ratios.

Characteristics of community-acquired respiratory viruses infections except seasonal influenza in transplant recipients and non-transplant critically ill patients.

BACKGROUND/PURPOSE: Transplant recipients are vulnerable to life-threatening community-acquired respiratory viruses (CA-RVs) infection (CA-RVI). Even if non-transplant critically ill patients in intensive care unit (ICU) have serious CA-RVI, comparison between these groups remains unclear. We aimed to evaluate clinical characteristics and mortality of CA-RVI except seasonal influenza A/B in transplant recipients and non-transplant critically ill patients in ICU. METHODS: We collected 37,777 CA-RVs multiplex real-time reverse transcription-polymerase chain reaction test results of individuals aged ≥18 years from November 2012 to November 2017. The CA-RVs tests included adenovirus, coronavirus 229E/NL63/OC43, human bocavirus, human metapneumovirus, parainfluenza virus 1/2/3, rhinovirus, and respiratory syncytial virus A/B. RESULTS: We found 286 CA-RVI cases, including 85 solid organ transplantation recipients (G1), 61 hematopoietic stem cell transplantation recipients (G2), and 140 non-transplant critically ill patients in ICU (G3), excluding those with repeated isolation within 30 days. Adenovirus positive rate and infection cases were most prominent in G2 (p < 0.001). The median time interval between transplantation and CA-RVI was 30 and 20 months in G1 and G2, respectively. All-cause in-hospital mortality was significantly higher in G3 than in G1 or G2 (51.4% vs. 28.2% or 39.3%, p = 0.002, respectively). The mechanical ventilation (MV) was the independent risk factor associated with all-cause in-hospital mortality in all three groups (hazard ratio, 3.37, 95% confidence interval, 2.04-5.56, p < 0.001). CONCLUSIONS: This study highlights the importance of CA-RVs diagnosis in transplant recipients even in long-term posttransplant period, and in non-transplant critically ill patients in ICU with MV.

Clinical characteristics, laboratory abnormalities and CT findings of COVID-19 patients and risk factors of severe disease: a systematic review and meta-analysis.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is an emerging pandemic of global public health concern. We aimed to summarize the characteristics of COVID-19 patients in the early stage of the pandemic and explore the risk factors of disease progression. METHODS: We conducted a systematic review with meta-analysis, searching three databases for studies published between January 1, 2020, and March 18, 2020. We used random-effects models to calculate the 95% confidence intervals of pooled estimated prevalence and the odds ratio between the severe and nonsevere cases. RESULTS: Ninety studies involving 16,526 COVID-19 patients were included. Hypertension (19.1%) and diabetes (9.5%) were the most common comorbidities. The most prevalent clinical symptoms were fever (78.4%), cough (58.5%), and fatigue (26.4%). Increased serum ferritin (74.2%), high C-reactive protein (73.3%), and high erythrocyte sedimentation rate (ESR) (72.2%) were the most frequently reported laboratory abnormalities. Most patients had bilateral lung involvement (82.2%) and showed peripheral (66.9%) and subpleural (62.1%) distribution, with multifocal involvement (73.1%). And the most common CT features were vascular enlargement (64.3%), ground-glass opacity (GGO) (60.7%), and thickened interlobular septa (55.1%). Respiratory failure was the most common complication (30.7%) and the overall case-fatality rate (CFR) was 4.2%. Moreover, male, history of smoking, and comorbidities might influence the prognosis. Most clinical symptoms such as fever, high fever, cough, sputum production, fatigue, shortness of breath, dyspnoea, and abdominal pain were linked to the severity of disease. Some specific laboratory indicators implied the deterioration of disease, such as leucocytosis, lymphopenia, platelet, alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, creatinine, creatine kinase (CK), lactic dehydrogenase (LDH), C-reactive protein, procalcitonin (PCT), and D-dimer. Besides, the risk of bilateral pneumonia, consolidation, pleural effusion, and enlarged mediastinal nodes was higher in severe cases. CONCLUSIONS: Most COVID-19 patients have fever and cough with lymphopenia and increased inflammatory indices, and the main CT feature is GGO involved bilateral lung. Patients with comorbidities and worse clinical symptoms, laboratory characteristics, and CT findings tend to have poor disease progression.

Christian Ethical Analysis of the L.A. Riots in 1992: The Media and Institutional Racism

This essay utilizes Reinhold Niebuhr"s theology of the universality of sin to analyze institutional racism, using the 1992 Los Angeles riots as a case study. Contrary to the conventional interpretation of the riots as a conflict between African Americans and Korean Americans, the pervasive institutional racism of the mainstream media of that era spread the riots into multiracial conflicts, which explains Niebuhr"s thinking regarding the universality of sin. Furthermore, the sensationalism of the media that fueled the massive violence deprived African Americans of the moral dynamic for social transformation and victimized Korean Americans as scapegoats. As a result, the institutional processes promoted the status quo that benefited the white privileged class at the expense of the racial minorities. Implications found in this essay may be applicable to current issues, such as anti-Asian racism that has surfaced during the COVID-19 pandemic in the United States.