ZBP1-Mediated Necroptosis: Mechanisms and Therapeutic Implications.

Cell death is a fundamental pathophysiological process in human disease. The discovery of necroptosis, a form of regulated necrosis that is induced by the activation of death receptors and formation of necrosome, represents a major breakthrough in the field of cell death in the past decade. Z-DNA-binding protein (ZBP1) is an interferon (IFN)-inducing protein, initially reported as a double-stranded DNA (dsDNA) sensor, which induces an innate inflammatory response. Recently, ZBP1 was identified as an important sensor of necroptosis during virus infection. It connects viral nucleic acid and receptor-interacting protein kinase 3 (RIPK3) via two domains and induces the formation of a necrosome. Recent studies have also reported that ZBP1 induces necroptosis in non-viral infections and mediates necrotic signal transduction by a unique mechanism. This review highlights the discovery of ZBP1 and its novel findings in necroptosis and provides an insight into its critical role in the crosstalk between different types of cell death, which may represent a new therapeutic option.

Hydrothermal deconstruction of single-use personal protective equipment during the COVID-19 pandemic.

To minimise the transmission of the SARS-CoV-2 virus, there has been a substantial increase in the production and usage of synthetic personal protective equipment (PPE) globally. Consequently, single-use PPE have been widely adopted without appropriate regulations for their disposal, leading to extensive environmental contamination worldwide. This study investigates the non-catalytic hydrothermal deconstruction of different PPE items, including isolation gowns, gloves, goggles, face shields, surgical masks, and filtering-facepiece respirators. The selected PPE items were subjected to hydrothermal deconstruction for 90 min in the presence of 30-bar initial oxygen pressure, at temperatures ranging between 250 °C and 350 °C. The solid content in form of total suspended solids (TSS) was reduced up to 97.6%. The total chemical oxygen demand (tCOD) and soluble chemical oxygen demand (sCOD) decreased with increasing deconstruction temperature, and at 350 °C the lowest tCOD and sCOD content of 546.6 mg/L and 470 mg/L, respectively, was achieved. Short-chained volatile fatty acids were produced after 90 min of deconstruction, predominantly acetic acid at concentrations up to 8974 mg/L. Ammonia nitrogen content (NH3-N) of up to 542.6 mg/L was also detected. Carbon dioxide (CO2) and unreacted oxygen (O2) were the main gaseous by-products at up to 15.6% (w/w) and 88.7% (w/w), respectively. The findings suggest that non-catalytic hydrothermal deconstruction is a viable option to process and manage PPE waste.

Deconstruction and Valorisation of a Mixture of Personal Protective Equipment using Hydrothermal Processing

This study used non-catalytic hydrothermal deconstruction to examine the deconstruction of a mixture of numerous PPE items, including isolation gowns, gloves, goggles, face shields, surgical masks, and filtering-facepiece respirators. A mixture of PPE items was subjected to hydrothermal deconstruction at temperatures varying between 250 °C and 350 °C and reaction times of 90 min and 180 min, respectively. A reduction of up to 95 % was attained in the total suspended solids (TSS). The total chemical oxygen demand (tCOD) and soluble chemical oxygen demand (sCOD) decreased dramatically to 703 mg/L and 480 mg/L, respectively. Volatile fatty acids, mainly acetic acid and ammonia nitrogen (NH3-N) were the primary end products with a concentration of up to 15,625 mg/L and 38 mg/L after 180 min of deconstruction, respectively. Carbon dioxide and oxygen were found to be the primary gaseous product, with a concentration of up to 14 % (w/w) for CO2 and 76 % (w/w) for O2. Further experiments were conducted at 300 °C and 350 °C to reuse process water for five cycles to demonstrate the feasibility of process water recycling. The results propose that non-catalytic hydrothermal deconstruction may potentially reduce PPE waste by minimising solid waste and water usage.

Hydrothermal deconstruction of single-use personal protective equipment: process design and economic performance.

Increased demand for single-use personal protective equipment (PPE) during the COVID-19 pandemic has resulted in a marked increase in the amount of PPE waste and associated environmental pollution. Developing efficient and environmentally safe technologies to manage and dispose of this PPE waste stream is imperative. We designed and evaluated a hydrothermal deconstruction technology to reduce PPE waste by up to 99% in weight. Hydrothermal deconstruction of single-use PPE waste was modelled using experimental data in Aspen Plus. Techno-economic and sensitivity analyses were conducted, and the results showed that plant scale, plant lifetime, discount rate, and labour costs were the key factors affecting overall processing costs. For a 200 kg/batch plant under optimal conditions, the cost of processing PPE waste was found to be 10 NZD/kg (6 USD/kg), which is comparable to the conventional practice of autoclaving followed by landfilling. The potential environmental impacts of this process were found to be negligible; meanwhile, this practice significantly reduced the use of limited landfill space.

Diagnostic Performance of a Deep Learning Model Deployed at a National COVID-19 Screening Facility for Detection of Pneumonia on Frontal Chest Radiographs.

(1) Background: Chest radiographs are the mainstay of initial radiological investigation in this COVID-19 pandemic. A reliable and readily deployable artificial intelligence (AI) algorithm that detects pneumonia in COVID-19 suspects can be useful for screening or triage in a hospital setting. This study has a few objectives: first, to develop a model that accurately detects pneumonia in COVID-19 suspects; second, to assess its performance in a real-world clinical setting; and third, by integrating the model with the daily clinical workflow, to measure its impact on report turn-around time. (2) Methods: The model was developed from the NIH Chest-14 open-source dataset and fine-tuned using an internal dataset comprising more than 4000 CXRs acquired in our institution. Input from two senior radiologists provided the reference standard. The model was integrated into daily clinical workflow, prioritising abnormal CXRs for expedited reporting. Area under the receiver operating characteristic curve (AUC), F1 score, sensitivity, and specificity were calculated to characterise diagnostic performance. The average time taken by radiologists in reporting the CXRs was compared against the mean baseline time taken prior to implementation of the AI model. (3) Results: 9431 unique CXRs were included in the datasets, of which 1232 were ground truth-labelled positive for pneumonia. On the "live" dataset, the model achieved an AUC of 0.95 (95% confidence interval (CI): 0.92, 0.96) corresponding to a specificity of 97% (95% CI: 0.97, 0.98) and sensitivity of 79% (95% CI: 0.72, 0.84). No statistically significant degradation of diagnostic performance was encountered during clinical deployment, and report turn-around time was reduced by 22%. (4) Conclusion: In real-world clinical deployment, our model expedites reporting of pneumonia in COVID-19 suspects while preserving diagnostic performance without significant model drift.

Improvement to the subjective well-being of pet ownership may have positive psychological influence during COVID-19 epidemic.

The COVID-19 epidemic and government intervention measures may have adverse effects on people's mental health. To explore the influence of pets on the intervention of people's psychological problems during the COVID-19 epidemic, an online survey was carried out between April 9 and April 29, 2020. A total of 756 participants replied to this questionnaire. Mental health variables were assessed, and the comparison of behavior changes among pet owners and pets on positive mental well-being during COVID-19 epidemic. Comparative analysis was performed; compared with individuals without pets (n = 575), pet owners (n = 181) had a higher prevalence of insomnia (p = 0.006). Living in Wuhan city was a risk factor for people with psychological stress (p < 0.05). Dog owners exhibited lower than average scores of insomnia and uncertainty of infection than cat owners (p = 0.004). People with more than one pet exhibited lower than average scores of depression than having one pet (p = 0.040). For analysis of psychological effects of pets on people, the role of pets in subjective feeling and positive psychological changes of pet owner was significantly different. Pet owners relieve that psychological pressure through behavioral changes towards their pets in early stage. Pets provided positive subjective well-being and psychological effects for their owners.

Efficacy and Safety of COVID-19 Vaccines in Phase III Trials: A Meta-Analysis.

Nowadays, the vaccination with COVID-19 vaccines is being promoted worldwide, professionals and common people are very concerned about the efficacy and safety of COVID-19 vaccines. No published systematic review and meta-analysis has assessed the efficacy and safety of the COVID-19 vaccines based on data from phase III clinical trials. Therefore, this study has estimated the efficacy and safety of COVID-19 vaccines and the differences between vaccine types. PubMed, Embase, the Cochrane Library, CNKI, Wanfang, medRxiv databases and two websites were used to retrieve the studies. Random-effects models were used to estimate the pooled efficacy and safety with risk ratio (RR). A total of eight studies, seven COVID-19 vaccines and 158,204 subjects were included in the meta-analysis. All the vaccines had a good preventive effect on COVID-19 (RR = 0.17, 95% CI: 0.09-0.32), and the mRNA vaccine (RR = 0.05, 95% CI: 0.03-0.09) was the most effective against COVID-19, while the inactivated vaccine (RR = 0.32, 95% CI: 0.19-0.54) was the least. In terms of safety, the risk of overall adverse events showed an increase in the vaccine group after the first (RR = 1.46, 95% CI: 1.03-2.05) or second (RR = 1.52, 95% CI: 1.04-2.20) injection. However, compared with the first injection, the risk of local (RR = 2.64, 95% CI: 1.02-6.83 vs. RR = 2.25, 95% CI: 0.52-9.75) and systemic (RR = 1.33, 95% CI: 1.21-1.46 vs. RR = 1.59, 95% CI: 0.84-3.01) adverse events decreased after the second injection. As for the mRNA vaccine, the risk of overall adverse events increased significantly, compared with the placebo, no matter whether it was the first (RR = 1.83, 95% CI = 1.80-1.86) or the second (RR = 2.16, 95% CI = 2.11-2.20) injection. All the COVID-19 vaccines that have published the data of phase III clinical trials have excellent efficacy, and the risk of adverse events is acceptable. The mRNA vaccines were the most effective against COVID-19, meanwhile the risk and grade of adverse events was minimal, compared to that of severe symptoms induced by COVID-19.

Government Intervention Measures Effectively Control COVID-19 Epidemic in Wuhan, China.

The Coronavirus disease 2019 (COVID-19) outbreak has been brought under control through a nationwide effort, and now it has become a global pandemic and the situation seems grim. We summarized the measures taken in Wuhan and analyzed the effects to comprehensively describe the factors involved in controlling the COVID-19 in China. In China, several measures such as the lockdown of Wuhan, restriction of traffic and communities, increasing hospital beds, nationwide support from medical staff, epidemic prevention equipment and supplies, and establishment of makeshift shelter hospitals have been taken. The lockdown of Wuhan reduced the propagation of cases to other cities in Hubei province and throughout China, traffic and community restrictions reduced the flow of population and the spread of disease, increasing wards and beds and medical personnel reduced the incidence of severe cases and mortality, the establishment of the Fangcang shelter hospitals provided a good isolation and monitoring environment, and further reduced the spread and fatality of the disease. The fact that China was able to control the spread of COVID-19 within three months without a specific drug or vaccine suggests that these measures are more adequate and effective.

Epidemiologic characteristics of traumatic fractures in elderly patients during the outbreak of coronavirus disease 2019 in China.

PURPOSE: This study aimed to describe the epidemiologic characteristics of fracture in the elderly during the COVID-19. METHODS: This was a retrospective multi-centre study, which included patients who sustained fractures between 20 January and 19 February 2020. The collected data included patients' demographics (age and gender), injury-related (injury type, fracture location, injury mechanism, places where fracture occurred), and treatment modality. SPSS 23.0 was used to describe the data and perform some analysis. RESULTS: A total of 436 patients with 453 fractures were included; there were 153 males and 283 females, with an average age of 76.2 years (standard deviation, SD, 7.7 years; 65 to 105). For either males or females, 70-74 years was the most commonly involved age group. A total of 317 (72.7%) patients had their fractures occurring at home. Among 453 fractures, there were 264 (58.3%) hip fractures, accounting for 58.3%. Fall from standing height was the most common cause of fracture, making a proportion of 89.4% (405/453). Most fractures (95.8%, 434/453) were treated surgically, and 4.2% (19/453) were treated by plaster fixation or traction. Open reduction and internal fixation (ORIF) was the most used surgical method, taking a proportion of 49.2% (223/453). CONCLUSION: These findings highlighted the importance of primary prevention (home prevention) measures and could be used for references for individuals, health care providers, or health administrative department during the global pandemic of COVID-19.