Data_Sheet_1_Clinical Features Predicting Mortality Risk in Patients With Viral Pneumonia: The MuLBSTA Score.docx

ObjectiveThe aim of this study was to further clarify clinical characteristics and predict mortality risk among patients with viral pneumonia.MethodsA total of 528 patients with viral pneumonia at RuiJin hospital in Shanghai from May 2015 to May 2019 were recruited. Multiplex real-time RT-PCR was used to detect respiratory viruses. Demographic information, comorbidities, routine laboratory examinations, immunological indexes, etiological detections, radiological images and treatment were collected on admission.Results76 (14.4%) patients died within 90 days in hospital. A predictive MuLBSTA score was calculated on the basis of a multivariate logistic regression model in order to predict mortality with a weighted score that included multilobular infiltrates (OR = 5.20, 95% CI 1.41–12.52, p = 0.010; 5 points), lymphocyte ≤ 0.8∗109/L (OR = 4.53, 95% CI 2.55–8.05, p ConclusionHere, we designed an easy-to-use clinically predictive tool for assessing 90-day mortality risk of viral pneumonia. It can accurately stratify hospitalized patients with viral pneumonia into relevant risk categories and could provide guidance to make further clinical decisions.</p

Dynamic Formation of Brønsted Acid Sites over Supported WO<i>_x</i>/Pt on SiO₂ Inverse CatalystsSpectroscopy, Probe Chemistry, and Calculations

Platinum-tungsten oxides are among the most studied metal–metal oxide pair catalysts for C–O hydrogenolysis reactions. The Brønsted acid density and synergy between Pt and WOx, especially in the inverse structure, are critical to reactivity and selectivity. However, a clear molecular-level understanding of the formation and dynamics of Brønsted acid sites (BAS) is lacking. Here, using in situ spectroscopic characterizations (Raman and FTIR), chemical probing (CO chemisorption and pyridine titration), density functional theory (DFT) calculations, and a model reaction (tert-butanol dehydration), we demonstrate the structural evolution of WOx species and associated BAS dynamics in various environments. In situ Raman and DFT calculations show that below monolayer coverage, the WOx species stay as isolated monomers on the SiO2 support and W3Ox trimers on Pt. The W3Ox trimers on Pt are dynamic and 10× more active toward dehydration than the WOx species on the SiO2 support. H2 plays a complex role: at low temperatures (3O7H on Pt by reversible hydrogen spillover, and at higher temperatures (>573 K), it partially reduces the W3Ox. We further show that the inverse configuration allows changes in the BAS density via catalyst pretreatments. This study provides a strategy for tuning Brønsted acid density and regenerating sites by pretreatment and catalyst composition

Results of binary logistic regression.

Results of binary logistic regression.</p

Feasibility Study on Prenatal Cardiac Screening Using Four-Dimensional Ultrasound with Spatiotemporal Image Correlation: A Multicenter Study - Fig 2

Required reconstructed fetal cardiac views: (A) abdominal view; (B) 4CV; (C) 5CV; (D) SVC + IVC; (E) RVOT; (F) 3VV; (G) short-axis view of great vessels; (H) LVOT; (I) DA; and (J) AA. DAO, descending aorta; LV, left ventricle; RV, right ventricle; LA, left atrium; RA, right atrium; FO, foramen ovale; AAO, ascending aorta; SVC, superior vena cava; IVC, inferior vena cava; RVOT, right ventricular outflow tract; MPA, main pulmonary artery; RPA, right pulmonary artery; LPA, left pulmonary artery; AO, aorta; AV, aortic valve; PA, pulmonary artery; TV, tricuspid valve; LVOT, left ventricular outflow tract; 4CV, four-chamber view; 3VV: three-vessel trachea view; DA, ductal arch; AA, aortic arch.</p

Data_Sheet_1_Different Pattern of Cardiovascular Impairment in Methylmalonic Acidaemia Subtypes.docx

Methylmalonic acidaemia (MMA) has been reported to be associated with cardiovascular involvement, especially for the combined type with homocystinuria. We have screened 80 control subjects and 99 MMA patients (23 isolated type and 76 combined type) using electrocardiograph and echocardiography. 32 cases (34%) of ECG changes were found including sinus tachycardia (n = 11), prolonged QTc interval (n = 1), I-degree atrioventricular block (n = 1), left axis deviation (n = 5) and T wave change (n = 14). By echocardiography, 8 cases of congenital heart disease were found in 4 combined MMA patients (5.3%) including ventricular septal defect (n = 2), atrial septal defect (n = 3), patent ductus arteriosus (n = 1) and coronary artery-pulmonary artery fistula (n =2). Pulmonary hypertension (n = 2) and hypertrophic cardiomyopathy (n = 1) in combined subtype were also noted. Moreover, echocardiographic parameters were analyzed by multiple regression to clarify the influence of different subtypes on cardiac function. It was found that the left ventricular mass index (LVMI) was significantly reduced only in combined subtype [R = −3.0, 95%CI (−5.4, −0.5), P = 0.017]. For left ventricle, the mitral E' velocity was significantly reduced [isolated type: R = −1.8, 95%CI (−3.3, −0.4), P = 0.016; combined type: R = −2.5, 95%CI (−3.5, −1.5), P < 0.001], the global longitudinal strain (GLS) was the same [isolated type: R = −1.4, 95%CI (−2.3, −0.4), P = 0.007; Combined type: R = −1.1, 95%CI (−1.8, −0.4), P = 0.001], suggesting weakened left ventricular diastolic and systolic functions in both subtypes. For right ventricle, only in combined subtype, the tricuspid E' velocity was significantly reduced [R = −1.4, 95%CI (−2.6, −0.2), P = 0.021], and the tricuspid annular plane systolic excursion (TAPSE) was the same [R = −1.3, 95%CI (−2.3, −0.3), P=0.013], suggesting impaired right ventricular systolic and diastolic function. In conclusion, isolated and combined types showed different pattern of cardiac dysfunction, specifically the former only affected the left ventricle while the latter affected both ventricles. And it is necessary to perform echocardiographic screening and follow up in both MMA subtypes.</p

Data_Sheet_1_Novel compound heterozygous CCDC40 mutations in a familial case of primary ciliary dyskinesia.ZIP

Primary ciliary dyskinesia (PCD) is a rare genetic disorder characterized by motile ciliary dysfunction and impaired ultrastructure. Despite numerous studies, the genetic basis for about 30% of PCD cases remains to be elucidated. Here, we present the identification and functional analysis of two novel mutations in the gene encoding coiled-coil domain-containing protein 40 (CCDC40), which are found in a familial case of PCD. These novel CCDC40 mutations, NM_017950.4: c.2236-2delA and c.2042_2046delTCACA, NP_060420.2: p.(Ile681fs), were identified by whole-exome sequencing (WES). Sanger sequencing was then performed to confirm the WES results and determine the CCDC40 gene sequences of the proband’s parents. The c.2042_2046delTCACA mutation disrupts the reading frame of the protein and is therefore predicted to produce a non-functional protein. Using a minigene assay with the pcDNA3.1(+) plasmid, we further investigated the potential pathogenic effects of the c.2236-2delA mutation and found that this mutation leads to formation of a truncated protein via splicing disruption. Thus, in summary, we identified two mutations of the CCDC40 gene that can be considered pathogenic compound heterozygous mutations in a case of familial PCD, thereby expanding the known mutational spectrum of the CCDC40 gene in this disease.</p

Source Apportionment of Speciated Mercury in Chinese Rice Grain Using a High-Resolution Model

Rice grain consumption is a primary pathway of human mercury exposure. To trace the source of rice grain mercury in China, we developed a rice paddy mercury transport and transformation model with a grid resolution of 1 km × 1 km by using the unit cell mass conservation method. The simulated total mercury (THg) and methylmercury (MeHg) concentrations in Chinese rice grain ranged from 0.08 to 243.6 and 0.03 to 238.6 μg/kg, respectively, in 2017. Approximately, 81.3% of the national average rice grain THg concentration was due to atmospheric mercury deposition. However, soil heterogeneity, especially the variation in soil mercury, led to the wide rice grain THg distribution across grids. Approximately, 64.8% of the national average rice grain MeHg concentration was due to soil mercury. In situ methylation was the main pathway via which the rice grain MeHg concentration was increased. The coupled impact of high mercury input and methylation potential led to extremely high rice grain MeHg in partial grids among Guizhou province and junctions with surrounding provinces. The spatial variation in soil organic matter significantly impacted the methylation potential among grids, especially in Northeast China. Based on the high-resolution rice grain THg concentration, we identified 0.72% of grids as heavily polluted THg grids (rice grain THg > 20 μg/kg). These grids mainly corresponded to areas in which the human activities of nonferrous metal smelting, cement clinker production, and mercury and other metal mining were conducted. Thus, we recommended measures that are targeted at the control of heavy pollution of rice grain by THg according to the pollution sources. In addition, we observed a wide spatial variation range of MeHg to THg ratios not only in China but also in other regions of the world, which highlights the potential risk of rice intake

Image_2_Different Pattern of Cardiovascular Impairment in Methylmalonic Acidaemia Subtypes.TIF

Methylmalonic acidaemia (MMA) has been reported to be associated with cardiovascular involvement, especially for the combined type with homocystinuria. We have screened 80 control subjects and 99 MMA patients (23 isolated type and 76 combined type) using electrocardiograph and echocardiography. 32 cases (34%) of ECG changes were found including sinus tachycardia (n = 11), prolonged QTc interval (n = 1), I-degree atrioventricular block (n = 1), left axis deviation (n = 5) and T wave change (n = 14). By echocardiography, 8 cases of congenital heart disease were found in 4 combined MMA patients (5.3%) including ventricular septal defect (n = 2), atrial septal defect (n = 3), patent ductus arteriosus (n = 1) and coronary artery-pulmonary artery fistula (n =2). Pulmonary hypertension (n = 2) and hypertrophic cardiomyopathy (n = 1) in combined subtype were also noted. Moreover, echocardiographic parameters were analyzed by multiple regression to clarify the influence of different subtypes on cardiac function. It was found that the left ventricular mass index (LVMI) was significantly reduced only in combined subtype [R = −3.0, 95%CI (−5.4, −0.5), P = 0.017]. For left ventricle, the mitral E' velocity was significantly reduced [isolated type: R = −1.8, 95%CI (−3.3, −0.4), P = 0.016; combined type: R = −2.5, 95%CI (−3.5, −1.5), P < 0.001], the global longitudinal strain (GLS) was the same [isolated type: R = −1.4, 95%CI (−2.3, −0.4), P = 0.007; Combined type: R = −1.1, 95%CI (−1.8, −0.4), P = 0.001], suggesting weakened left ventricular diastolic and systolic functions in both subtypes. For right ventricle, only in combined subtype, the tricuspid E' velocity was significantly reduced [R = −1.4, 95%CI (−2.6, −0.2), P = 0.021], and the tricuspid annular plane systolic excursion (TAPSE) was the same [R = −1.3, 95%CI (−2.3, −0.3), P=0.013], suggesting impaired right ventricular systolic and diastolic function. In conclusion, isolated and combined types showed different pattern of cardiac dysfunction, specifically the former only affected the left ventricle while the latter affected both ventricles. And it is necessary to perform echocardiographic screening and follow up in both MMA subtypes.</p

Success rates of reconstructed cardiac views.

<p>Success rates of reconstructed cardiac views.</p

ROC curve for aggregate score criteria and stated obstetric screening plane criteria (used in this study) for judging the STIC quality.

<p>ROC curve for aggregate score criteria and stated obstetric screening plane criteria (used in this study) for judging the STIC quality.</p