Clinical Progression and Outcome of Hospitalized Patients Infected with SARS-CoV-2 Omicron Variant in Shanghai, China

Background: Studies on the Omicron variant infection have generally been restricted to descriptions of its initial clinical and epidemiological characteristics. We investigated the timeline-related progression and clinical outcome in hospitalized individuals with the Omicron variant. Methods: We conducted a retrospective, single-centered study including 226 laboratory-confirmed cases with the Omicron variant between 6 April and 11 May 2022 in Shanghai, China. The final date of follow-up was 30 May 2022. Results: Among 226 enrolled patients, the median age was 52 years, and 118 (52.2%) were female. The duration from onset of symptoms to hospitalization was 3 days (interquartile range (IQR): 2–4 days) for symptomatic patients. Cough occurred in 168 patients (74.3%). The median interval to negative reverse-transcriptase PCR tests of nasopharynx swab was 10 days ((IQR): 8–13 days). No radiographic progressions were found in 196 patients on the 7th day after onset of symptoms. The median duration of fever in all participants was 5 days (IQR: 4–6 days). The median PCR conversion time of Paxlovid-treated patients was 8 days (IQR: 7–10 days) compared with that of a traditional Chinese herb medicine lianhuaqingwen (10 days, IQR: 8–13 days) (p = 0.00056). Booster vaccination can significantly decrease the severity of Omicron infection when compared with unvaccinated patients (p = 0.009). In multivariate logistic analysis, erythrocyte sedimentation rate (ESR) (OR = 1.05) was independently related to the severity of the infection. Conclusions: The majority of clinical symptoms of Omicron infection were not severe. Early and aggressive administration of Paxlovid can significantly reduce the PCR conversion time. Booster vaccination should also be highly recommended in the population over 14 years old

The use of bidirectional rapid reductor in minimally invasive treatment of bicondylar tibial plateau fractures: preliminary radiographic and clinical results

Abstract Background Minimally invasive treatment of complex tibial plateau fracture represents one of the most challenging problems in orthopedic surgery. We intended to describe the percutaneous surgery involving an originally designed traction device which might facilitate the closed reduction for bicondylar tibial plateau fractures. Further, to assess the clinical outcomes of this minimally invasive technique. Methods Between December 2015 and July 2016, Twenty-one patients, mean age 43.71 ± 13.80 years, suffering from a bicondylar tibial plateau fracture (AO/OTA 41-type C) were included. All fractures were firstly reduced by skeletal traction with the aid of bidirectional rapid reductor, and residual depressed fragments were treated with minimally invasive bone tamp reduction. We then evaluated at a minimum follow-up of one year: (1) the rate of complications, (2) the radiographic outcomes (the amount of depression, tibial plateau widening, tibial plateau angle and posterior slope angle) and (3) the clinical outcome (Rasmussen scoring system). Results All patients had their fractures healed without secondary displacement. No instrument-related complications occurred during operation. Post-operatively, superficial infection was found in two patients and donor-site morbidity was found in one patient. We observed a  90° or PSA > 15°. At last evaluation, the Rasmussen clinical score was excellent in 11 patients (52.3%), good in 9 (42.9%) and fair in 1 (4.8%), and the radiological score was excellent in seven patients (33.3%), good in 14 (66.7%). Conclusions The bidirectional rapid reductor facilitates the minimally invasive treatment of bicondylar tibial plateau fracture. The patients exhibited excellent functional recovery. These results should be validated with a larger group of patients and longer period results. Trial registration ChiCTR-OPC-16008011

Continuous real-time monitoring of carbon dioxide emitted from human skin by quartz-enhanced photoacoustic spectroscopy

In this study, a skin gas detection system based on quartz enhanced photoacoustic spectroscopy (QEPAS) with a constant temperature collection chamber and an automatic frequency adjustment function was used to collect and monitor carbon dioxide (CO2) emissions from human skin. The detection element of the system is an on-beam structure assembled by a 30.72 kHz quartz tuning fork (QTF). A laser with a wavelength of 4991.26 cm−1 is emitted (with a wavelength adjustment range of 10 cm−1) to excite the QTF. When the integration time is 365 s, the system can achieve a minimum detection limit (MDL) of 2.6 ppmv. The sensitivity of the system is 636.9 ppmv/V. The gas detection system is used to monitor the concentration of CO2 emissions from different parts of the skin and the same part covered by different cosmetics. The CO2 emission rate is defined as the ratio of the skin gas monitoring time of 25 min to the CO2 concentration variable in the gas chamber (volume of 8 mL). The results were collected from three healthy volunteers. Among the six different parts, the cheeks emitted the fastest rate (the average rate was 365.5 ppmv/min) of CO2, and the thighs emitted the slowest rate (the average rate was 56.4 ppmv/min) of CO2. Comparing the experimental results of the six sites at different times, the order of the CO2 emission rate is identical for all six sites. In the experiments with the three cosmetic products (experimental site: forearm), comparing the CO2 emission rate from clean skin with the CO2 emission rate from cosmetic-covered skin shows that sunscreen is the most breathable, followed by barrier cream, and foundation is the least breathable

Anti-retroviral therapy decreases but does not normalize indoleamine 2,3-dioxygenase activity in HIV-infected patients.

Indoleamine 2,3-dioxygenase (IDO), which is mainly expressed in activated dendritic cells, catabolizes tryptophan to kynurenine and other downstream catabolites. It is known to be an immune mediator in HIV pathogenesis. The impact of anti-retroviral therapy on its activity has not been well established.We measured systemic IDO activity (the ratio of plasma kynurenine to tryptophan) in HIV-infected patients before and after highly active antiretroviral therapy (HAART) and its association with a microbial translocation marker, soluble CD14 (sCD14).Among 76 participants, higher baseline IDO activity was associated with lower CD4+ T cell counts (P<0.05) and higher plasma sCD14 levels (P<0.001). After 1 year of HAART, IDO activity decreased significantly (P<0.01), but was still higher than in healthy controls (P<0.05). The baseline IDO activity did not predict CD4+ T cell recovery after 1 year of therapy. The percentages of myeloid and plasmacytoid dendritic cells were not correlated with IDO activity.IDO activity is elevated in HIV-infected patients, which is partially associated with microbial translocation. HAART reduced, but did not normalize the activity of IDO

Thermal Stability of YSZ Coatings Deposited by Plasma Spray–Physical Vapor Deposition

The plasma spray&ndash;physical vapor deposition (PS&ndash;PVD) process has received considerable attention due to its non-line of sight deposition ability, high deposition rates, and cost efficiency. Compared with electron beam&ndash;physical vapor deposition (EB&ndash;PVD), PS&ndash;PVD can also prepare thermal barrier coatings (TBCs) with columnar microstructures. In this paper, yttria-stabilized zirconia (YSZ) coatings were fabricated by PS&ndash;PVD. Results showed that the as-deposited coating presented a typical columnar structure and was mainly composed of metastable tetragonal (t&prime;-ZrO2) phase. With thermal exposure, the initial t&prime; phase of YSZ evolved gradually into monoclinic (m-ZrO2) phase. Significant increase in hardness (H) and the Young&rsquo;s modulus (E) of the coating was attributed to the sintering effect of the coating during the thermal exposure, dependent on exposure temperature and time. However, the values of H and E decreased in the coatings thermally treated at 1300&ndash;1500 &deg;C for 24 h, which is mainly affected by the formation of m-ZrO2 phase

Thermal Stability of PS-PVD YSZ Coatings with Typical Dense Layered and Columnar Structures

Yttria-stabilized zirconia (YSZ) coatings with typical pyramid columnar and dense layered structure were prepared by plasma spray-physical vapor deposition (PS-PVD). The evolution behavior of microstructure and crystallography of the coatings before and after thermal aging treatment were observed by electron backscatter diffraction (EBSD) and field emission scanning electron microscopy (FE-SEM). Results showed that the as-deposited coatings exhibited many types of structures and were mainly composed of a nonequilibrium tetragonal (t&rsquo;-ZrO2) phase. With the prolonging of thermal exposure time, the initial nonequilibrium tetragonal phase of YSZ coatings gradually transformed into a monoclinic (m-ZrO2) phase. During the process of stationary deposition, at a proper spraying distance, each column exhibited a certain preferred orientation, but the ceramic topcoat did not exhibit distinct preferred orientation statistically

Thermal Stability of YSZ Thick Thermal Barrier Coatings Deposited by Suspension and Atmospheric Plasma Spraying

Two types of segmentation-crack structured yttria-stabilized zirconia (YSZ) thick thermal barrier coatings (&gt;500 &mu;m, TTBCs) were deposited onto the stainless steel substrates using atmospheric plasma spraying (APS) and suspension plasma spraying (SPS) process, respectively. In this work, thermal aging behaviors, such as the microstructures, phase compositions, grain growth, and mechanical properties of APS TTBCs and SPS TTBCs, were systematically investigated. Results showed that both as-sprayed TTBCs exhibited a typical segmentation-crack structure in the through-thickness direction. APS coatings mainly comprised of larger columnar crystals, while a large number of smaller equiaxed grains existed in SPS coatings. Both of the coatings underwent tetragonal-monoclinic phase transformation after 155 &deg;C/40 h heat treatment. The poorer phase stability of SPS TTBCs may have a connection with smaller grain size. Thermal-aged APS and SPS coatings exhibited a significant increase in H and E values with the rising of thermal aging temperature, and for the samples that thermal aged at 1550 &deg;C, the H and E values increased sharply during initial stage then decreased after 80 h due to the phase decomposition. The segmented APS coatings had weak bonding between the lamellaes during thermal exposure, which caused the mean Vickers hardness value of APS TTBCs to be much lower than that of SPS TTBCs