All authors contributed significantly and in keeping with the latest guidelines of the International Committee of Medical Journal Editors (ICMJE). Takatoshi Anno is the guarantor of this work and, as such, had full access to all data in the study, and takes responsibility for the integrity of the data and their accuracy. T.A. researched data and wrote the manuscript. R.S., F.K., S.I. and N.M. researched the data and contributed to discussion. K.K. and H.K. wrote and reviewed the manuscript.
Background and AimCirculating levels of interleukin (IL)-6, a well-known inflammatory cytokine, are often elevated in coronavirus disease-2019 (COVID-19). Elevated IL-6 levels are also observed in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Our study aimed to describe the association between circulating IL-6 levels and MAFLD at hospital admission with risk of severe COVID-19.MethodsA total of 167 patients with laboratory-confirmed COVID-19 from three Chinese hospitals were enrolled. Circulating levels of IL-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ were measured at admission. All patients were screened for fatty liver by computed tomography. Forty-six patients were diagnosed as MAFLD.ResultsPatients with MAFLD (n = 46) had higher serum IL-6 levels (median 7.1 [interquartile range, 4.3–20.0] vs. 4.8 [2.6–11.6] pg/mL, p = 0.030) compared to their counterparts without MAFLD (n = 121). After adjustment for age and sex, patients with MAFLD had a ~2.6-fold higher risk of having severe COVID-19 than those without MAFLD. After adjustment for age, sex and metabolic co-morbidities, increased serum IL-6 levels remained associated with higher risk of severe COVID-19, especially among infected patients with MAFLD (adjusted-odds ratio 1.14, 95% CI 1.05–1.23; p = 0.002). There was a significant interaction effect between serum IL-6 levels and MAFLD for risk of severe COVID-19 (p for interaction = 0.008).ConclusionsPatients with MAFLD and elevated serum IL-6 levels at admission are at higher risk for severe illness from COVID-19.
The projections of ocellar fibres within the brain and thorax of the honey bee, Apis mellifera, were established using a modified cobalt sulphide technique, supplemented by serial sectioning of the brain for the light microscope. The results are: 5 large fibres in each lateral nerve and 12 in the median nerve have wide-field terminal arborisations in ocellar association areas on either side of the posterior slope area. 9 medium-sized fibres in each lateral nerve and 12 in the median nerve form a second ocellar association area on each side of the perioesophageal foramen. A group of fine fibres , stained via the ocellar nerves, arborise just below and anterior to the protocerebral bridge. 10 medium-sized fibres run from the level of the ocellar nerve tracts to the first and second thoracic ganglia, branching in a number of discrete areas within each ganglion. These fibres also form a restricted ocellar association area within the suboesophageal ganglion. A few fibres run between the higher-order optic centres and the ocellar tract. The large- and medium-sized fibres give off short, stout spines from their axons within the ocellar tracts.
Clinicians have been faced with the challenge of differentiating between severe acute respiratory syndrome associated coronavirus 2 (SARS-CoV-2) infected pneumonia (NCP) and influenza A infected pneumonia (IAP), a seasonal disease that coincided with the outbreak. We aim to develop a machine-learning algorithm based on radiomics to distinguish NCP from IAP by texture analysis based on computed tomography (CT) imaging. Forty-one NCP and 37 IAP patients admitted from January to February 6, 2019 admitted to two hospitals in Wenzhou, China. All patients had undergone chest CT examination and blood routine tests prior to receiving medical treatment. NCP was diagnosed by real-time RT-PCR assays. Eight of 56 radiomic features extracted by LIFEx were selected by least absolute shrinkage and selection operator regression to develop a radiomics score and subsequently constructed into a nomogram to predict NCP with area under the operating characteristics curve of 0.87 (95% confidence interval: 0.77-0.93). The nomogram also showed excellent calibration with Hosmer-Lemeshow Abbreviations: ASA, American Society of Anesthesiologists; AUC, area under the operating characteristics curve; CT, computed tomography; IAP, influenza A virus infected pneumonia; LASSO, least absolute shrinkage and selection operator; NGLDM, neighborhood gray-level dependence matrix; ROI, region of interest; SARS-CoV-2, severe acute respiratory syndrome-associated coronavirus 2; SVM, support vector machine This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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