To investigate factors associated with the duration of viral shedding in patients with COVID-19, outside of Wuhan. Methods: In this retrospective cohort study, patients with laboratory-confirmed COVID-19 in Changsha, China were included. Clinical characteristics, laboratory findings, treatment, and outcome were retrieved. Univariate and multivariate analyses were performed to explore potential factors. Results: Overall, 147 patients with COVID-19 were included. The median duration of viral shedding (the number of days from symptoms onset until the successive negative detection of SARS-CoV-2 RNA) was 17 days (interquartile range [IQR], 12-21). Multivariate Logistic regression analysis indicated that the highest temperature at admission (odds ratio [OR], 5.200; 95% confidence interval [CI]: 1.190À22.726; p = 0.028), time from symptom onset to admission (OR, 1.740; 95% CI: 1.296À2.337; p < 0.001) and hospital length of stay (OR, 1.604; 95% CI: 1.262À2.040; p < 0.001) were risk factors for prolonged duration of viral shedding. Conclusions: This study, with a relatively large sample size, focused on the duration of viral shedding and related factors in patients with COVID-19, outside of Wuhan, China. Potential risk factors were identified and should be taken into consideration for the strategy of quarantining infected patients.

Accurate knowledge of in vivo ankle joint complex (AJC) biomechanics is critical for understanding AJC disease states and for improvement of surgical treatments. This study investigated 6 degrees-of-freedom (DOF) in vivo kinematics of the human AJC using a combined dual-orthogonal fluoroscopic and magnetic resonance imaging (MRI) technique. Five healthy ankles of living subjects were studied during three in vivo activities of the foot, including maximum plantarflexion and dorsiflexion, maximum supination and pronation, and three weight-bearing positions in simulated stance phases of walking. A three-dimensional (3D) computer model of the AJC (including tibia, fibula, talus, and calcaneus) was constructed using 3D MR images of the foot. The in vivo AJC position at each selected position of the foot was captured using two orthogonally positioned fluoroscopes. In vivo AJC motion could then be reproduced by coupling the orthogonal images with the 3D AJC model in a virtual dual-orthogonal fluoroscopic system. From maximum dorsiflexion to plantarflexion, the arc of motion of the talocrural joint (47.5 AE 2.28) was significantly larger than that of the subtalar joint (3.1 AE 6.88). Both joints showed similar degrees of internalexternal and inversion-eversion rotation. From maximum supination to pronation, all rotations and translations of the subtalar joint were significantly larger than those of the talocrural joint. From heel strike to midstance, the plantarflexion contribution from the talocrural joint (9.1 AE 5.38) was significantly larger than that of the subtalar joint (À0.9 AE 1.28). From midstance to toe off, internal rotation and inversion of the subtalar joint (12.3 AE 8.38 and À10.7 AE 3.88, respectively) were significantly larger than those of the talocrural joint (À1.6 AE 5.98 and À1.7 AE 2.78). Strong kinematic coupling between the talocrural and subtalar joints was observed during in vivo AJC activities. The contribution of the talocrural joint to active dorsi-plantarflexion was higher than that of the subtalar joint, whereas the contribution of the subtalar joint to active supination-pronation was higher than that of the talocrural joint. In addition, the talocrural joint demonstrated larger motion during the early part of stance phase while the subtalar joint contributes more motion during the later part of stance phase. The results add quantitative data to an in vivo database of normals that can be used in clinical diagnosis, treatment, and evaluation of the AJC after injuries. ß

Sensory gating (SG) is a prevalent physiological process important for information filtering in complex systems. SG is evaluated by presenting repetitious stimuli and measuring the degree of neural inhibition that occurs. SG has been found to be impaired in several psychiatric disorders. Recent animal and human research has made great progress in the study of SG, and in this review we provide an overview of recent research on SG using different methods. Animal research has uncovered findings that suggest (1) SG is displayed by single neurons and can be similar to SG observed from scalp recordings in humans, (2) SG is found in numerous brain structures located in sensory, motor and limbic subregions, (3) SG can be significantly influenced by state changes of the organism, and (4) SG has a diverse pharmacological profile accented by a strong influence from nicotine receptor activation. Human research has addressed similar issues using deep electrode recordings of brain structures. These experiments have revealed that (1) SG can be found in cortical regions surrounding hippocampus, (2) the order of neural processing places hippocampal involvement during a later stage of sensory processing than originally thought, and (3) multiple subtypes of gating exist that could be dependent on different brain circuits and more or less influenced by alterations in organismal state. Animal and human research both have limitations. We emphasize the need for integrative approaches to understand the process and combine information between basic and clinical fields so that a more complete picture of SG will emerge.