Background We aimed to describe the epidemiological, virological and serological features of coronavirus disease 2019 (COVID-19) cases in people living with HIV (PLWH). Methods This population-based cohort study identified all COVID-19 cases among the whole PLWH in Wuhan city, China, by April 16, 2020. The epidemiological, virological and serological features were analyzed based on the demographic data, temporal profile of nucleic acid test for SARS-CoV-2 during the disease, and SARS-CoV-2-specific IgM and IgG after recovery. Results From January 1 to April 16, 2020, 35 of 6001 PLWH have experienced COVID-19, with the cumulative incidence of COVID-19 to be 0.58% (95%CI: 0.42%-0.81%). Among the COVID-19 cases, 15 (42.86%) had severe illness, with 2 deaths. The incidence, case-severity and case-fatality of COVID-19 in PLWH were comparable to that in the entire population in Wuhan. 197 persons had cART discontinuation, of whom 4 persons experienced COVID-19. Risk factors for COVID-19 were age ≥50 years old and cART discontinuation. The median duration of SARS-CoV-2 viral shedding among confirmed COVID-19 cases in PLWH was 30 (IQR: 20-46) days. Cases with high HIV viral load (≥20 copies/ml) had lower IgM and IgG levels than those with low HIV viral load (<20 copies/ml) (median S/CO for IgM, 0.03 vs. 0.11, P<0.001; median S/CO for IgG, 10.16 vs. 17.04, P=0.069). Conclusions Efforts need to maintain the persistent supply of antiretroviral treatment to elderly PLWH aged 50 years or above during the COVID-19 epidemic. The coinfection of HIV and SARS-CoV-2 might change the progression and prognosis of COVID-19 patients in PLWH.
Background Methadone maintenance treatment (MMT) reduces the harms of opioid use disorder and is being rapidly scaled-up in China. This study evaluated the real-world implementation of MMT system in Wuhan, China. Methods Data extracted from electronic medical records collected in 2010 on 8,811 patients were used to compute for each patient indices of the prescribed and consumed daily methadone doses, an adherence index, dose adjustments following missed doses, the rates of opiate positive urine tests, self-reported drug use, injection drug use (IDU), and the duration of MMT exposure. Findings The modal daily doses prescribed were 60 mg and above for 68.5% of patients. Adherence was variable: 51% of patients attended less than 60% and 26% attended 80% to 100% of their treatment days; and patients with long MMT exposure had significantly higher adherence rates than patients with short MMT exposure. The differences between doses dispensed immediately before and after the interruption in dosing days ranged from 0 to 7 mg, independently of the length of the interruption or the prescribed dosing level. The overall rate of opiate positive tests was 20%; 45% of patients had at least one opiate positive test; 29% reported past month drug use and 53% of them reported past month IDU. Adherence and MMT exposure duration correlated significantly with the proportion of opiate negative urine tests (r=0.355, p<0.001; r=0.351, p<0.001, respectively). Treatment for males and females was comparable. Conclusions Provision of safe methadone dosing after absences and improving daily attendance are identified as priority improvement areas.
BackgroundOral pre-exposure prophylaxis (PrEP) is recommended as an additional prevention choice for men who have sex with men (MSM) at substantial risk of HIV. The aim of this study was to evaluate the extent, and reasons, for MSM’s willingness to use oral PrEP in Wuhan and Shanghai, China.MethodsBetween May and December 2015, a cross-sectional survey was conducted among 487 MSM recruited through snowball sampling in physical locations frequented by MSM and through social media applications. Exploratory factor analysis was used to group reasons for being willing or not willing to use PrEP. Chi-square tests were used to explore bivariate associations between groupings of reasons for being willing or unwilling to use PrEP, and key sociodemographic and sexual-behavioral characteristics of MSM.ResultsOverall, 71.3% of respondents were willing to use PrEP. The most commonly reported reasons for being willing to use PrEP were preventing HIV infection (91.6%), taking responsibility for own sexual health (72.6%) and protecting family members from harm (59.4%). The main reasons for being unwilling to use PrEP were being worried about side effects (72.9%), the necessity of taking PrEP for long periods of time (54.3%) and cost (40.4%). Individual characteristics that influenced the type of reasons given for being willing or unwilling to use PrEP included being married to a woman, having a regular sex partner, rates of condom use with regular and casual sex partners, and the number of casual sex partners.ConclusionThe introduction of PrEP in China could benefit from promotion campaigns that emphasize its role in preventing HIV infection, in taking responsibility for own sexual health, and in protecting family members from potential harm. To reduce uptake barriers, it will be essential to provide accurate information to potential PrEP users about the mild and short-term nature of side effects, and the possibility of taking PrEP only during particular periods of life when the risk of HIV exposure might be highest.
Background The epidemiological characteristics of older patients with COVID-19 was far from clear. Objective To explore the epidemiology of older patients with COVID-19 in Wuhan, China. Design A retrospective cross-sectional study. Setting A population-based study. Subjects The resident older patients (older than 65 years old) diagnosed with COVID-19. Methods Citywide case series reported to Wuhan Center for Disease Control and Prevention from 12 December 2019 to 17 March 2020 were included. The epidemic curves were constructed by dates of disease onset. Results 14238 confirmed COVID-19 cases were older persons. The number of male cases were slightly less than female cases (1:1.01). The attack rate of COVID-19 in the older persons was 11.49‰ in Wuhan. There was a rapid increase of disease at the early stage of the epidemic and then a gradual and steady decrease was performed. 3,723 (26.15%) and 734 (5.16%) patients were diagnosed as severe and critical cases, respectively. The attributable crude fatality ratio of COVID-19 in the older population was 222.57/100,000, and the crude fatality ratio of COVID was 19.37%. The proportion of severe and critical cases, and fatality ratio were both higher in downtown area and increased with age. Conclusions The older persons are sensitive to COVID-19. The proportion of severe and critical cases and fatality ratio are higher than that in children and younger adults. Strengthen the protection and control strategies for the older adults is of priorities. More detailed epidemiological and clinical information should be measured in further studies.
The whole-genome transcriptional response of Pseudomonas putida KT2440 to stress-inducing concentrations of zinc was analyzed in this study by RNA sequencing to thoroughly investigate the bacterial cell response to zinc toxicity. The data revealed that different levels of zinc stress strongly affected the transcription of genes from the following categories: metal transport genes, genes involved in membrane homeostasis, oxidative-stress-responding genes, and genes associated with basic cellular metabolism. At the lowest zinc dose, only several genes associated with metal transport and membrane homeostasis were strongly influenced. At the intermediate zinc dose, transcriptional changes of genes belonging to these two categories were highly pronounced. In addition, the intermediate zinc stress produced high levels of oxidative stress, and influenced amino acid metabolism and respiratory chains of P. putida. At the highest zinc dose, the induction of genes responsible for Fe–S cluster biogenesis was the most remarkable feature. Moreover, upregulation of glyoxylate cycle was observed. In summary, the adaptation of the cell envelope, the maintenance of metal homeostasis and intracellular redox status, and the transcriptional control of metabolism are the main elements of stress response, which facilitates the survival of P. putida KT2440 in zinc-polluted environments.
Baiyunbian baijiu, the most popular miscellaneous-flavor baijiu in China, has been widely consumed for decades. Similar to many Chinese baijiu, Baiyunbian baijiu is fermented in five successive batches every year. Sensory analysis demonstrated that the raw baijiu obtained from the last two fermentation batches always has better quality than that produced from the former three batches. In this study, the microbial compositions of fungi and bacteria in each fermentation batch were investigated via high-throughput sequencing. The results showed that Bacillus, Virgibacillus, and Lactobacillus dominated the bacterial community in the last two batches, and the most prevalent fungi were Paecilomyces, Saccharomyces, and Zygosaccharomyces. In contrast, large percentages of fungi belonging to Thermomyces, Thermoascus, Monascus, and Issatchenkia and prokaryotes belonging to Acetobacter, Lactobacillus, and Thermoactinomyces were observed in the former three fermentation batches. GC-MS analysis revealed that the fermented grains sampled from the latter two batches contained high concentrations of ethyl lactate, 2,3-butanediol and ethyl caproate, which were mainly generated by co-fermentation of Lactobacillus and yeast. The high acidity of the fermented grains in the fourth and fifth fermentation batches as well as the large contents of ethanol and moisture promoted the formation of the functional microbial community. This study provides insight into factors that influenced the baijiu fermentation and is helpful for developing new fermentation techniques with higher baijiu quality.
Chen, Liu, and Shen Reply: The authors of the Comment [1] mention that the bound phonon can be stable only under the condition that the impurity transition energy is higher thanhv LO , while this condition is not fulfilled at low fields used in Ref. [2]. They further argue that a n-GaAs layer at low temperature acts as a bolometer.It is true that most experimental results of bound phonons were achieved under the condition that impurity transition energy is larger thanhv LO . This kind of bound phonon is indeed stable. But, nevertheless, the microscopic bound phonon theory generalized by Rashba [3] has demonstrated that the bound phonon can also be formed as a quasibound state when the impurity transition energy is smaller thanhv LO , this microscopic theory is, for now, the unique quantitative quantum model for bound phonons. Besides, there already is an experimental result indicating the existence of such a bound phonon [4], or the so-called quasilocalized mode [3]. Such a quasilocalized mode is known as metastable states, which would relax into extended states and have been observed in many different systems as different quasiparticles [5]. The observation of many metastable electronic states of impurities under magnetic fields [2,6] also supports our attribution of the photoconductivity (PC)structure near hv LO to the presence of the metastable bound phonons, the quasiparticles of impurities electron and phonon.A bolometer is one type of thermal detector, whose PC mechanism is, up to now, ambiguous, but, nevertheless, it is generally believed that the PC mechanism of the bolometer is mainly due to phonon and free electron absorption. The line shape of the simulated peaks due to phonon absorption in Ref.[1] is not completely in agreement with the experimental results. In Fig. 2 of Ref.[2], note that the observed PC responses at either 290 or 350 cm 21 approximately correspond to zero (noise limitation). There are no observable PC responses below 293 cm 21 (within a reststrahlen band) [2], while the simulated results [1] show large power absorption tails below 293 cm 21 , which can also be expected from the experimental absorption and reflectivity spectra of GaAs [7]. This fact is strongly against the assumption of bolometric effect due to phonon absorption, as suggested in Ref. [1]. In addition, our measurement is the standard technology of photothermal ionization spectroscopy [8]. It is not likely that our GaAs sample acts as a bolometer due to free electron absorption. Otherwise, a remarkably wide PC response should appear in the lower energy region ͑,hv LO ͒ [8]. However, this is not the case in our experiment. Moreover, note that absorptivity is not always equivalent to the PC response. The variance in absorptivity nearhv LO due to phonon absorption cannot induce the change of conductivity of n-GaAs at 4.2 K since our GaAs sample cannot act as a bolometer (as discussed above) and the transition probability from the 1S state to the conduction band landau levels is nearly zero at abouthv LO in GaAs (as we ...
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