Background The global numbers of confirmed cases and deceased critically ill patients with COVID-19 are increasing. However, the clinical course, and the 60-day mortality and its predictors in critically ill patients have not been fully elucidated. The aim of this study is to identify the clinical course, and 60-day mortality and its predictors in critically ill patients with COVID-19. Methods Critically ill adult patients admitted to intensive care units (ICUs) from 3 hospitals in Wuhan, China, were included. Data on demographic information, preexisting comorbidities, laboratory findings at ICU admission, treatments, clinical outcomes, and results of SARS-CoV-2 RNA tests and of serum SARS-CoV-2 IgM were collected including the duration between symptom onset and negative conversion of SARS-CoV-2 RNA. Results Of 1748 patients with COVID-19, 239 (13.7%) critically ill patients were included. Complications included acute respiratory distress syndrome (ARDS) in 164 (68.6%) patients, coagulopathy in 150 (62.7%) patients, acute cardiac injury in 103 (43.1%) patients, and acute kidney injury (AKI) in 119 (49.8%) patients, which occurred 15.5 days, 17 days, 18.5 days, and 19 days after the symptom onset, respectively. The median duration of the negative conversion of SARS-CoV-2 RNA was 30 (range 6–81) days in 49 critically ill survivors that were identified. A total of 147 (61.5%) patients deceased by 60 days after ICU admission. The median duration between ICU admission and decease was 12 (range 3–36). Cox proportional-hazards regression analysis revealed that age older than 65 years, thrombocytopenia at ICU admission, ARDS, and AKI independently predicted the 60-day mortality. Conclusions Severe complications are common and the 60-day mortality of critically ill patients with COVID-19 is considerably high. The duration of the negative conversion of SARS-CoV-2 RNA and its association with the severity of critically ill patients with COVID-19 should be seriously considered and further studied.

Primary renal cell carcinomas (pRCCs) have a high degree of intratumoral heterogeneity and are composed of multiple distinct subclones. However, it remains largely unknown that whether metastatic renal cell carcinomas (mRCCs) also have startling intratumoral heterogeneity or whether development of mRCCs is due to early dissemination or late diagnosis. To decipher the evolution of mRCC, we analyzed the multilayered molecular profiles of pRCC, local invasion of the vena cava (IVC), and distant metastasis to the brain (MB) from the same patient using whole-genome sequencing, whole-exome sequencing, DNA methylome profiling, and transcriptome sequencing. We found that mRCC had a lower degree of heterogeneity than pRCC and was likely to result from recent clonal expansion of a rare, advantageous subclone. Consequently, some key pathways that are targeted by clinically available drugs showed distinct expression patterns between pRCC and mRCC. From the genetic distances between different tumor subclones, we estimated that the progeny subclone giving rise to distant metastasis took over half a decade to acquire the full potential of metastasis since the birth of the subclone that evolved into IVC. Our evidence supported that mRCC was monoclonal and distant metastasis occurred late during renal cancer progression. Thus, there was a broad window for early detection of circulating tumor cells and future targeted treatments for patients with mRCCs should rely on the molecular profiles of metastases.Metastasis is the leading cause of death in cancer patients but its molecular basis is poorly understood. 1 About 30% of renal cancer patients are diagnosed with metastases and few of them show sustained responses to targeted or chemotherapeutic agents. 2 Recent studies have showed that pRCCs have a high degree of intratumoral heterogeneity, which may contribute to tumor adaptation and therapeutic resistance. 3,4 However, little is known about the extents of intratumoral heterogeneity in mRCCs. The clonal relations between the primary tumors and local invasives or distant metastases are also poorly

We propose and experimentally demonstrate a tunable microwave photonic notch filter with a megahertz order bandwidth based on a silica microsphere cavity coupled by an optical microfiber. The silica microsphere with a quality factor of hundreds of millions offers a full width at half-maximum bandwidth down to the order of megahertz in the transmission spectrum. Due to the coupling flexibility between the microcavity and the optical microfiber, the bandwidth and suppression ratio can be tuned and optimized to get a rejection ratio beyond 30 dB. The tunability of over 15 GHz is also achieved. To the best of our knowledge, this single-stopband microwave photonic filter has the narrowest bandwidth filter that has ever been experimentally demonstrated. This microwave photonic notch filter shows distinct advantages of high selectivity, compactness, flexibility, and low insertion loss.

Abstract. The high incidence and mortality of breast cancer requires an effective, rapid, and cost-effective method for its diagnosis. Here, visible and near-infrared spectroscopy in the wavelength range of 400 to 2200 nm is utilized for distinguishing the malignant tumor tissue from benign tumor and normal breast tissues. Based on the absorption and scattering spectra of fixed samples, three spectral analysis methods are proposed which include an absorption spectral analysis, a scattering spectral analysis, and a combined spectral analysis of the two. By comparison with the histopathological examination, the sensitivity, specificity, and accuracy of the three analysis methods are calculated. The results showed that the combined spectral analysis method can significantly enhance the effectiveness when compared with the sole absorption or scattering spectral analysis method. The sensitivity, specificity, and accuracy of the combined spectral analysis method are 100%, 87.82%, and 87.50% for the benign tumor tissue and 81.82%, 100%, and 87.5% for malignant tumor tissue, respectively. All of the three values are 100% for normal breast tissue. This study demonstrates that the combined spectral analysis method has better potential for in vitro optical diagnosis for breast lesions. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.