Rationale: Use of ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) is a major concern for clinicians treating coronavirus disease 2019 (COVID-19) in patients with hypertension. Objective: To determine the association between in-hospital use of ACEI/ARB and all-cause mortality in patients with hypertension and hospitalized due to COVID-19. Methods and Results: This retrospective, multi-center study included 1128 adult patients with hypertension diagnosed with COVID-19, including 188 taking ACEI/ARB (ACEI/ARB group; median age 64 [interquartile range, 55–68] years; 53.2% men) and 940 without using ACEI/ARB (non-ACEI/ARB group; median age 64 [interquartile range 57–69]; 53.5% men), who were admitted to 9 hospitals in Hubei Province, China from December 31, 2019 to February 20, 2020. In mixed-effect Cox model treating site as a random effect, after adjusting for age, gender, comorbidities, and in-hospital medications, the detected risk for all-cause mortality was lower in the ACEI/ARB group versus the non-ACEI/ARB group (adjusted hazard ratio, 0.42 [95% CI, 0.19–0.92]; P =0.03). In a propensity score-matched analysis followed by adjusting imbalanced variables in mixed-effect Cox model, the results consistently demonstrated lower risk of COVID-19 mortality in patients who received ACEI/ARB versus those who did not receive ACEI/ARB (adjusted hazard ratio, 0.37 [95% CI, 0.15–0.89]; P =0.03). Further subgroup propensity score-matched analysis indicated that, compared with use of other antihypertensive drugs, ACEI/ARB was also associated with decreased mortality (adjusted hazard ratio, 0.30 [95% CI, 0.12–0.70]; P =0.01) in patients with COVID-19 and coexisting hypertension. Conclusions: Among hospitalized patients with COVID-19 and coexisting hypertension, inpatient use of ACEI/ARB was associated with lower risk of all-cause mortality compared with ACEI/ARB nonusers. While study interpretation needs to consider the potential for residual confounders, it is unlikely that in-hospital use of ACEI/ARB was associated with an increased mortality risk.

Metal foams, especially close-celled foams, are generally regarded as poor sound absorbers. This paper studies the sound absorption behaviour of the open-celled Al foams manufactured by the infiltration process, and the mechanisms involved. The foams show a significant improvement in sound absorption compared with close-celled Al foams, because of their high flow resistance. The absorption performance can be further enhanced, especially at low frequencies, if the foam panel is backed by an appropriate air gap. Increasing the air-gap depth usually increases both the height and the width of the absorption peak and shifts the peak towards lower frequencies. The foam samples with the smallest pore size exhibit the best absorption capacities when there is no air gap, whereas those with medium pore sizes have the best overall performance when there is an air gap. The typical maximum absorption coefficient, noise reduction coefficient and half-width of the absorption peak are 0.96-0.99, 0.44-0.62 and 1500-3500 Hz, respectively. The sound dissipation mechanisms in the open-celled foams are principally viscous and thermal losses when there is no air-gap backing and predominantly Helmholtz resonant absorption when there is an air-gap backing.

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Developing exceedingly efficient, cost-effective, and environmentally friendly bifunctional catalysts for the hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) especially at high current density is crucial for realizing the industrial application of electrocatalytic overall water splitting. In this work, non-noble-metal bifunctional catalysts with single Ni atoms, single Fe atoms, and NiFe nanoalloys supported on carbon nanotubes (Ni SA Fe SA -Ni x Fe/CNT) are rationally designed and fabricated. In 1 M KOH, the optimized Ni SA Fe SA -Ni 50 Fe/CNT catalyst affords low overpotentials of 64 and 227 mV at 10 mA cm −2 for catalyzing the HER and OER, respectively. Moreover, the catalyst enables the overall water splitting at a low cell voltage of 1.49 V to achieve 10 mA cm −2 in 1 M KOH. At a cell voltage of 1.80 V, the current density is as high as 382 mA cm −2 , which surpasses those of most materials reported so far. After a simple two-step oxidation and rereduction procedure, the catalytic performances of the OER, HER, and overall water splitting recover completely to their original levels. This work not only provides a potential catalyst candidate for economically realizing water splitting but also shows a method for reactivatable catalyst design.

Correspondence to: E.M.B. ebrunt@ wustl.edu Nonalcoholic fatty liver disease (NAFLD) is a liver disease characterized by excess fat accumulation in the hepatocytes (nonalcoholic fatty liver, NAFL); in up to 40% of individuals, there are additional findings of portal and lobular inflammation, and hepatocyte injury (nonalcoholic steatohepatitis, NASH). A small percent of patients will develop progressive fibrosis and cirrhosis. Hepatocellular carcinoma and cardiovascular complications are life-threatening co-morbidities of both NAFL and NASH. NAFLD is closely associated with insulin resistance; obesity and metabolic syndrome are common underlying factors. As a consequence, the prevalence of NAFLD is estimated to be 10-40% in adults worldwide, and it is the most common liver disease in children and adolescents in developed countries. Mechanistic insights into fat accumulation, subsequent hepatocyte injury, the role of the immune system and fibrosis as well as the role of the gut microbiome are unfolding, and genetic and epigenetic factors might explain the considerable inter-individual variation in disease phenotype, severity and progression. To date, no effective medical interventions exist that completely reverse the disease other than lifestyle changes, dietary alterations and possibly, bariatric surgery. However, several strategies targeting pathophysiological processes such as oversupply of fatty acids to the liver, cell injury and inflammation are currently under investigation. Diagnosis of NAFLD, and detecting the lesions of NASH, still depend on the gold-standard but invasive liver biopsy. Several non-invasive strategies are being validated to replace or complement biopsies, especially for follow-up monitoring.[H3] The United States and Europe. NAFLD is currently the most common cause of abnormal liver function tests in Western countries. According to population studies using ultrasonography or CT imaging, the prevalence of NAFLD is in the range 20-50% (Table 1). 10-13 NAFLD prevalence varies markedly between ethnic groups. An urban population study in the United States using protonmagnetic resonance spectroscopy ( 1 H-MRS) showed that the prevalence of hepatic steatosis was 45% in Hispanic, 33% in white, and 24% in black populations. 14 These variations can be explained by differences in lifestyle, prevalence of metabolic syndrome and genetics, such as polymorphism of the patatin-like phospholipase domain-containing protein 3 (PNPLA3) gene, which encodes a lipase that mediates triacylglycerol hydrolysis in adipocytes. (Figure 1). NAFLD is strongly associated with metabolic disorders. Not surprisingly, fatty liver has been reported in 40-80% of patients with type 2 diabetes mellitus and 30-90% of obese patients. 15,16 Since imaging can only detect fatty liver but not necroinflammation or fibrosis, the prevalence of NASH and the related liver fibrosis in the population is unclear. Histological analyses suggest that 6-55% of patients with NAFLD have NASH, depending on the patient inclusion criteria and the def...