Underwater target localization technology plays a vital role in the development and utilization of marine resources. Due to the multipath effect in the hydroacoustic channel, the received signal is the superposition of a series of direct and reflected acoustic paths, making it challenging to accurately identify the direct path using existing methods. To address this issue, this paper proposes a high-precision direct path recognition method based on LightGBM, which utilizes the amplitude, Time of Arrival (TOA), reception angle, and phase of the received pulse as input features. Meanwhile, due to the propagation time of acoustic waves from transmitter to receiver cannot be linearly converted to a distance value, as in the case of radio ranging in air, a method based on Effective Sound Velocity (ESV) is introduced to compensate for the bending of sound rays. By utilizing the recognized direct path delay value and the sound velocity value after compensating for sound ray bending, we can calculate the precise position of underwater targets. Experimental results validate the effectiveness of the proposed method in significantly improving the accuracy of underwater target localization.

Membrane proteins are those biomolecules that are attached to or incorporated into the membranes of cells and their organelles. Depending on their functions, they are located in various regions of a cell and are essential to several cellular processes. The locale revelation of these biomolecules is critical as it portrays their activities. Most protein subcellular localization predictors have been trained particularly on globular type and perform poorly on those residing on membranes, specifically through Deep Learning. To overcome this issue, membrane proteins are forecasted in three distinct locations, (a) plasma membrane, (b) internal membrane, and (c) organelle membrane. Features are extracted through Pseudo Amino Acid Composition and some other features from a redundancy curtailed MemLoci dataset. Pseudo Amino Acid Composition is an illustrious approach that excerpts factual protein information through amino acid sequences. Another key feature is that the Pseudo Amino Acid Composition’s impact is unrelated to the Deep Learning Execution of these membrane proteins. This novel study employs four deep learning models, including (a) Artificial Neural Networks (ANN), (b) Recurrent neural networks (RNN), (c) Convolutional neural networks (CNN), and (c) Long Short Term Memory (LSTM). After extensive experimentation, the accuracy of yields is 83.2%, 83.4%, 82.4%., and 80.5% respectively. The outcomes indicate that the simple RNN and ANN models, which are less used in the research, are more suitable compared to the other two models CNN and LSTM which are frequently implemented models in proteomics. The results of the first two models is approximately similar, with a difference of 0.2% among each other, however, they surpass the other two models with better of outcomes in the range of 2 - 3%.

Alzheimer’s disease (AD) is a neurodegenerative disorder that is characterized by the formation of extracellular amyloid- β (A β) plaques. The underlying cause of AD is unknown, however, post-translational modifications (PTMs) of A β have been found in AD patients and are thought to play a role in protein aggregation. One such PTM is pyroglutamylation, which can occur at two sites in A β, Glu3 and Glu11. This modification of A β involves the truncation and charge-neutralization of N-terminal glutamate, causing A β to become more hy- drophobic and prone to aggregation. The molecular mech- anism by which the introduction of pyroglutamate (pE) pro- motes aggregation has not been determined. To gain a greater understanding of the role that charge neutralization and trun- cation of the N-terminus plays on A β conformational sam- pling, we used the Drude polarizable force field (FF) to per- form molecular dynamics simulations on A β pE3-42 and A β pE11-42 and comparing their properties to previous simulations of A β 1-42. The Drude polarizable FF allows for a more accurate representation of electrostatic interactions, therefore pro- viding novel insights into the role that charge plays in pro- tein dynamics. Here, we report the parametrization of pE in the Drude polarizable FF and the effect of pyroglutamyla- tion on A β. We found that A β pE3-42 and A β pE11-42 alter the permanent and induced dipoles of the peptide. Specifically, we found that A β pE3-42 and A β pE11-42 have modification- specific backbone and sidechain polarization response and perturbed solvation properties that shift the A β conforma- tional ensemble.

Objective of investigation: Enhancing soil organic carbon (SOC) content in farmland is crucial for soil quality maintenance and food security. Crop rotation plays a significant role in this regard. However, the relationship between crop rotation and SOC sequestration remains unclear. This study focused on the effects of wheat −maize crop rotation on SOC in the Sushui River Basin in 2017–2021. Experimental material: soil organic carbon (SOC) content of monoculture wheat (47), monoculture maize (30), and wheat-maize rotation (35) sites in 2017 and 2021 cropland quality monitoring sites. Influencing factors were average temperature and rainfall during the study period, topographic factors, soil factors, and anthropogenic factors dominated by cropping systems. Method of investigation: Geographically Weighted Regression and Geodetector were used to explore the spatial effects of major food cropping systems on SOC trends and their interactions with other factors. Data collection: Soil, climate, and terrain data were obtained from Shanxi Province Cropland Quality Monitoring Data, Yuncheng Meteorological Bureau, and the Geospatial Data Cloud website of the Computer Network Information Center of the Chinese Academy of Sciences, respectively. Results: Analysis of variance (ANOVA) indicated significant differences only between wheat and maize monocrops. Altitude, temperature, rainfall, and pH were the main factors affecting SOC spatial heterogeneity. Although the impact of the cropping system alone on spatial heterogeneity was not significant, the influence increased after interactions with other factors. Concerning SOC variation, wheat–maize rotation had a trade-off effect with elevation and synergistic effects with rainfall and pH. It displayed a synergistic effect with temperature in the southwest and a trade-off effect in the northeast. Conclusions: The degrees of trade-offs and synergy varied spatially among all interacting factors. Our results provide valuable insights that could facilitate optimization of planting layout and improvement of farmland management schemes.

Rhino-orbital-cerebral mucormycosis (ROCM) is a rare angioinvasive fungal infection known to be associated with high morbidity and over 50% mortality and has increased lately due to increasing predisposing immunocompromising comorbidities as well as COVID-19. In addition to the common acute disease progression, chronic less aggressive courses have been described less often. In this paper we report two cases – a 75-year-old woman with diabetes and a 39-year-old man with recurrent diabetic ketoacidosis. Both presented initially with acute sinonasal symptoms, were positive for SARS-COV-2 and later diagnosed with acute ROCM.  Both underwent mutilating surgical therapy as well as high administered dose Amphotericin B and long term continuous antifungal therapy. Patient 1 showed stable symptoms with radiographically increasing disease and died of urosepsis 5 months after first surgery. Patient 2 was first lost to follow-up after repatriation to his home country and 1 year later sent us a holiday picture of himself, having recovered from the disease.Key words:Rhino-orbital-cerebral mucormycosis, mucormycosis, Amphotericin-B, COVID-19, invasive fungal infection

Background and Aims: The long-term respiratory sequelae of COVID-19 infection in children remain poorly understood and may differ across countries. This study aims to investigate the respiratory sequelae, including residual respiratory symptoms and pulmonary function in Thai children. The secondary aim is to identify factors associated with the respiratory sequelae. Materials and Methods: This is an observational study involving 56 healthy children, aged between 7-18 years, who were diagnosed with COVID-19 infection from July 2021 to February 2023. Clinical data relating to COVID-19 infection and persistent symptoms after the infection were assessed after the infection up to six months. Spirometry was performed to assess pulmonary function. Results: Post COVID-19 symptoms were identified in 14 patients (25%), with fatigue, cough, and dyspnea being common symptoms (28-35%). A significant correlation was found between post COVID-19 symptoms and pneumonia (OR = 6.00, 95%CI [1.54,23.33], p=0.01). Abnormal pulmonary function was identified in 10 patients (17.8%) with obstructive impairment being the most common. However, there were no significant association between clinical factors and pulmonary function impairment. Conclusion: Prolonged respiratory symptoms and abnormal pulmonary function following COVID-19 infection are not uncommon in children. The post COVID-19 symptoms are possibly associated with COVID-19 pneumonia.

Comparing causal effect estimates obtained using observational data to those obtained from the gold standard (i.e., randomized controlled trials, RCTs) helps us assess the validity of these estimates. However, comparisons are challenging due to differences between observational data and RCT generated data: First, the treatment assignment mechanism is often unknown for observational data, and second, the sampling mechanism often differs between the RCT and the observational data. Differences in the treatment assignment mechanism introduce potential confounding, whereas differences in the sampling mechanism introduce sampling bias. This article proposes a two-step framework for the validation of causal effect estimates obtained from observational data by adjusting for both mechanisms. A simulation study is conducted to show that our suggested two-step framework enables observational data to produce causal effect estimates similar to those of an RCT. An application of our approach to validate treatment effects of adjuvant chemotherapy obtained from registry data is demonstrated. This article establishes a novel framework for comparing causal effect estimates between observational data and RCT data, facilitating the assessment of the validity of causal effect estimates obtained from observational data.

A document by Sergio Perez. Click on the document to view its contents.

This study aims to evaluate the acupuncture effect on exercise-induced fatigue utilizing transcranial magnetic stimulation (TMS). A total of 20 sports enthusiasts were recruited in this study, all participants would be assigned to receive acupuncture and sham acupuncture intervention on exercise-induced fatigue randomly. TMS and heart rate monitor would be used to measure the amplitude and latency of motor evoked potential (MEP) and heart rate every 5 minutes over a 30-minute period. Lactate Scout+ was used to measure the blood lactic acid (BLA) in baseline, 0 minutes and 30 minutes after fatigue. Two-way repeated measures ANOVA was used to compare the difference between acupuncture method and time effects. Bonferroni post hoc tests were conducted to compare specific differences. Significance was set at P < 0.05. Interaction effect was found between acupuncture method and time effect in amplitude (F (1, 38) = 5.40, P < 0.001, η2 = 0.12) and latency (F (1, 38) = 3.78, P = 0.008, η2 = 0.09) of MEP. Acupuncture intervention can promote the recovery of heart rate especially at 30 minutes (P < 0.05), but which seem insufficient to generate significant difference in BLA (F (1, 38) = 0.067, P = 0.797, η2 = 0.002). Preliminary findings provide new perspectives for sports enthusiasts to relieve fatigue and reduce the inhibition of motor cortex excitability utilizing acupuncture.

[Abstract] Purpose: This study employed bibliometric methods to analyze the research hotspots and future development trends regarding the application of mesenchymal stem cells in peripheral nerve injury and regeneration. Methods: We screened relevant articles published between January 1, 2013, and October 1, 2023, by using the search TS=(“Mesenchymal stem cells” AND “Peripheral nerve injury”) OR TS=(“Mesenchymal stem cells” AND “Peripheral nerve regeneration”) through the Web of Science database. Subsequently, we conducted a comprehensive evaluation using visualization analysis software CitesSpace and VOSviewer from various perspectives, such as publication quantity, authors, countries, institutions, keywords, and popular research topics. Results: In this study, we extensively searched the Web of Science database and obtained 350 relevant literatures. These documents were written by 2049 collaborative authors from 41 countries, who were affiliated with 585 different research institutions. These collaborative authors published their research findings in 167 different journals and cited 21,064 literatures from 3,339 journals. Conclusion: In the past decade, the number of publications and citations related to mesenchymal stem cells in the field of peripheral nerve injury and regeneration has shown an overall increasing trend. Stem cell therapy for nerve injury has become a highly focused research field, especially mesenchymal stem cell therapy, which has enormous potential in nerve injury treatment and may provide better treatment and rehabilitation opportunities for patients, as well as making important contributions to the progress and innovation of medicine.

Differences between autistic and non-autistic individuals in perception of the temporal relationships between sights and sounds are theorized to underlie difficulties in integrating relevant sensory information. These, in turn, are thought to contribute to problems with speech perception and higher level social behaviors. However, the literature establishing this connection often involves limited sample sizes and focuses almost entirely on children. To determine whether these differences persist into adulthood, we compared 469 autistic and 373 non-autistic adults (aged 17 to 75 years). Participants completed an online version of the McGurk/MacDonald paradigm, a multisensory illusion indicative of the ability to integrate audiovisual speech stimuli. Audiovisual asynchrony was manipulated, and participants responded both to the syllable they perceived (revealing their susceptibility to the illusion) and to whether or not the audio and video were synchronized (allowing insight into temporal processing). In contrast with prior research with smaller, younger samples, we detected no evidence of impaired temporal or multisensory processing in autistic adults. Instead, we found that in both groups, multisensory integration correlated strongly with age. This contradicts prior presumptions that differences in multisensory perception persist and even increase in magnitude over the lifespan of autistic individuals. It also suggests that the compensatory role multisensory integration may play as the individual senses decline with age is intact. These findings challenge existing theories and provide an optimistic perspective on autistic development. They also underline the importance of expanding autism research to better reflect the age range of the autistic population.

In the last decade, electronic surveillance systems have been actively employed for monitoring traffic rule violations with the aim of enhancing traffic regulation. The utilization of these systems has resulted in increased compliance with traffic regulations, consequently leading to a reduction in losses attributed to traffic accidents. The impact created by these systems is expected to be further amplified through the incorporation of artificial intelligence (AI) support. Within the scope of this study, a detailed analysis of the socio-economic impact of AI-assisted Electronic Traffic Monitoring Systems has been conducted, focusing on economic, mobility, health, environmental, and quality of life aspects.

Wild honey poisoning: A case report from Central Nepal

Background matching and disruptive colouration are defense mechanisms of animals against visual predators. Disruptive colouration tends to evolve in microhabitats that are visually heterogeneous, while background matching is favored in microhabitats that are chromatically homogeneous. This is one of the few comparative studies that have tested the relative impact of background matching and disruptive markings in the chromatic evolution. Controlling for the phylogeny, we explored the evolution of the colouration and the marking patterns in the sexual dichromatic and widely distributed Neotropical grasshoppers of the genus Sphenarium. These grasshoppers represent an excellent model to investigate the evolution of cryptic colouration on insects due to the heterogeneity of the environments where they have evolved. We found a correlation between the grasshoppers' colouration and disruptive markings with the chromatic properties of their environments that was inferred by the levels of precipitation during the rainy season. The results suggest that colours and marks patterns could evolve due to predation pressures. Colour in both sexes could offer camouflage that is not perfectly background matched to a single habitat but instead offers a degree of resemblance to multiple backgrounds. Moreover, we found that males and females chromatic properties differ between them and precipitation levels where the species are found. This suggests that the sexes have diverged in their response to the environments, favoring the evolution of sexual dichromatism in these grasshoppers.

This paper presents a nonlinear extended state observer-based sliding mode control strategy of Permanent magnet synchronous motor (PMSM) to address the poor performance of conventional double closed-loop PI control under tough conditions. A variable speed reaching law is proposed to balance the rapidity and robustness under the fixed parameters of the exponential reaching law. Then, a nonlinear extended observer is proposed to ensure the estimated accuracy of disturbance and rotational speed. Then, a deadbeat current prediction control is designed to replace the conventional dual PI current control to ensure efficient current loop control of PMSM. Furthermore, the stability proof of the proposed control strategy is developed. Experimental results are given to validate the effectiveness of the proposed control strategy. The proposed control approach can effectively improve speed and current control performance with tough conditions (e.g., speed and torque step-changes, periodic disturbances).

Pairing assistance (PA) of health professionals between county hospitals and township health centers is one of the key components of the reform of medical alliances in China to strengthen the development of health workforce in primary health care (PHC). This study aims to examine the effect of PA on healthcare utilization for patients with chronic diseases in rural areas. Two waves of National Health Services Survey (2013 and 2018) were used. A total of 13893 and 22725 rural residents with chronic diseases were included in the 2013 and 2018 waves, respectively. Multiple logistic regressions were used to examine the associations between PA and outpatient and inpatient service utilization in PHC. Chow test was used to examine the difference between PA in two models. Among rural patients with chronic diseases, two-week outpatient visits increased from 22.69% to 27.54%, and annual hospitalization admission increased from 20.72% in 2013 to 25.44%. PA was associated with a significant decrease in outpatient visits (p<0.001) in 2018 after controlling for individual and county characteristics. Patients in PA counties were 1.45 times (95% CI 1.10-1.90) more likely to use PHC outpatient care in 2013, but the difference disappeared in 2018 (OR=0.85, 95% CI 0.71-1.01). PA did not reverse the downward trend in the share of PHC outpatient visits. PA under medical alliances in China provides a potential model for building integrated people-centered health systems for other low- and middle-income countries.

This letter presents a design of single photon avalanche diode (SPAD) light detection and ranging (LiDAR) sensor with 128×128 pixels and 128 column-parallel time-to-analog-merged-analog-to-digital converts (TA-ADCs). Unlike the conventional TAC-based SPAD LiDAR sensor, in which the TAC and ADC are separately implemented, we proposed to merge the TAC and ADC by sharing their capacitors, thus avoiding the analog readout noise of TAC’s output buffer, improving the conversion rate, and reducing chip area. The reverse stop-start logic is employed to reduce the power of the TA-ADC. Fabricated in a 180nm CMOS process, our prototype sensor exhibits a timing resolution of 25ps, a DNL of +0.30/-0.77 LSB, an INL of +1.41/-2.20 LSB, and a total power consumption of 190mW. A flash LiDAR system based on this sensor demonstrates the function of 2D/3D imaging with 128×128 resolution, 25k inter-frame rate, and sub-centimeter ranging precision.

Rhododendron nivale subsp. boreale Philipson et M. N. Philipson is a kind of ornamental alpine woody flower from mountaintop scrub at an altitude of approximately 4000 meters. Despite ecological significance, the lack of genomic resources has hindered a comprehensive understanding of its evolutionary and adaptive characteristics in high-altitude environments. In this work, we sequenced and assembled the genome of R. nivale subsp. boreale, which is an assembly of the first subgenus Rhododendron and the first high-altitude woody flowering autotetraploid. The assembly included 52 pseudochromosomes, which belonged to 4 haplotypes, harbor 127,810 predicted protein-coding genes. Comparative genomic analysis revealed that R. nivale subsp. boreale originated as a neopolyploid resulting from R. nivale and experienced two rounds of ancient polyploidy event. Transcriptional expression analysis showed that the expression differences of alleles were common, randomly distributed in the genome. We identified signatures of positive selection involved not only in adaptations to mountaintop ecosystem (response to UV radiation and developmental regulation), but also in strategy of autotetraploid reproduction (meiotic stabilization). Notably, highly expressed ERF VIIs aid survival in hypoxic mountaintop environments. Meanwhile, the expanded families was enriched in brassinosteroid (BR) biosynthesis, which enhances adaptability to the dramatic changes in alpine weather, is likely mediated by the increased number of cytochrome P450 (CYP) genes. This valuable genome of mountaintop woody flowering autotetraploids not only provides genetic resources for studying high-altitude polyploid formation but also provides new insights for understanding the evolution and adaptation mechanism of high-altitude plants.

Background: Voriconazoleis(VRC) often used in complex therapeutic environments for the treatment and prevention of invasive fungal infections. The steady-state valley concentration (Cminss) of VRC not only varies between individuals, but also within individuals, which is difficult to fully explain by pharmacogenomic theory. It is necessary to propose a new perspective to explain the variation of voriconazole steady-state valley concentration. Objectives: Based on the regulation of ADME gene expression by DNA methylation, this study aimed to explore the effect of CYP2C19 DNA methylation level on the VRC Cminss. Methods: In this study, 116 concentration points were divided into low concentration group (Cminss<1.0mg/L), standard concentration group (Cminss =1.0-5.5mg/L) and high concentration group (Cminss>5.5mg/L) according to Voriconazole Cmin standard range of 1.0-5.5 mg/L. The effect of CYP2C19 DNA methylation was highlighted by predisposition score matching to exclude other confounding factors. Results: The CYP2C19 CpG25 methylation level was different between low concentration group and standard concentration group (p=0.047). There was no difference in the CYP2C19 DNA methylation between the high concentration group and the standard concentration group, but there were significant differences in CRP (p<0.001), Alb (p=0.007) and T-BIL (p=0.024) between the high concentration group and the standard concentration group. Conclusions: The VRC Cminss in the low concentration group may be related to the methylation degree of CYP2C19 CpG25 site, while the VRC Cminss in the high concentration group may be unrelated to the methylation degree of CYP2C19 but related to the levels of CRP, Alb and T-BIL.

TITLE: CLINICAL EVIDENCE OF PANCREATIC RECOVERY IN CHILDREN WITH CYSTIC FIBROSIS ON IVACAFTORTo the Editor,Pediatric research has shown that young children with cystic fibrosis (CF) and treated with ivacaftor have seen improvements in pancreatic function. KIWI was a 24-week safety and efficacy trial of ivacaftor in children aged 2-5 years with CF (1). KLIMB was an 84-week open label extension of KIWI (2). Patients enrolled in KIWI revealed an average increase of 99.8 ug/g in fecal elastase (FE). Before beginning ivacaftor, 26 of 27 patients were pancreatic insufficient. After 24 weeks, 25% of these 26 patients had FE results demonstrating pancreatic sufficiency (>200 ug/g) (1). These improvements in FE were maintained during the 84-week KLIMB extension (2).In the ARRIVAL Study, a younger population was studied. Infants aged 12-24 months previously diagnosed with pancreatic insufficiency were assessed (3). After 24 weeks post ivacaftor initiation, six of nine, or 67%, of the infants had repeat FE values of >200 ug/g, consistent with pancreatic sufficiency, as well as evidence of decreased pancreatic inflammation noted with reduction in immunoreactive trypsinogen.Based on this data we instituted a new protocol for repeat FE monitoring in all patients with pancreatic insufficiency who started on ivacaftor by the age of two years. If FE is normal (>200 ug/g), discontinuation of pancreatic enzyme replacement therapy (PERT) is considered along with ongoing monitoring of clinical symptoms and adjustments to vitamin and diet recommendations as indicated.Below is a review of our cohort of pediatric patients who were currently, had been consistently treated with ivacaftor, and were assessed for current pancreatic function by repeat FE testing. All FE values were collected prior to initiation of elexacaftor/tezacaftor/ivacaftor (ETI) in those newly eligible. Nine patients at our CF center who were on PERT have started ivacaftor in the last 6 years with a mean current age of 4.9 years (SD 1.7). The median age of ivacaftor initiation was 1.1 years (range 0.4 - 2). The mean duration of treatment is 3.9 years (SD 1.3).Seven patients had a repeat FE result >200 ug/g. Six of the seven pancreatic insufficient patients presented as newly pancreatic sufficient as evidenced by a FE result of >200 ug/g compared to previous result of <200 ug/g. Patient I was included in this cohort as he was treated with PERT for clinical symptoms of pancreatic insufficiency even though his baseline FE values were above 200 ug/g.The six newly pancreatic sufficient patients started ivacaftor between 0.4 and 1.1 years of age. Our recovery data of 75% is close to the rate seen in the ARRIVAL study. We calculated binomial probability for pancreatic recovery in this small case control series using 0.67 factor based on previous data in ARRIVAL (4). This resulted in a 28% favorability of success.Unsurprisingly, the rate of recovery was higher in the younger age of initiation of ivacaftor than that seen in the older 2–5 year-old cohort in KIWI. A correlation between pancreatic recovery and younger age of initiation was also noted in a recently published multi-center retrospective study of all available CFTR modulators and PE recovery (5). In this study, of the 15 patients with FE results of 200 or greater, 10 had been treated with ivacaftor as their initial modulator therapy. Based on the demographic data, 62.5% of those treated with ivacaftor had pancreatic recovery, which is similar to our cohort data.We urge CF Centers to institute clinical protocols to recheck pancreatic elastase to assess for restoration of pancreatic function in all pediatric patients treated with PERT on ivacaftor. Subsequently, CF Centers should establish processes for discontinuing PERT, monitoring fat soluble vitamins, and adjusting diet as indicated. Resulting medication adjustments will significantly impact the treatment burden and cost for these children and their families. Those with pancreatic restoration should be monitored for symptoms of pancreatic insufficiency as well as growth trends at routine intervals and pursue repeat FE as indicated based on clinical assessment.This study was approved by the Oregon Health and Science University Institutional Review Board (IRB#26442).

The fusion estimation problem for a class of multi-rate systems (MRS) subject to state saturation is examined in this paper. varying sensors have varying sensor sampling rates (SSRs), and in MRS, the system’s status update rate (SUR) and the SSR can differ from one another. In addition, to incorporate the requirements of actual engineering practice, the measurement output of sensors is influenced by the sensor resolution and the phenomenon of integral measurements. The aim of this paper is to design an appropriate set of local estimators for each sensor node, taking into account the effects of integral measurement, sensor resolution and multi-rate sampling mechanism. Then, Design of the upper bound on the error covariance of the estimator can be obtained by solution of the matrix difference equation, and the relevant filter parameter is determined by minimizing the obtained upper bound. For local state estimation, an acceptable fusion estimating approach based on the covariance intersection (CI) method is given, and its consistency is demonstrated. Lastly, the effectiveness and appropriateness of the suggested multi-rate fusion estimation approach are confirmed by a simulated example.

Introduction: COVID-19 pandemic led to significant reductions in influenza detection worldwide, making influenza trends challenging to monitor. The number of influenza cases decreased significantly in Japan, raising concerns about the potential risk of decreased immunity to influenza in the population. Our single-center study aimed to investigate influenza trends before and during the COVID-19 pandemic in Tokyo, Japan. Materials and Methods: This cross-sectional study included patients of all ages who visited Tokyo Shinagawa Hospital between April 1, 2018, and March 31, 2023. Influenza and COVID-19 tests were conducted using Quick Navi-Flu2 and polymerase chain reaction (PCR). We analyzed data from before and during the COVID-19 epidemic, based on patient background, hospitalization, and deaths, collected from medical records. Results: A total of 12,577 influenza tests were conducted, with approximately 100 tests consistently performed each month even in the influenza off-season. Throughout the observation period, 962 positive cases were identified. However, no cases were observed for 27 months between March 2020 and November 2022. Cases of influenza A were observed again in December 2022, and cases of influenza B were observed again in March 2023, similar to the influenza incidence reports from Tokyo. The positivity rate during the 2022–2023 winter season was lower than before the COVID-19 epidemic and decreased in elderly patients, with no hospitalizations or deaths observed. Conclusion: This single-center study provided actual trend data for influenza patients before and during COVID-19 outbreaks in Tokyo, which could offer insights into the potential impact and likelihood of influenza virus infection in Japan.

Background: Compelling evidence suggests associations between influenza infection and thromboembolism (TE) events. Risk factors related to the outcomes of severe influenza-complicated TE in intensive care unit (ICU) patients remain unknown. Methods: A retrospective cohort study was conducted, recruiting consecutive patients with thromboembolism (TE) events admitted to the intensive care unit (ICU) between December 2015 through December 2018 at our institution in Taiwan. A study cohort of patients with severe influenza (n=108) and a control group of patients with severe community-acquired pneumonia (n=192) were included. Associations between complicated TE, length of ICU stay, 90-day mortality were evaluated. Results: Thromboembolism events prevalence was significantly higher in ICU patients with severe influenza than in ICU patients with severe CAP (21.3% vs. 5.7%, respectively; p<0.05). The ratio of mechanical ventilation use, length of mechanical ventilation use, ICU stay and 90-day mortality increased significantly in ICU patients with severe influenza after developing TE compared with patients without TE (all p<0.05). Influenza infection and hypertension are the risk factors for thromboembolic events in patients with severe influenza (p< 0.05). Besides, complicated TE and severity of APACHE II score are risk factors for 90-day mortality in ICU patients with severe influenza (p< 0.05). Conclusions: ICU patients with severe influenza and complicated TE have an increased risk of extended ICU stay and 90-day mortality compared to patients with severe CAP. Risk is significantly increased in patients with higher APACHE II score. this study may help define better strategies for early recognition and prevention of severe influenza-complicated TE.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19), which is associated with cardiovascular problems and serious lung damage. COVID-19 patients with comorbid conditions are at a significantly elevated risk of increased morbidity and mortality. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) are the two key host contributing factors for the severity and pathogenesis of COVID-19. The principal SARS-CoV-2 entrance receptor, ACE2, is expressed equally in most organs and produces cardio-protective vasodilators by physically degrading angiotensin II, the main controller of the Renin-Angiotensin Aldosterone System. However, treatment for cardiovascular disease (CVD) commonly involves RAAS inhibitors, which may increase ACE2 expression. Objective: To summarize the pharmacological molecular discoveries into the processes of viral infection and its consequences for cardiovascular disease and to offer suggestions for the practical management and treatment of COVID-19-related cardiovascular injury. Methods: This review focuses on the important considerations related to the cardiovascular manifestations of COVID-19 and discusses the various mechanisms of COVID-19 that contribute to its molecular and pharmacological presentation of cardiovascular injury. Results: The host-pathogen relationship began with ACE2’s attachment to the S-protein and proceeded with TMPRSS2’s proteolytic cleavage of the viral spike (S)-protein and ACE2. Currently discovered protein-protein interactions explain the uniqueness of SARS-CoV-2 infection. Conclusion: COVID-19 is associated with cardiovascular problems and serious lung damage. ACE2 and TMPRSS2 are key host contributing factors for the severity and pathogenesis of COVID-19. The molecular discoveries into the processes of viral infection and its consequences for cardiovascular disease provide important considerations for the management and treatment of COVID-19-related cardiovascular injury.