Thromboelastometry demonstrates endogenous coagulation activation in nonsevere and severe COVID-19 patients and has applicability as a decision algorithm for intervention

In patients with severe forms of COVID-19, thromboelastometry has been reported to display a hypercoagulant pattern. However, an algorithm to differentiate severe COVID-19 patients from nonsevere patients and healthy controls based on thromboelastometry parameters has not been developed. Forty-one patients over 18 years of age with positive qRT-PCR for SARS-CoV-2 were classified according to the severity of the disease: nonsevere (NS, n = 20) or severe (S, n = 21). A healthy control (HC, n = 9) group was also examined. Blood samples from all participants were tested by extrinsic (EXTEM), intrinsic (INTEM), non-activated (NATEM) and functional assessment of fibrinogen (FIBTEM) assays of thromboelastometry. The thrombodynamic potential index (TPI) was also calculated. Severe COVID-19 patients exhibited a thromboelastometry profile with clear hypercoagulability, which was significantly different from the NS and HC groups. Nonsevere COVID-19 cases showed a trend to thrombotic pole. The NATEM test suggested that nonsevere and severe COVID-19 patients presented endogenous coagulation activation (reduced clotting time and clot formation time). TPI data were significantly different between the NS and S groups. The maximum clot firmness profile obtained by FIBTEM showed moderate/elevated accuracy to differentiate severe patients from NS and HC. A decision tree algorithm based on the FIBTEM-MCF profile was proposed to differentiate S from HC and NS. Thromboelastometric parameters are a useful tool to differentiate the coagulation profile of nonsevere and severe COVID-19 patients for therapeutic intervention purposes.

Ecosystem services and disservices in the Luanhe River Basin in China under past, current and future land uses: implications for the sustainable development goals

Understanding how ecosystem services (ES) and ecosystem disservices (EDS) are affected by human-induced landscape changes is important to minimise trade-offs and maximise synergies between Sustainable Development Goals (SDGs) and targets, and for equitable development across governance scales. However, limited research investigates how ES and EDS can change under past, current, and future land uses. This study, conducted in the Luanhe River Basin (LRB), demonstrates the interaction between humans and the environment under past, current, and future land uses at the river basin scale in China, using a stakeholders’ participatory capacity matrix to characterise both ES and EDS. Results indicate that forests and water bodies provided the highest overall ES capacity, while the lowest scores were reached in built-up and unused land areas. Built-up land and cropland provided the highest overall EDS, while the lowest EDS scores were for water bodies. By applying the ecosystem services potential index (ESPI) and ecosystem disservices potential index (EDSPI), we found that the ESPI of all the ES declined from 1980 to 2018 and would continue to decline until 2030 without sustainable and conservation development strategies in the LRB. The EDSPI under all future scenarios in 2030 was projected to increase compared to the baseline in 1980. This study recommends establishing and implementing sustainable environmental protection policies and cross-regional and trans-provincial eco-compensation schemes for minimising trade-offs in ES. The study proposes an integrated research framework that could be useful for understanding the effect of historical and future human–environment interactions on ES and EDS, and SDGs achievement.

Investigation of a Limited but Explosive COVID-19 Outbreak in a German Secondary School

The role of schools as a source of infection and driver in the coronavirus-pandemic has been controversial and is still not completely clarified. To prevent harm and disadvantages for children and adolescents, but also adults, detailed data on school outbreaks is needed, especially when talking about open schools employing evidence-based safety concepts. Here, we investigated the first significant COVID-19 school outbreak in Hamburg, Germany, after the re-opening of schools in 2020. Using clinical, laboratory, and contact data and spatial measures for epidemiological and environmental studies combined with whole-genome sequencing (WGS) analysis, we examined the causes and the course of the secondary school outbreak. The potential index case was identified by epidemiological tracking and the lessons in classrooms with presumably high virus spreading rates and further infection chains in the setting. Sequence analysis of samples detected one sample of a different virus lineage and 25 virus genomes with almost identical sequences, of which 21 showed 100% similarity. Most infections occurred in connection with two lesson units of the primary case. Likely, 31 students (12–14 years old), two staff members, and three family members were infected in the school or the typical household. Sequence analysis revealed an outbreak cluster with a single source that was epidemiologically identified as a member of the educational staff. In lesson units, two superspreading events of varying degrees with airborne transmission took place. These were influenced by several parameters including the exposure times, the use of respiratory masks while speaking and spatial or structural conditions at that time.

HeGRI: A Novel Index of Serum Hepcidin Suppression in Relation to the Degree of Renal Dysfunction among β-Thalassemia Major Patients

Background: The progressive renal function inadequacy results in altered hepcidin metabolism due to a shifting of its renal elimination, which consequently affects enteric iron absorption and iron stores’ availability. This study aimed to investigate and correlate renal function, iron status, and hepcidin in patients with β-thalassemia major through a novel index. Methods: In this 1:1 case–control study, serum hepcidin, serum ferritin, iron study, hematological and renal function parameters were compared between 60 β-thalassemia major patients with iron overload and 61 healthy individuals (2–30 years old). Results: The concentrations of serum hepcidin (21.898 vs. 9.941 ng/mL; p < 0.001) and eGFR (179.71 vs. 132.95; p < 0.001) were significantly higher in β-thalassemia major patients compared to the controls. The serum hepcidin levels decreased with increasing levels of total iron-binding capacity (TIBC; β = −0.442; p = 0.024), transferrin saturation (β = −0.343; p = 0.023), serum creatinine (β = −0.625; p = 0.0030), and eGFR (β = −0.496; p = 0.011). The mean hepcidin/ferritin ratio was significantly lower in the β-thalassemia major cases (0.0069 vs. 0.3970; p < 0.001). The novel hepcidin/eGFR ratio index (HeGRI) was significantly higher in the patient group compared to controls (0.12 vs. 0.09; p = 0.031), respectively. Conclusions: These results suggest that HeGRI could be a potential index of the appropriateness of serum hepcidin suppression associated with the degree of renal dysfunction among β-thalassemia major patients.

Cumulus Cell DNA Damage as an Index of Human Oocyte Competence

The determination of oocyte quality is crucial for achieving effective syngamy post-sperm injection and embryonic development. Cumulus cells (CCs) have been proposed as biomarkers of oocyte quality because of their close bio-dynamic relationship with the oocyte. To determine the quality of the oocyte, CCs were sampled during oocyte preparation for ICSI to determine a CC DNA fragmentation index (CCDFI) of each individual oocyte using a variant of the chromatin dispersion test. One hundred and thirty oocytes were selected and studied from two Spanish fertility clinics, 90 of which were fertilized and developed to embryos. Significant differences were found between the CCDFI of unfertilized and fertilized oocytes (p < .001) and between the CCDFI of embryos that were discarded and those that developed suitable for transfer or cryopreservation (p < .001). Oocyte quality was negatively correlated with CCDFI (Spearman’s rho = − 0.45; p < .001). Receiver operator characteristics curves (ROC) suggested that a cut-off value of 24% CCDFI was able to discriminate the capacity of the gametes to result in syngamy with a sensitivity and specificity of 75.6% and 65%, respectively. This cut-off supports the application of CCDFI as potential index for the evaluation of the reproductive potential of oocytes prior to fertilization.

On the Potential Self-Amplification of Aneurysms Due to Tissue Degradation and Blood Flow Revealed From FSI Simulations

Tissue degradation plays a crucial role in the formation and rupture of aneurysms. Using numerical computer simulations, we study the combined effects of blood flow and tissue degradation on intra-aneurysm hemodynamics. Our computational analysis reveals that the degradation-induced changes of the time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) within the aneurysm dome are inversely correlated. Importantly, their correlation is enhanced in the process of tissue degradation. Regions with a low TAWSS and a high OSI experience still lower TAWSS and higher OSI during degradation. Furthermore, we observed that degradation leads to an increase of the endothelial cell activation potential index, in particular, at places experiencing low wall shear stress. These findings are robust and occur for different geometries, degradation intensities, heart rates and pressures. We interpret these findings in the context of recent literature and argue that the degradation-induced hemodynamic changes may lead to a self-amplification of the flow-induced progressive damage of the aneurysmal wall.

On Stabilization of the Construction Sector

This article is devoted to assessing the business potential and risk tolerance of the construction industry. New requirements for ensuring the quality and competitiveness of construction organizations are put forward to enterprises of the construction industry in the conditions of self-regulation. The material base, qualified personnel, used technologies and efficient management of the enterprise are the main factors in ensuring the quality of construction. Only a combination of these factors guarantees the stable functioning of the enterprise. The article revealed development trends and main changes in the construction industry of the Russian Federation in recent years. The consequences of the influence of coronavirus spread around the world on the functioning of the industry were determined. The dynamics of the Business Potential Index in construction is presented. Dynamics of the Risk Tolerance Index in the industry were analyzed.

The Use of Phytoplankton in the Assessment of Water Quality in the Lower Section of Poland’s Largest River

Phytoplankton studies were carried out in the lower course of Poland’s largest river, the Vistula. This section of the Vistula has changed much since the 19th century due to regulation of the bed and limitation of its flood banks. In the years 1994–2020, hydrobiological studies of physical and chemical parameters and phytoplankton were carried out. On the basis of these studies, this research investigated the water quality of the river. Since 2000, a gradual improvement in water quality in the river has been observed, as manifested by decreasing phytoplankton biomass (from over 15 mg/L in 1994 and 2003 to less than 10 mg/L in the 2000s) and lower chlorophyll a concentrations (from 48 µg/L in 1998 to 12.5 µg/L in 2020). The river’s ecological potential index, calculated on the basis of indicator species of phytoplankton and chlorophyll a concentration, also indicates a progressive improvement. In the 1990s, the ecological potential was poor; at the turn of the century, it was moderate; and in the following years, the phytoplankton studies showed an ecological potential that was good or moderate (slightly below the lower threshold of good potential).