Ocular manifestations and SARS-CoV-2 detection in tears and conjunctival scrape from non-severe COVID-19 patients

AIM:To explore the ocular features of corona virus disease(COVID)-19 and severe acute respiratory syndrome coronavirus(SARS-CoV)-2 detection in tears and conjunctival scrapes in non-severe COVID-19 patients.METHODS:This is a multicenter observational clinical study with no intervention conducted from Jan 25th to March 1st,2020.Clinical data and samples of tears and conjunctival scraping were collected in consecutive laboratory-confirmed,non-severe COVID-19 patients from three hospitals.COVID-19 virus was analyzed by real-time reverse transcriptase polymerase chain reaction(RT-PCR)kits.RESULTS:Totally 255 laboratory-confirmed,non-severe COVID-19 patients were recruited for ocular manifestation investigation.Of them,54.9%were females,with a mean age of 49.4 y.None of the patients has evidence of uveitis;11 patients(4.3%)complained of mild asthenopia;2(0.8%)had mild conjunctival congestion and serous secretion.Twenty-five of them had performed tears and conjunctival scrape for COVID-19 virus detection,with 4 yield possible positive results in the nucleoprotein gene.One of them were asymptomatic with normal chest CT and positive pharyngeal swab result.CONCLUSION:Ocular manifestations are neither common nor specific in non-severe COVID-19 patients.Meanwhile,COVID-19 virus nucleotides can be detected in the tears and conjunctival scrape samples,warranting further research on the transmissibility by the ocular route.

Flap failure prediction in microvascular tissue reconstruction using machine learning algorithms

BACKGROUND Microvascular tissue reconstruction is a well-established,commonly used technique for a wide variety of the tissue defects.However,flap failure is associated with an additional hospital stay,medical cost burden,and mental stress.Therefore,understanding of the risk factors associated with this event is of utmost importance.AIM To develop machine learning-based predictive models for flap failure to identify the potential factors and screen out high-risk patients.METHODS Using the data set of 946 consecutive patients,who underwent microvascular tissue reconstruction of free flap reconstruction for head and neck,breast,back,and extremity,we established three machine learning models including random forest classifier,support vector machine,and gradient boosting.Model performances were evaluated by the indicators such as area under the curve of receiver operating characteristic curve,accuracy,precision,recall,and F1 score.A multivariable regression analysis was performed for the most critical variables in the random forest model.RESULTS Post-surgery,the flap failure event occurred in 34 patients(3.6%).The machine learning models based on various preoperative and intraoperative variables were successfully developed.Among them,the random forest classifier reached the best performance in receiver operating characteristic curve,with an area under the curve score of 0.770 in the test set.The top 10 variables in the random forest were age,body mass index,ischemia time,smoking,diabetes,experience,prior chemotherapy,hypertension,insulin,and obesity.Interestingly,only age,body mass index, and ischemic time were statistically associated with the outcomes.CONCLUSIONMachine learning-based algorithms, especially the random forest classifier, were very important incategorizing patients at high risk of flap failure. The occurrence of flap failure was a multifactordrivenevent and was identified with numerous factors that warrant further investigation.Importantly, the successful application of machine learning models may help the clinician indecision-making, understanding the underlying pathologic mechanisms of the disease, andimproving the long-term outcome of patients.

Decoupling between Oxygen and Radiogenic Isotopes: Evidence for Generation of Juvenile Continental Crust by Partial Melting of Subducted Oceanic Crust

There is increasing evidence indicating that melts derived from subducted oceanic crust and sediments may have played a key role in building continental crust. This mechanism predicts that juvenile arc crust should have oxygen isotope characteristics ranging from mantle-like to supracrustal, but consistent mantle-like radiogenic(Nd-Hf) isotopic signatures. Here we present in-situ zircon U-Pb dating, Hf-O isotope analyses, and whole rock major-trace element and Nd isotope analyses of a granitoid from NW India. In-situ secondary ion mass spectrometry(SIMS) zircon U-Pb dating yields a weighted mean ^(207)Pb/^(206)Pb age of 873±6 Ma for the granitoid. It displays mantle-like zircon εHf(εHf(873 Ma)= +9.3 to +10.9) and whole-rock Nd(εNd(873 Ma)= +3.5) values but supracrustal δ^(18)O values, the latter mostly varying between 9‰ and 10‰. The calculated whole-rock δ^(18)O value of 11.3‰±0.6‰ matches well with those of hydrothermally-altered pillow lavas and sheeted dykes from ophiolites. The major and trace element composition of the granitoid is similar to petrological experimental melts derived from a mixture of MORB+sediments. Thus, the granitoid most likely represents the product of partial melting of the uppermost oceanic crust(MORB+sediments). We propose that the decoupling between Hf-Nd and O isotopes as observed in this granitoid can be used as a powerful tool for the identification of slab melting contributing to juvenile continental crustal growth. Such isotopic decoupling can also account for high δ^(18)O values observed in ancient juvenile continental crust, such as Archean tonalitetrondhjemite-granodiorite suites.

Revisiting Rhenium-Osmium Isotopic Investigations of Petroleum Systems: From Geochemical Behaviours to Geological Interpretations

Recent decades have witnessed an increasing number of studies investigating petroleum systems with the application of rhenium-osmium(Re-Os) isotopic geochemistry. Here, we review the use of the 187 Re-187 Os geochronometer with respect to the geochemical behaviour of rhenium and osmium in hydrocarbon-related geological processes. The Re-Os budget in hydrocarbon source rock predominantly originates from natural water columns during its deposition. Open seawater tends to have a homogeneous Os isotopic composition because its residence time in seawater is longer than the time taken for ocean mixing. On the contrary, restricted water bodies(e.g., lakes) may have heterogeneous Os isotopic compositions due to the greater amount of terrigenous input. Hydrogenous Re and Os atoms are sequestered from the water body into sedimentary organic matter and transferred into crude oil through thermal maturation of organic matter. Thermal maturation likely does not significantly alter the Re-Os isotopic systematics of the source rock as a Re-Os isochron age of 442±21 Ma(2σ) is yielded in this study for over matured source rocks within the Silurian Longmaxi Formation from the Sichuan Basin. Re-Os atoms are mainly hosted by the highly polar/aggregating/aromatic asphaltenes in hydrocarbons, possibly chelating with organic complexes or occurring as metalloporphyrins. Resin and aromatic hydrocarbons also contribute to the Re-Os budget, but are 2 to 3 orders of magnitude lower than that of asphaltenes, whereas saturates do not contain appreciable Re-Os contents. The distribution of Re-Os atoms in hydrocarbons is heterogeneous because the duplicate analysis of pure single bitumen samples yields similar ^(187)Os/^(188)Os ratios whereas variable ^(187)Re/^(188)Os ratios. The Re-Os system in crude oils can be reset during transport away from the source rocks, with Os-rich organic fractions more readily expelled than Re-rich fractions. Contact with metal-rich fluids(e.g., hydrothermal fluid) or compositional changes related to asphaltene contents(e.g., deasphalting, biodegradation, thermal cracking and thermochemical sulphate reduction) are also likely to alter the Re-Os systematics in hydrocarbons. These geochemical features enable the ^(187)Re-^(187)Os isotopic system to have robust applicability for petroleum system investigations, which may use the Re-Os radiometric tool for:(1) stratigraphic correlation of source rocks,(2) dating geological events altering the asphaltene content in hydrocarbon such as hydrocarbon generation, thermochemical sulphate reduction, etc., and,(3) fingerprinting hydrocarbons. Regardless of the robustness of the ^(187)Re-^(187)Os geochronometer for petroleum system investigations, there are several pending questions such as partitioning between solid organic species or between organic matter and sulphide, chelating sites in hydrocarbons and Os isotopic equilibration between hydrocarbon subfractions. To improve the understanding of the Re-Os behaviour in petroleum systems, we underscore multi-proxies-based geochemistry(e.g., inorganic-organic geochemistry) and experimental studies(e.g., hydrous pyrolysis).