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Understanding the factors that contribute to efficient SARS-CoV-2 infection of human cells may provide insights on SARS-CoV-2 transmissibility and pathogenesis, and reveal targets of intervention. Here, we analyze host and viral determinants essential for efficient SARS-CoV-2 infection in both human lung epithelial cells and ex vivo human lung tissues. We identify heparan sulfate as an important attachment factor for SARS-CoV-2 infection. Next, we show that sialic acids present on ACE2 prevent efficient spike/ACE2-interaction. While SARS-CoV infection is substantially limited by the sialic acid-mediated restriction in both human lung epithelial cells and ex vivo human lung tissues, infection by SARS-CoV-2 is limited to a lesser extent. We further demonstrate that the furin-like cleavage site in SARS-CoV-2 spike is required for efficient virus replication in human lung but not intestinal tissues. These findings provide insights on the efficient SARS-CoV-2 infection of human lungs. Here, using lung epithelial cells and ex vivo tissue explants, the authors show that, in addition to ACE2, host heparan sulfate is directly involved in SARS-CoV-2 attachment and entry and provide data suggesting that host sialic acids may act as viral restriction factor in lung tissues.

This study investigated the effects of dietary niacinamide supplementation on blood parameters, antioxidant status, and intestinal health in finishing pigs fed low-protein diets. Sixty-four pigs (Duroc × Landrace × Yorkshire; 80.4 ± 0.1 kg) were randomly allocated to four dietary treatments supplemented with 30 (NAM30), 130 (NAM130), 230 (NAM230), and 330 (NAM330) mg/kg niacinamide for 30 days. Each treatment had four replicate pens and four pigs per pen. Growth performance was not significantly affected. However, the NAM130 group showed higher (p < 0.05) hemoglobin levels, reduced (p < 0.05) serum malondialdehyde and interleukin-1β (IL-1β) concentrations, and altered intestinal microbiota composition, including lower Streptococcus abundance (p < 0.05). Serum alanine aminotransferase levels increased quadratically (p < 0.05) with niacinamide supplementation, with a breakpoint at approximately 221 mg/kg. These results suggest that dietary supplementation with 130 mg/kg niacinamide improves antioxidant status, modulates inflammation, and supports intestinal microbial balance, with a safety threshold to avoid hepatic stress.

Low-protein diets are increasingly used in nursery pigs to reduce nitrogen excretion and control post-weaning diarrhea. Niacinamide, as a bioavailable form of niacin, improves protein metabolic regulation and nitrogen utilization via promoting energy metabolism, redox balance, and intestinal integrity. In addition, synergistic effects in enhancing anti-inflammation and protecting against environmental stress are reported by combining niacinamide and Zn. The levels of dietary niacinamide for optimal growth and intestinal health were determined in two experiments using nursery pigs fed a low-protein diet with and without the addition of 0.2% ZnO. The diets were supplemented with 0, 30, 130, 230, or 330 mg/kg niacinamide. In Exp. 1, niacinamide quadratically improved (p < 0.05) growth performance with optimal effects at 50 mg/kg, increased hemoglobin (HGB) and mean corpuscular volume, and decreased diarrhea occurrence (p < 0.05) at 140 mg/kg in the diet with ZnO. In Exp. 2, niacinamide improved feed efficiency (p < 0.05) peaked at 130 mg/kg, and serum HGB and immunoglobulin A (p < 0.05) peaked at 170 mg/kg while decreasing diarrhea occurrence (p < 0.05) by up to 315 mg/kg in the pigs with no ZnO. The level of niacinamide required for optimal growth and intestinal health was associated with Zn availability.

To combat the stress of weaning, we utilized novel gruel creep feeders to supplement suckling pigs with divergent soluble (n = 6 litters) versus insoluble (n = 6) diets compared with un-supplemented controls (n = 6). Post-weaning, pigs were fed a common phase 1 diet. Average daily weight gains of pigs fed soluble and insoluble creep diets were 53% and 17% greater than control pigs, respectively (p < 0.01). Creep intake was higher (82%) for pigs fed the soluble diet, and the accompanying weight increase was sustained post-weaning (p < 0.02). Villus measures were prematurely altered in soluble-creep-fed pigs (p < 0.01), with decreases in villi length, crypt depth, and villus area pre-weaning. No effects of treatment were detected for VFA concentrations and pH in the cecum. There was an interaction between treatment and age for several pro- and anti-inflammatory cytokines (p < 0.01), where soluble-creep-fed pigs had increased cytokine levels with age, whereas cytokine levels in the insoluble and control groups decreased over time. We conclude that a soluble creep diet fed in a gruel state during the pre-weaning period has a positive impact on weaning weight that is sustained post-weaning, and is accompanied by alterations in the intestinal health of young pigs.

Background Weaning stress reduces growth performance and health of young pigs due in part to an abrupt change in diets from highly digestible milk to fibrous plant-based feedstuffs. This study investigated whether dietary galactooligosaccharide (GOS), supplemented both pre- and post-weaning, could improve growth performance and intestinal health via alterations in the hindgut microbial community. Methods Using a 3 × 2 factorial design, during farrowing 288 piglets from 24 litters received either no creep feed (FC), creep without GOS (FG–) or creep with 5% GOS (FG+) followed by a phase 1 nursery diet without (NG–) or with 3.8% GOS (NG+). Pigs were sampled pre- (D22) and post-weaning (D31) to assess intestinal measures. Results Creep fed pigs grew 19% faster than controls ( P  < 0.01) prior to weaning, and by the end of the nursery phase (D58), pigs fed GOS pre-farrowing (FG+) were 1.85 kg heavier than controls ( P  < 0.05). Furthermore, pigs fed GOS in phase 1 of the nursery grew 34% faster ( P  < 0.04), with greater feed intake and efficiency. Cecal microbial communities clustered distinctly in pre- vs. post-weaned pigs, based on principal coordinate analysis ( P  < 0.01). No effects of GOS were detected pre-weaning, but gruel creep feeding increased Chao1 α-diversity and altered several genera in the cecal microbiota ( P  < 0.05). Post-weaning, GOS supplementation increased some genera such as Fusicatenibacter and Collinsella, whereas others decreased such as Campylobacter and Frisingicoccus ( P  < 0.05). Changes were accompanied by higher molar proportions of butyrate in the cecum of GOS-fed pigs ( P  < 0.05). Conclusions Gruel creep feeding effectively improves suckling pig growth regardless of GOS treatment. When supplemented post-weaning, prebiotic GOS improves piglet growth performance associated with changes in hindgut microbial composition.

BackgroundOsmidrosis is a troublesome disease characterized by excessive bodily malodor. Invasive surgical treatments have proven effective and permanent in treating this disease. This study sets out to evaluate the effect of tumescent liposuction with power-assisted dermal curettage for the treatment of axillary osmidrosis.MethodsTwenty-eight patients with axillary osmidrosis (56 axillae) were treated with tumescent liposuction and power-assisted dermal curettage between January 2016 and May 2019. Patients were followed up and evaluated using survey questionnaire at least 3 months after the procedure.ResultsTwenty-four (85.7%) patients responded excellent for malodor elimination, 4 (14.3%) patients evaluated it as good and no patients evaluated it as fair or poor. One patient reported mild pigmentation in the axilla after the procedure. No recurrence and no serious side effects were reported.ConclusionTumescent liposuction with power-assisted dermal curettage is a safe and effective surgical treatment of axillary osmidrosis with high patient satisfaction, rapid recovery time and minimal complications or recurrences.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

PurposeTo evaluate the efficacy of the integrated and stepwise epicanthoplasty combined with blepharoplasty (ISEB) technique in an ethnic Asian population.MethodThe medical records of patients who underwent ISEB at the Eye Hospital of Wenzhou Medical University over a period of 36 months were retrospectively reviewed.ResultsA total of 104 patients (208 eyelids) were included in this study with ages ranging from 16 to 36 years old (mean 21.2 ± 2.8 years) and follow-up duration ranging from 6 months to 26 months (mean 9.7 ± 4.1 months). All patients achieved cosmetically desirable and natural appearances with adequate lacrimal caruncle exposure and horizontal lengthening of palpebral fissure. At the 6-month follow-up, there was no or minimal visible scarring in the medial canthal region. Postoperative evaluation at least 6 months following surgery showed that 98.1% (102/104) of patients felt that their surgical results were good or excellent. No recurrences of the epicanthal fold or disturbances of lacrimal function occurred throughout the follow-up period.ConclusionThe ISEB is a novel surgical technique that is effective in dealing with vector forces during epicanthoplasty in combination with blepharoplasty and has been shown to be a practical and reliable method with good aesthetic outcomes.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Blood lipids are important risk factors for coronary artery disease (CAD). Here we perform an exome-wide association study by genotyping 12,685 Chinese, using a custom Illumina HumanExome BeadChip, to identify additional loci influencing lipid levels. Single-variant association analysis on 65,671 single nucleotide polymorphisms reveals 19 loci associated with lipids at exome-wide significance ( P <2.69 × 10 −7 ), including three Asian-specific coding variants in known genes ( CETP p.Asp459Gly, PCSK9 p.Arg93Cys and LDLR p.Arg257Trp). Furthermore, missense variants at two novel loci— PNPLA3 p.Ile148Met and PKD1L3 p.Thr429Ser — also influence levels of triglycerides and low-density lipoprotein cholesterol, respectively. Another novel gene, TEAD2 , is found to be associated with high-density lipoprotein cholesterol through gene-based association analysis. Most of these newly identified coding variants show suggestive association ( P <0.05) with CAD. These findings demonstrate that exome-wide genotyping on samples of non-European ancestry can identify additional population-specific possible causal variants, shedding light on novel lipid biology and CAD. An important risk factor for coronary artery disease is the level of blood lipids. Here the authors conduct an exome-wide association study in Chinese cohorts and identify three novel loci associated with lipid levels as well as three Asian-specific variants in known loci.

At present, natural orifice specimen extraction surgery (NOSES) has attracted more and more attention worldwide, because of its great advantages including minimal cutaneous trauma and post-operative pain, fast post-operative recovery, short hospital stay, and positive psychological impact. However, NOSES for the treatment of gastric cancer (GC) is still in its infancy, and there is great potential to improve its theoretical system and clinical practice. Especially, several key points including oncological outcomes, bacteriological concerns, indication selection, and standardized surgical procedures are raised with this innovative technique. Therefore, it is necessary to achieve an international consensus to regulate the implementation of GC-NOSES, which is of great significance for healthy and orderly development of NOSES worldwide.