Displaying publications 1 - 20 of 47 in total

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  1. Wang Z, Hu J, Hamzah SS, Ge S, Lin Y, Zheng B, et al.
    J Agric Food Chem, 2019 Jan 30;67(4):1092-1103.
    PMID: 30621393 DOI: 10.1021/acs.jafc.8b05281
    In this study, the antiobesity effects of n-butanol extract of lotus seeds (LBE) were evaluated in cultured 3T3-L1 preadipocytes and in high-fat diet (HFD)-fed mice. LBE decreased lipid contents in mature 3T3-L1 cells without obvious cytotoxicity. Meanwhile, LBE supplementation also led to weight loss and improved plasma lipid profiles in HFD-fed mice. Furthermore, LBE could activate AMP-activated protein kinase (AMPK) accompanied by down-regulation of lipogenesis related genes (PPARγ, aP2, LPL, C/EBPα, FAS, SREBP-1c) and up-regulation of lipolysis genes (adiponectin and PPARα) in vitro and in vivo. Collectively, our data demonstrated LBE possesses antiadipogenic and antilipogenic activities which are, at least partially, mediated by the activation of AMPK signaling pathways.
  2. Neoh KB, Hu J, Yeoh BH, Lee CY
    Pest Manag Sci, 2012 May;68(5):749-56.
    PMID: 22076820 DOI: 10.1002/ps.2322
    The effectiveness of chlorantraniliprole and other insecticides (bifenthrin, fipronil, indoxacarb, imidacloprid and chlorfenapyr) were tested against Coptotermes gestroi (Wasmann). Four experiments were conducted: a topical bioassay, a horizontal transfer study, an insecticide bioavailability test and a feeding bioassay.
  3. Feng X, Jiang G, Xia Z, Hu J, Wan X, Gao JM, et al.
    Org. Lett., 2015 Sep 18;17(18):4428-31.
    PMID: 26315849 DOI: 10.1021/acs.orglett.5b02046
    The first enantioselective synthesis of (-)-conolutinine was achieved in 10 steps. The synthesis featured a catalytic asymmetric bromocyclization of tryptamine to forge the tricycle intermediate. Hydration of an alkene catalyzed by Co(acac)2 was also employed as a key step to diastereoselectively introduce the tertiary alcohol moiety. The absolute configuration of (-)-conolutinine was established to be (2S,5aS,8aS,13aR) based on this asymmetric total synthesis.
  4. Hu J, Chan LF, Souza RP, Tampakeras M, Kennedy JL, Zai C, et al.
    Neurosci Lett, 2014 Jan 24;559:39-43.
    PMID: 24275212 DOI: 10.1016/j.neulet.2013.11.025
    Evidence has shown that attempted suicide in psychiatric disorders is a complex interplay of genes and environment. Noradrenergic dysfunction due to abnormalities in the tyrosine hydroxylase (TH) gene has been implicated in the pathogenesis of suicidal behavior in mood disorders. However, suicide is a leading cause of mortality in schizophrenia too. Recent evidence suggests that TH gene variants may also increase the risk of suicide attempts in schizophrenia patients, although the interaction with established clinical risk factors is unclear. This study aimed to identify TH gene variants conferring risk for suicide attempt in schizophrenia while accounting for the interaction between this gene and clinical risk factors. We performed analysis on four TH SNPs (rs11564717, rs11042950, rs2070762, rs689) and the common TCAT repeat (UniSTS:240639) for 234 schizophrenia patients (51 suicide attempters and 183 non-attempters). Clinical risk factors and ethnic stratification were included as covariates. Single marker analysis identified the SNP rs11564717 (p=0.042) and the TCAT(6) (p=0.004) as risk variants for suicide attempt. We also identified the haplotype A-A-A-G as a risk factor for suicide attempt (p=0.0025). In conclusion, our findings suggest that TH polymorphisms may contribute to the risk of attempted suicide in schizophrenia even after accounting for established clinical risk factors and ethnic stratification. Further larger scale studies are needed to confirm these findings and to understand the mechanisms underlying the role of TH gene variants in suicide attempt in schizophrenia.
  5. Wong LP, Wu Q, Hao Y, Chen X, Chen Z, Alias H, et al.
    Int Health, 2021 May 04.
    PMID: 33945613 DOI: 10.1093/inthealth/ihab023
    BACKGROUND: We aimed to investigate the association between institution trust and public responses to the coronavirus disease 2019 (COVID-19) outbreak.

    METHODS: An Internet-based, cross-sectional survey was administered on 29 January 2020. A total of 4393 adults ≥18 y of age and residing or working in the province of Hubei, central China were included in the study.

    RESULTS: The majority of the participants expressed a great degree of trust in the information and preventive instructions provided by the central government compared with the local government. Being under quarantine (adjusted odds ratio [OR] 2.35 [95% confidence interval {CI} 1.80 to 3.08]) and having a high institutional trust score (OR 2.23 [95% CI 1.96 to 2.53]) were both strong and significant determinants of higher preventive practices scores. The majority of study participants (n=3640 [85.7%]) reported that they would seek hospital treatment if they suspected themselves to have been infected with COVID-19. Few of the participants from Wuhan (n=475 [16.6%]) and those participants who were under quarantine (n=550 [13.8%]) expressed an unwillingness to seek hospital treatment.

    CONCLUSIONS: Institutional trust is an important factor influencing adequate preventive behaviour and seeking formal medical care during an outbreak.

  6. Chen L, Xu YY, Lin JY, Ji ZP, Yang F, Tan S, et al.
    Asian J Psychiatr, 2024 Mar;93:103958.
    PMID: 38364597 DOI: 10.1016/j.ajp.2024.103958
    BACKGROUND AND AIM: Suicide is nearly always associated with underlying mental disorders. Risk factors for suicide attempts (SAs) in patients with bipolar disorder (BD) misdiagnosed with major depressive disorder (MDD) remain unelucidated. This study was to evaluate the prevalence and clinical risk factors of SAs in Chinese patients with BD misdiagnosed with MDD.

    METHODS: A total of 1487 patients with MDD from 13 mental health institutions in China were enrolled. Mini International Neuropsychiatric Interview (MINI) was used to identify patients with BD who are misdiagnosed as MDD. The general sociodemographic and clinical data of the patients were collected and MINI suicide module was used to identify patients with SAs in these misdiagnosed patients.

    RESULTS: In China, 20.6% of patients with BD were incorrectly diagnosed as having MDD. Among these misdiagnosed patients, 26.5% had attempted suicide. These patients tended to be older, had a higher number of hospitalizations, and were more likely to experience frequent and seasonal depressive episodes with atypical features, psychotic symptoms, and suicidal thoughts. Frequent depressive episodes and suicidal thoughts during depression were identified as independent risk factors for SAs. Additionally, significant sociodemographic and clinical differences were found between individuals misdiagnosed with MDD in BD and patients with MDD who have attempted suicide.

    CONCLUSIONS: This study highlights the importance of accurate diagnosis in individuals with BD and provide valuable insights for the targeted identification and intervention of individuals with BD misdiagnosed as having MDD and those with genuine MDD, particularly in relation to suicidal behavior.

  7. Hu J, Neoh KB, Appel AG, Lee CY
    PMID: 22085890 DOI: 10.1016/j.cbpa.2011.10.028
    The foraging patterns of termites are strongly related to physiological limits in overcoming desiccation stress. In this study, we examined moisture preferences and physiological characteristics of Macrotermes carbonarius (Hagen) and M. gilvus (Hagen) as both exhibit conspicuous patterns of foraging activity. Despite both species showing no significant differences in calculated cuticular permeability, and percentage of total body water, they differed greatly in rate of water loss and surface area to volume ratio. For example, M. carbonarius which had a lower surface area to volume ratio (29.26-53.66) showed lower rate of water loss and percentage of total body water loss. This also resulted in higher LT(50) when exposed to extreme conditions (≈2% RH). However, contrasting observations were made in M. gilvus that has smaller size with higher surface area to volume ratio of 40.28-69.75. It is likely that the standard equation for calculating insect surface areas is inadequate for these termite species. The trend was further supported by the result of a moisture preference bioassay that indicated M. carbonarius had a broader range of moisture preference (between 5% and 20%) than M. gilvus which had a relatively narrow moisture preference (only 20%). These results explain why M. carbonarius can tolerate desiccation stress for a longer period foraging above-ground in the open air; while M. gilvus only forages below ground or concealed within foraging mud tubes.
  8. Hu J, Pradit S, Loh PS, Chen Z, Guo C, Le TPQ, et al.
    Mar Pollut Bull, 2024 Jan 29;200:116064.
    PMID: 38290368 DOI: 10.1016/j.marpolbul.2024.116064
    Mangrove forests can help to mitigate climate change by storing a significant amount of carbon (C) in soils. Planted mangrove forests have been established to combat anthropogenic threats posed by climate change. However, the efficiency of planted forests in terms of soil organic carbon (SOC) storage and dynamics relative to that of natural forests is unclear. We assessed SOC and nutrient storage, SOC sources and drivers in a natural and a planted forest in southern Thailand. Although the planted forest stored more C and nutrients than the natural forest, the early-stage planted forest was not a strong sink relative to mudflat. Both forests were predominated by allochthonous organic C and nitrogen limited, with total nitrogen being a major driver of SOC in both cases. SOC showed a significant decline along land-to-sea and depth gradients as a result of soil texture, nutrient availability, and pH in the natural forest.
  9. Choi JR, Hu J, Feng S, Wan Abas WA, Pingguan-Murphy B, Xu F
    Biosens Bioelectron, 2016 May 15;79:98-107.
    PMID: 26700582 DOI: 10.1016/j.bios.2015.12.005
    Lateral flow assays (LFAs) have currently attracted broad interest for point-of-care (POC) diagnostics, but their application has been restricted by poor quantification and limited sensitivity. While the former has been currently solved to some extent by the development of handheld or smartphone-based readers, the latter has not been addressed fully, particularly the potential influences of environmental conditions (e.g., temperature and relative humidity (RH)), which have not yet received serious attention. The present study reports the use of a portable temperature-humidity control device to provide an optimum environmental requirement for sensitivity improvement in LFAs, followed by quantification by using a smartphone. We found that a RH beyond 60% with temperatures of 55-60°C and 37-40°C produced optimum nucleic acid hybridization and antigen-antibody interaction in LFAs, respectively representing a 10-fold and 3-fold signal enhancement over ambient conditions (25°C, 60% RH). We envision that in the future the portable device could be coupled with a fully integrated paper-based sample-to-answer biosensor for sensitive detection of various target analytes in POC settings.
  10. Wang S, Zhang Q, Goh PH, Hu J, Liu X, Du J, et al.
    J Clin Psychol Med Settings, 2023 Sep;30(3):645-653.
    PMID: 36385422 DOI: 10.1007/s10880-022-09927-z
    Breast cancer impacts not only the physical and mental health of patients but also the people around them-especially their caregivers. This study examined the relationship between post-traumatic stress symptoms (PTSS) and caregiver burden in breast cancer patients through the mediating pathway of anxiety and depression.

    METHODS: A total of 236 breast cancer patients from China completed the Chinese Version of the Posttraumatic Stress Disorder Symptom Scale (PSS), the Chinese version of the Patient Health Questionnaire (PHQ-9), the Chinese version of the General Anxiety Symptoms Scale (GAD-7). In addition, caregivers of these breast cancer patients were surveyed by the Caregiver Self-Assessment Questionnaire (CSAQ).

    RESULTS: Structural equation model showed that our model fitted well [χ2 /df = 1.966, TLI = 0.959, CFI = 0.994, RMSEA (90% CI) = 0.065 (0-0.12)] and revealed that anxiety, but not depression, mediated the relationship between PTSS in breast cancer patients and caregiver burden.

    CONCLUSION: The level of PTSS was positively correlated with anxiety and depression in breast cancer patients, and the level of anxiety and depression was positively related to caregiver burden. The PTSS of patients positively predicted caregiver burden and this relationship appears to be mediated by the patient's anxiety.

  11. Lai D, Zhou A, Tan BK, Tang Y, Sarah Hamzah S, Zhang Z, et al.
    Food Chem, 2021 Nov 01;361:130117.
    PMID: 34058659 DOI: 10.1016/j.foodchem.2021.130117
    To overcome the poor water solubility of curcumin, a curcumin-β-cyclodextrin (Cur-β-CD) complex was prepared as a novel photosensitizer. Fourier-transform infrared spectroscopy (FT-IR), differential scanning calorimetry (DSC), and X-ray diffraction (XRD) were used to verify the formation of Cur-β-CD. Furthermore, the ROS generation capacity and photodynamic bactericidal effect were measured to confirm this Cur-β-CD complex kept photodynamic activity of curcumin. The result showed Cur-β-CD could effectively generate ROS upon blue-light irradiation. The plate count assay demonstrated Cur-β-CD complex possess desirable photodynamic antibacterial effect against food-borne pathogens including Staphylococcus aureus, Listeria monocytogenes and Escherichia coli. The cell morphology determined by scanning electron microscope (SEM) and transmission electron microscope (TEM) showed Cur-β-CD could cause cell deformation, surface collapse and cell structure damage of the bacteria, resulting in the leakage of cytoplasmic; while agarose gel electrophoresis and SDS-PAGE further illustrated the inactivation mechanisms by Cur-β-CD involve bacterial DNA damage and protein degradation.
  12. Choi JR, Liu Z, Hu J, Tang R, Gong Y, Feng S, et al.
    Anal Chem, 2016 06 21;88(12):6254-64.
    PMID: 27012657 DOI: 10.1021/acs.analchem.6b00195
    In nucleic acid testing (NAT), gold nanoparticle (AuNP)-based lateral flow assays (LFAs) have received significant attention due to their cost-effectiveness, rapidity, and the ability to produce a simple colorimetric readout. However, the poor sensitivity of AuNP-based LFAs limits its widespread applications. Even though various efforts have been made to improve the assay sensitivity, most methods are inappropriate for integration into LFA for sample-to-answer NAT at the point-of-care (POC), usually due to the complicated fabrication processes or incompatible chemicals used. To address this, we propose a novel strategy of integrating a simple fluidic control strategy into LFA. The strategy involves incorporating a piece of paper-based shunt and a polydimethylsiloxane (PDMS) barrier to the strip to achieve optimum fluidic delays for LFA signal enhancement, resulting in 10-fold signal enhancement over unmodified LFA. The phenomena of fluidic delay were also evaluated by mathematical simulation, through which we found the movement of fluid throughout the shunt and the tortuosity effects in the presence of PDMS barrier, which significantly affect the detection sensitivity. To demonstrate the potential of integrating this strategy into a LFA with sample-in-answer-out capability, we further applied this strategy into our prototype sample-to-answer LFA to sensitively detect the Hepatitis B virus (HBV) in clinical blood samples. The proposed strategy offers great potential for highly sensitive detection of various targets for wide application in the near future.
  13. Hu J, Lin S, Tan BK, Hamzah SS, Lin Y, Kong Z, et al.
    Food Res Int, 2018 09;111:265-271.
    PMID: 30007685 DOI: 10.1016/j.foodres.2018.05.042
    Burkholderia cepacia (B. cepacia) is an aerobic Gram-negative bacillus found in various aquatic environments and can cause food contamination. We investigated the photodynamic antibacterial effects of food additive curcumin combined with EDTA on B. cepacia. We found a ~4-log reduction in B. cepacia viability when photo-irradiated with curcumin at 50 μM by blue LED light (16 mW/cm2) for 30 min with 0.4% (w/v) EDTA. Moreover, the bacterial morphological alterations and the leakage of intracellular contents were observed after photodynamic treatment. There were also obvious genomic DNA cleavage and a general loss of bacterial proteins assigned to large-scale protein degradation after photodynamic inactivation treatment. Collectively, curcumin in combination with EDTA illuminated by blue LED is a potential candidate for photodynamic inactivation of B. cepacia.
  14. Choi JR, Hu J, Wang S, Yang H, Wan Abas WA, Pingguan-Murphy B, et al.
    Crit Rev Biotechnol, 2017 Feb;37(1):100-111.
    PMID: 26912259
    Dengue endemic is a serious healthcare concern in tropical and subtropical countries. Although well-established laboratory tests can provide early diagnosis of acute dengue infections, access to these tests is limited in developing countries, presenting an urgent need to develop simple, rapid, and robust diagnostic tools. Point-of-care (POC) devices, particularly paper-based POC devices, are typically rapid, cost-effective and user-friendly, and they can be used as diagnostic tools for the prompt diagnosis of dengue at POC settings. Here, we review the importance of rapid dengue diagnosis, current dengue diagnostic methods, and the development of paper-based POC devices for diagnosis of dengue infections at the POC.
  15. Hu J, Yew CT, Chen X, Feng S, Yang Q, Wang S, et al.
    Talanta, 2017 Apr 01;165:419-428.
    PMID: 28153277 DOI: 10.1016/j.talanta.2016.12.086
    The identification and quantification of chemicals play a vital role in evaluation and surveillance of environmental health and safety. However, current techniques usually depend on costly equipment, professional staff, and/or essential infrastructure, limiting their accessibility. In this work, we develop paper-based capacitive sensors (PCSs) that allow simple, rapid identification and quantification of various chemicals from microliter size samples with the aid of a handheld multimeter. PCSs are low-cost parallel-plate capacitors (~$0.01 per sensor) assembled from layers of aluminum foil and filter paper via double-sided tape. The developed PCSs can identify different kinds of fluids (e.g., organic chemicals) and quantify diverse concentrations of substances (e.g., heavy metal ions) based on differences in dielectric properties, including capacitance, frequency spectrum, and dielectric loss tangent. The PCS-based method enables chemical identification and quantification to take place much cheaply, simply, and quickly at the point-of-care (POC), holding great promise for environmental monitoring in resource-limited settings.
  16. Li Y, Hou J, Sun Z, Hu J, Thilakavathy K, Wang Y, et al.
    Signal Transduct Target Ther, 2023 Jul 17;8(1):278.
    PMID: 37460567 DOI: 10.1038/s41392-023-01540-2
  17. Li X, Abdullah LC, Sobri S, Syazarudin Md Said M, Aslina Hussain S, Poh Aun T, et al.
    J Air Waste Manag Assoc, 2023 Sep;73(9):649-678.
    PMID: 37449903 DOI: 10.1080/10962247.2023.2232744
    Clarifying the spatiotemporal distribution and impact mechanism of pollution is the prerequisite for megacities to formulate relevant air pollution prevention and control measures and achieve carbon neutrality goals. Chongqing is one of the dual-core key megacities in Cheng-Yu region and as a typical mountain-city in China, environmental problems are complex and sensitive. This research aims to investigate the exceeding standard levels and spatio-temporal evolution of criteria pollutants between 2014 and 2020. The results indicated that PM10, PM2.5, CO and SO2 were decreased significantly by 45.91%, 52.86%, 38.89% and 66.67%, respectively. Conversely, the concentration of pollutant O3 present a fluctuating growth and found a "seesaw" phenomenon between it and PM. Furthermore, PM and O3 are highest in winter and summer, respectively. SO2, NO2, CO, and PM showed a "U-shaped", and O3 showed an inverted "U-shaped" seasonal variation. PM and O3 concentrations are still far behind the WHO, 2021AQGs standards. Significant spatial heterogeneity was observed in air pollution distribution. These results are of great significance for Chongqing to achieve "double control and double reduction" of PM2.5 and O3 pollution, and formulate a regional carbon peaking roadmap under climate coordination. Besides, it can provide an important platform for exploring air pollution in typical terrain around the world and provide references for related epidemiological research.Implications: Chongqing is one of the dual-core key megacities in Cheng-Yu region and as a typical mountain city, environmental problems are complex and sensitive. Under the background of the "14th Five-Year Plan", the construction of the "Cheng-Yu Dual-City Economic Circle" and the "Dual-Carbon" goal, this article comprehensively discussed the annual and seasonal excess levels and spatiotemporal evolution of pollutants under the multiple policy and the newest international standards (WHO,2021AQG) backgrounds from 2014 to 2020 in Chongqing. Furthermore, suggestions and measures related to the collaborative management of pollutants were discussed. Finally, limitations and recommendations were also put forward.Clarifying the spatiotemporal distribution and impact mechanism of pollution is the prerequisite for cities to formulate relevant air pollution control measures and achieve carbon neutrality goals. This study is of great significance for Chongqing to achieve "double control and double reduction" of PM2.5 and O3 pollution, study and formulate a regional carbon peaking roadmap under climate coordination and an action plan for sustained improvement of air quality.In addition, this research can advanced our understanding of air pollution in complex terrain. Furthermore, it also promote the construction of the China national strategic Cheng-Yu economic circle and build a beautiful west. Moreover, it provides scientific insights for local policymakers to guide smart urban planning, industrial layout, energy structure, and transportation planning to improve air quality throughout the Cheng-Yu region. Finally, this is also conducive to future scientific research in other regions of China, and even megacities with complex terrain in the world.
  18. Li X, Abdullah LC, Sobri S, Md Said MS, Hussain SA, Aun TP, et al.
    Water Air Soil Pollut, 2023;234(5):328.
    PMID: 37200574 DOI: 10.1007/s11270-023-06279-8
    Currently, air quality has become central to global environmental policymaking. As a typical mountain megacity in the Cheng-Yu region, the air pollution in Chongqing is unique and sensitive. This study aims to comprehensively investigate the long-term annual, seasonal, and monthly variation characteristics of six major pollutants and seven meteorological parameters. The emission distribution of major pollutants is also discussed. The relationship between pollutants and the multi-scale meteorological conditions was explored. The results indicate that particulate matter (PM), SO2 and NO2 showed a "U-shaped" variation, while O3 showed an "inverted U-shaped" seasonal variation. Industrial emissions accounted for 81.84%, 58% and 80.10% of the total SO2, NOx and dust pollution emissions, respectively. The correlation between PM2.5 and PM10 was strong (R = 0.98). In addition, PM only showed a significant negative correlation with O3. On the contrary, PM showed a significant positive correlation with other gaseous pollutants (SO2, NO2, CO). O3 is only negatively correlated with relative humidity and atmospheric pressure. These findings provide an accurate and effective countermeasure for the coordinated management of air pollution in Cheng-Yu region and the formulation of the regional carbon peaking roadmap. Furthermore, it can improve the prediction accuracy of air pollution under multi-scale meteorological factors, promote effective emission reduction paths and policies in the region, and provide references for related epidemiological research.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11270-023-06279-8.

  19. Tang R, Yang H, Choi JR, Gong Y, Hu J, Feng S, et al.
    Talanta, 2016 May 15;152:269-76.
    PMID: 26992520 DOI: 10.1016/j.talanta.2016.02.017
    Lateral flow assays (LFAs) hold great promise for point-of-care testing, especially in resource-poor settings. However, the poor sensitivity of LFAs limits their widespread applications. To address this, we developed a novel device by integrating dialysis-based concentration method into LFAs. The device successfully achieved 10-fold signal enhancement in Human Immunodeficiency Virus (HIV) nucleic acid detection with a detection limit of 0.1nM and 4-fold signal enhancement in myoglobin (MYO) detection with a detection limit of 1.56ng/mL in less than 25min. This simple, low-cost and portable integrated device holds great potential for highly sensitive detection of various target analytes for medical diagnostics, food safety analysis and environmental monitoring.
  20. Duseja A, De A, Taneja S, Choudhury AK, Devarbhavi H, Hu J, et al.
    Liver Int, 2021 01;41(1):150-157.
    PMID: 32970356 DOI: 10.1111/liv.14671
    BACKGROUND: Metabolic risk factors may impact the severity and outcome of alcoholic liver disease. The present study evaluated this effect in patients with alcohol-associated acute-on-chronic liver failure (ACLF).

    METHODOLOGY: One thousand two hundred and sixteen prospectively enrolled patients with ACLF (males 98%, mean age 42.5 ± 9.4 years, mean CTP, MELD and AARC scores of 12 ± 1.4, 29.7 ± 7 and 9.8 ± 2 respectively) from the Asian Pacific Association for the Study of the Liver (APASL) ACLF Research Consortium (AARC) database were analysed retrospectively. Patients with or without metabolic risk factors were compared for severity (CTP, MELD, AARC scores) and day 30 and 90 mortality. Information on overweight/obesity, type 2 diabetes mellitus (T2DM), hypertension and dyslipidaemia were available in 1028 (85%), 1019 (84%), 1017 (84%) and 965 (79%) patients respectively.

    RESULTS: Overall, 392 (32%) patients died at day 30 and 528 (43%) at day 90. Overweight/obesity, T2DM, hypertension and dyslipidaemia were present in 154 (15%), 142 (14%), 66 (7%) and 141 (15%) patients, respectively, with no risk factors in 809 (67%) patients. Patients with overweight/obesity had higher MELD scores (30.6 ± 7.1 vs 29.2 ± 6.9, P = .007) and those with dyslipidaemia had higher AARC scores (10.4 ± 1.2 vs 9.8 ± 2, P = .014). Overweight/obesity was associated with increased day 30 mortality (HR 1.54, 95% CI 1.06-2.24, P = .023). None of other metabolic risk factors, alone or in combination, had any impact on disease severity or mortality. On multivariate analysis, overweight or obesity was significantly associated with 30-day mortality (aHR 1.91, 95% CI 1.41-2.59, P 

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