抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A

Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268

Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.

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Using social and behavioural science to support COVID-19 pandemic response.

https://sites.oxy.edu/clint/physio/article/therewardcircuitlinkingprimateanatomyandhumanimaging.pdf

The reward circuit: linking primate anatomy and human imaging.

On a daily basis, we place our lives in the hands of strangers. From dentists to pilots, we make inferences about their competence to perform their jobs and consequently to keep us from harm. Here we explore whether the perceived competence of others can alter one's anticipation of pain. In two studies, participants Receivers believed their chances of experiencing an aversive stimulus were directly dependent on the performance of another person Players. We predicted that perceiving the Players as highly competent would reduce Receivers' anxiety when anticipating the possibility of an electric shock. Results confirmed that high competence ratings consistently corresponded with lower reported anxiety, and complementary fMRI data showed that increased competence perception was further expressed as decreased activity in the bilateral posterior insula, a region localized to actual pain stimulation. These studies suggest that inferences of competence act as predictors of protection and reduce the expectation of negative outcomes.

Inferences of others' competence reduces anticipation of pain when under threat

Threats elicit physiological responses, the frequency and intensity of which have implications for survival. Ethical and practical limitations on human laboratory manipulations present barriers to studying immersive threat. Furthermore, few investigations have examined group effects and concordance with subjective emotional experiences to threat. The current preregistered study measured electrodermal activity in 156 adults while they participated in small groups in a 30-min haunted-house experience involving various immersive threats. Results revealed positive associations between (a) friends and tonic arousal, (b) unexpected attacks and phasic activity (frequency and amplitude), (c) subjective fear and phasic frequency, and (d) dissociable sensitization effects linked to baseline orienting response. Findings demonstrate the relevance of (a) social dynamics (friends vs. strangers) for tonic arousal and (b) subjective fear and threat predictability for phasic arousal.

Physiological Responses to a Haunted-House Threat Experience: Distinct Tonic and Phasic Effects

Dopey dopamine: high tonic results in ironic performance.

This article begins by discussing how emotions shape moral choices. We then review the imaging literature, highlighting how moral cognition relies on a broad and decentralized neural network. We focus in particular on the functional roles of the prefrontal cortex, temporal lobes (including the amygdala), and cingulate cortex, emphasizing how each distinct region differentially contributes to moral cognition. We conclude by examining the evidence that lesions to this neural network not only cause deficits in socioemotional responding but also can profoundly disrupt moral behavior.

Dean Mobbs

Papers

Inferences of others' competence reduces anticipation of pain when under threat

Physiological Responses to a Haunted-House Threat Experience: Distinct Tonic and Phasic Effects

Dopey dopamine: high tonic results in ironic performance.

A Neural Network for Moral Decision Making

Pavlovian occasion setting in human fear and appetitive conditioning: Effects of trait anxiety and trait depression