Validation of an HPLC-CAD Method for Determination of Lipid Content in LNP-Encapsulated COVID-19 mRNA Vaccines.

Lipid nanoparticles (LNPs) are widely used as delivery systems for mRNA vaccines. The stability and bilayer fluidity of LNPs are determined by the properties and contents of the various lipids used in the formulation system, and the delivery efficiency of LNPs largely depends on the lipid composition. For the quality control of such vaccines, here we developed and validated an HPLC-CAD method to identify and determine the contents of four lipids in an LNP-encapsulated COVID-19 mRNA vaccine to support lipid analysis for the development of new drugs and vaccines.

Therapeutic potency of compound RMY-205 for pulmonary fibrosis induced by SARS-CoV-2 nucleocapsid protein.

Pulmonary fibrosis is a typical sequela of coronavirus disease 2019 (COVID-19), which is linked with a poor prognosis for COVID-19 patients. However, the underlying mechanism of pulmonary fibrosis induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is unclear. Here, we demonstrated that the nucleocapsid (N) protein of SARS-CoV-2 induced pulmonary fibrosis by activating pulmonary fibroblasts. N protein interacted with the transforming growth factor ß receptor I (TßRI), to disrupt the interaction of TßRI-FK506 Binding Protein12 (FKBP12), which led to activation of TßRI to phosphorylate Smad3 and boost expression of pro-fibrotic genes and secretion of cytokines to promote pulmonary fibrosis. Furthermore, we identified a compound, RMY-205, that bound to Smad3 to disrupt TßRI-induced Smad3 activation. The therapeutic potential of RMY-205 was strengthened in mouse models of N protein-induced pulmonary fibrosis. This study highlights a signaling pathway of pulmonary fibrosis induced by N protein and demonstrates a novel therapeutic strategy for treating pulmonary fibrosis by a compound targeting Smad3.

Delay in seeking health care from community residents during a time with low prevalence of COVID-19: A cross-sectional national survey in China.

Background: The pandemic of COVID-19 has significant implications on health resources allocation and health care delivery. Patients with non-COVID illness may have to change their care seeking behaviors to mitigate the risk of infections. The research aimed to investigate potential delay of community residents in seeking health care at a time with an overall low prevalence of COVID-19 in China. Methods: An online survey was conducted in March 2021 on a random sample drawn from the registered survey participants of the survey platform Wenjuanxing. The respondents who reported a need for health care over the past month (n = 1,317) were asked to report their health care experiences and concerns. Logistic regression models were established to identify predictors of the delay in seeking health care. The selection of independent variables was guided by the Andersen's service utilization model. All data analyses were performed using SPSS 23.0. A two-sided p value of <0.05 was considered as statistically significant. Key results: About 31.4% of respondents reported delay in seeking health care, with fear of infection (53.5%) as a top reason. Middle (31-59 years) age (AOR = 1.535; 95% CI, 1.132 to 2.246), lower levels of perceived controllability of COVID-19 (AOR = 1.591; 95% CI 1.187 to 2.131), living with chronic conditions (AOR = 2.008; 95% CI 1.544 to 2.611), pregnancy or co-habiting with a pregnant woman (AOR = 2.115; 95% CI 1.154 to 3.874), access to Internet-based medical care (AOR = 2.529; 95% CI 1.960 to 3.265), and higher risk level of the region (AOR = 1.736; 95% CI 1.307 to 2.334) were significant predictors of the delay in seeking health care after adjustment for variations of other variables. Medical consultations (38.7%), emergency treatment (18.2%), and obtainment of medicines (16.5%) were the top three types of delayed care, while eye, nose, and throat diseases (23.2%) and cardiovascular and cerebrovascular diseases (20.8%) were the top two conditions relating to the delayed care. Self-treatment at home was the most likely coping strategy (34.9%), followed by Internet-based medical care (29.2%) and family/friend help (24.0%). Conclusions: Delay in seeking health care remained at a relatively high level when the number of new COVID-19 cases was low, which may present a serious health risk to the patients, in particular those living with chronic conditions who need continuous medical care. Fear of infection is the top reason for the delay. The delay is also associated with access to Internet-based medical care, living in a high risk region, and perceived low controllability of COVID-19.

Epidemiological trend in scarlet fever incidence in China during the COVID-19 pandemic: A time series analysis.

Objective: Over the past decade, scarlet fever has caused a relatively high economic burden in various regions of China. Non-pharmaceutical interventions (NPIs) are necessary because of the absence of vaccines and specific drugs. This study aimed to characterize the demographics of patients with scarlet fever, describe its spatiotemporal distribution, and explore the impact of NPIs on the disease in the era of coronavirus disease 2019 (COVID-19) in China. Methods: Using monthly scarlet fever data from January 2011 to December 2019, seasonal autoregressive integrated moving average (SARIMA), advanced innovation state-space modeling framework that combines Box-Cox transformations, Fourier series with time-varying coefficients, and autoregressive moving average error correction method (TBATS) models were developed to select the best model for comparing between the expected and actual incidence of scarlet fever in 2020. Interrupted time series analysis (ITSA) was used to explore whether NPIs have an effect on scarlet fever incidence, while the intervention effects of specific NPIs were explored using correlation analysis and ridge regression methods. Results: From 2011 to 2017, the total number of scarlet fever cases was 400,691, with children aged 0-9 years being the main group affected. There were two annual incidence peaks (May to June and November to December). According to the best prediction model TBATS (0.002, {0, 0}, 0.801, {<12, 5>}), the number of scarlet fever cases was 72,148 and dual seasonality was no longer prominent. ITSA showed a significant effect of NPIs of a reduction in the number of scarlet fever episodes (ß2 = -61526, P < 0.005), and the effect of canceling public events (c3) was the most significant (P = 0.0447). Conclusions: The incidence of scarlet fever during COVID-19 was lower than expected, and the total incidence decreased by 80.74% in 2020. The results of this study indicate that strict NPIs may be of potential benefit in preventing scarlet fever occurrence, especially that related to public event cancellation. However, it is still important that vaccines and drugs are available in the future.

Acceptance and Attitude towards the Traditional Chinese Medicine among Asymptomatic COVID-19 Patients: A cross-sectional study in Shanghai Fangcang hospital (preprint)

Objective The Coronavirus Disease 2019 (COVID-19) has brought severe damage to global health and socioeconomics. In China, traditional Chinese medicine (TCM) is the most important complementary and alternative medicine (CAM) and it has shown a beneficial role in the prevention and treatment of COVID-19. However, it is unknown whether patients are willing to accept TCM treatment. The objective of our study is to investigate the acceptance, attitude, and independent predictors of TCM among asymptomatic COVID-19 patients admitted to Shanghai fangcang hospital during the outbreak of the COVID-19 pandemic in Shanghai in 2022.Methods A cross-sectional study was conducted on asymptomatic COVID-19 patients in the largest fangcang hospital in Shanghai, China, from April 22, 2022, to May 25, 2022. Based on the literature review of previous similar studies, a self-report questionnaire was developed to assess the patients’ attitude and acceptance of TCM, and a multivariate logistic regression analysis was conducted to determine the independent predictors of TCM acceptance.Results A total of 1,121 patients completed the survey, of whom 91.53% were willing to accept CAM treatment whereas 8.65% of participants showed no willingness. Among those who were positive to receive CAM treatment, 70.51% of the participants were willing to be treated with Chinese herbal medicine, 62.79% with Chinese patent medicine, 34.96% with massage therapy, 33.20% with moxibustion treatment, and 29.00% with cupping therapy. There were significant differences in the 10 variables such as monthly income level, SARS-CoV-2 vaccination, and patients' cognition and attitude towards TCM among the patients who were willing or unwilling to accept TCM treatment. Multivariate logistic regression analysis revealed that the patients who have received two doses of COVID-19 vaccine (OR = 2.069, 95%CI: 1.029–4.162, P = 0.041 vs not received), understood the culture of TCM (OR = 2.293, 95%CI: 1.029–4.162, P = 0.014 vs not understood), thought TCM needs a longer time to exert efficacy (OR = 1.607, 95%CI: 0.849–3.034, P = 0.145 vs not thought), thought the treatment of TCM is safe (OR = 2.856, 95%CI: 1.334–6.112, P = 0.007 vs not thought), thought the treatment of TCM is effective (OR = 2.724, 95%CI: 1.249–5.940, P = 0.012 vs not thought), and those who informed their attending physician if using TCM for treatment (OR = 3.455, 95%CI:1.867–6.392, P < 0.001 vs not informed) were more likely to accept TCM treatment. However, patients who thought TCM might delay your treatment (OR = 0.256, 95%CI: 0.142–0.462, P < 0.001 not thought) was an independent predictor for unwillingness to accept TCM treatment.Conclusion This is the first study to investigate the acceptance, attitude, and predictors of intention to receive TCM among asymptomatic COVID-19 patients. The next step of this study will be a long-term follow-up of these patients to observe whether accepting TCM treatment will influence their quality of life.

Investor's herding behavior in Asian equity markets during COVID-19 period

In this paper we investigate herding behavior triggered by the COVID-19 outbreak in 2020 by considering six typical Asian stock markets. Cross-sectional Standard Deviation (CSSD) and Cross-sectional Absolute Deviation (CSAD) have been employed as the key indicators, which are aligned with the Markov-switching regression and HS model to identify the presence and magnitude of herding. We then elaborate our study by examining herding in specific time slots and markets with different idiosyncratic volatility. Our empirical results show a clear presence of herding in the “Feb 2020-Jan 2021” time window and we have captured a sharp rise of the magnitude of herding during the market crash in March 2020, and found herding emerged in these markets with shocks and fierce fluctuations.

The Impact of Mortality Salience on Purchase Intention and Creativity Evaluation on Products During COVID-19 Pandemic.

In the environment of COVID-19, people are faced with mortality salience (MS) and socioeconomic crisis. According to the terror management theory, the MS would lead to particular consumption attitudes and behaviors caused by the self-esteem and cultural worldview defense. The creativity as a potential value of products needs to be examined to explore how the MS changed the creativity evaluation of three types of products categorized into normal, renovative, and innovative products, based on the degree of originality (Zhang et al., 2019). Two experiments were conducted to examine (1) the MS effect on the creativity and purchase intention evaluation and (2) both MS and country-of-origin effect on the evaluations. The results show that usefulness and purchase intention are affected by both effects, and the novelty is mainly affected by MS.

Risk Culture and COVID-19 Protective Behaviors: A Cross-Sectional Survey of Residents in China.

The COVID-19 outbreak caused by the Severe Acute Respiratory Syndrome CoronaVirus type 2 (SARS-CoV-2) has spread across the world. However, our understanding of the public responses, in particular in adopting protective behaviors, has been limited. The current study aimed to determine the level of protective behaviors adopted by the residents in China and its association with their cultural attributes. A national cross-sectional online survey was conducted in mainland China from 4th to 13th August 2020. Protective behaviors were assessed as a summed score (ranging from 0 to 40) measured by ten items. The self-report tendency of study participants toward the four cultural attributes (individualism, egalitarianism, fatalism, hierarchy) was rated on a seven-point Likert scale. A total of 17651 respondents returned a valid questionnaire, representing 47.9% of those who accessed the online survey. Most (89.8%) respondents aged between 18 and 45 years in the age range of and 47.7% were male. High levels of protective behaviors (34.04 ± 5.78) were reported. The respondents had high scores in the cultural attributes of hierarchy (Median = 5) and egalitarianism (Median = 5), compared with low scores in individualism (Median = 1) and fatalism (Median = 1). High levels of protective behaviors were associated a higher tendency toward egalitarianism (AOR = 2.90, 95% CI 2.67-3.15) and hierarchy (AOR = 1.66, 95% CI 1.53-1.81) and a low tendency toward fatalism (AOR = 1.79, 95% CI 1.63-1.97) and individualism (AOR = 2.62, 95% CI 2.41-2.85). The cultural attributes explained 17.3% of the variations in the protective behavioral scores. In conclusion, the adoption of protective behaviors is associated a risk culture characterized by high levels of hierarchy and egalitarianism and low levels of individualism and fatalism. Government actions and communication strategies need to adapt to the cultural characteristics of their target audience.

High-Resolution CT Features of the COVID-19 Infection During Short-Term Follow-Up

Objective: To estimate the short-term follow-up chest HRCT manifestation in patients with COVID-19 who have left hospitals. Methods: Retrospective analysis was executed on the chest HRCT manifestation of 49 cases with RT-PCR confirmed COVID-19 pneumonia patients diagnosed in Beijing You’An hospital affiliated to capital medical university between 20 January 2020 to April 10, 2020. The study including 21 males and 28 females, and the median age was 59.5 years age ranged from 21 years to 80 years. The evolution characteristics of chest HRCT in short-term follow-up after discharge were analyzed. Results: Forty-nine patients were divided into two groups according to Diagnosis and Treatment Protocol of 2019 New Coronavirus Pneumonia (trial version 7) of National Health Commission of China. Severe group included 23 cases (46.9%) and 26 cases of ordinary (53.1%). The HRCT findings of patients in the 2 groups were analyzed on median follow-up time was 30 day (range, 14 to 46 days) after discharge. The follow-up chest HRCT were normal in 19 of 49 (38.8%) patients, abnormal HRCT findings were detected in 30 of 49 (61.2%) patients. The most frequent abnormality found on follow-up HRCT in COVID-19 patients who recovered from pneumonia was GGO which was seen in 26 of 49 (53.1%) patients, reticular pattern was in 9 of 49 (18.4%), traction bronchiectasis was in 3 of 49 (6.1%), small nodular consolidation was in 6 of 49 (12.2%), other findings including curved line in the subpleural area and irregular linear opacities were in 15 of 49 (30.6%). In the study, 3 of 49 (6.1%) patients were diagnosed with pulmonary fibrosis according to HRCT findings. Three cases were severe patients, aged from 65 to 80 years. Pulmonary fibrosis occurred within 30–50 days of onset. Conclusion: Pulmonary fibrosis may develop in 6.1% of COVID-19 patients, which was lower than that of SARS and MERS, suggesting that the lung damage caused by SARS-COV-2 in the recovered patients was lower than that of SARS and MERS.

Generating a synthetic probabilistic daily activity-location schedule using large-scale, long-term and low-frequency smartphone GPS data with limited activity information.

Household travel survey data is a critical input to travel behavior modeling, and it also can be used to generate trip schedules for activity-based traffic simulation. With emerging information and communication technology (ICT) tools like smartphones, the collection of passive datasets for travelers' real-time information becomes available. Smartphone GPS survey apps have emerged to be a popular tool for conducting household travel surveys. Most existing studies employ high-frequency smartphone GPS data and collect accurate activity information. However, their study periods are still rather short, ranging from a few days to a few weeks. For a long-term GPS survey, the issues of missing activity information and sparse GPS data are inevitable and must be addressed carefully. This paper uses 7-month low-frequency smartphone GPS data collected from over 2000 participants, who report 5 most frequently visited locations weekly. The essential goal is to develop a synthetic model of daily activity-location scheduling to capture data with both known and unknown activities. To handle missing activity data, this research develops a new probabilistic approach, which measures the probability of visiting a place by three scores, global visit score (GVS), temporal visit score (TVS), and periodical visit score (PVS). Three different levels of activity-location schedule are modeled respectively. The first level handles only those data with known activities, while data with unknown activities are disregarded. The second takes unknown activities into account but combines all types of them into a single category. The third one models each location with unknown activities separately. These models are able to generate activity-location schedule in different levels of detail for activity-based traffic simulator. After developing activity-location schedule models, both individual and aggregated validation processes are performed with simulation. The validation result shows that the simulated proportion of activity types and activity duration are close to the survey data, indicating the effectiveness of the proposed approaches. This research sheds a light on building sustainable and long-term travel survey using GPS data with missing activity information. In addition, this study will be valuable to model infectious disease transmission, e.g. COVID-19 and assess health risk in urban areas.

Plasmapheresis: a feasible choice for bullous pemphigoid patients infected with SARS-CoV-2.

Bullous pemphigoid (BP) patients were vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection because they have similar risk factors, so we should pay attention to patients with BP during the epidemic of coronavirus disease-19 (COVID-19). As far as treatment is concerned, many strategies for BP were changed during the epidemic. Plasmapheresis not only has been included in the guidelines for BP but also has been used successfully to rescue COVID-19 patients, especially in severe cases. Therefore, it is a feasible choice for BP patients, especially for refractory BP patients, infected with SARS-CoV-2. Apart from these, we have reviewed some points for attention during the plasmapheresis session.

Emotional Creativity Improves Posttraumatic Growth and Mental Health During the COVID-19 Pandemic.

Emotional creativity refers to a set of cognitive abilities and personality traits related to the originality of emotional experience and expression. Previous studies have found that emotional creativity can positively predict posttraumatic growth and mental health. The outbreak of coronavirus disease 2019 (COVID-19) has posed great challenges to people's daily lives and their mental health status. Therefore, this study aims to address the following two questions: whether emotional creativity can improve posttraumatic growth and mental health during the COVID-19 pandemic and how it works. To do this, a multiple mediation model has been proposed, which supposes that emotional creativity is associated with posttraumatic growth and mental health through perceived social support and regulatory emotional self-efficacy. The study involved 423 participants from multiple regions with different COVID-19 involvement levels. Participants were asked to complete a questionnaire with six parts, which included Emotional Creativity Inventory (ECI), Regulatory Emotional Self-Efficacy Scale (RES), Stress-Related Growth Scale-Short Form (SRGS-SF), Multidimensional Scale of Perceived Social Support scale (MSPSS), Brief Symptom Inventory-18 scale (BSI-18), and COVID-19-related life events questionnaire. Path analysis used to examine the mediation model indicated that under the control of COVID-19-related life events and age, perceived social support mediated a positive association between emotional creativity and posttraumatic growth as well as a negative association between emotional creativity and all mental health problems, including somatization, depression, and anxiety. Regulatory emotional self-efficacy mediates the association between emotional creativity and posttraumatic growth, emotional creativity and anxiety, and emotional creativity and depression. The results suggest that emotional creativity plays an important role in coping with stressful events related to COVID-19. Furthermore, these results might provide a better understanding of the possible paths through which emotional creativity is related to psychological outcomes, such as mental health and posttraumatic growth.

Benevolent Creativity Buffers Anxiety Aroused by Mortality Salience: Terror Management in COVID-19 Pandemic.

With the outbreak of the COVID-19 crisis, the public keeps getting epidemic-related information on the media. News reports on the increasing number of fatalities have exposed individuals to death, which causes negative emotional experiences such as tension, anxiety, and fear. This study aimed to investigate whether creativity could serve as an anxiety-buffer when mortality is salient. Based on previous findings, the present study utilized type of creative task and personal search for meaning as moderators. In Study 1, a 2 (mortality salience: absent, present) × 2 (type of creative task: benevolent, malevolent) between-subject design was utilized, and 168 subjects were randomly assigned to four experimental conditions. In Study 2, 221 subjects were recruited. The experimental procedure was similar to Study 1, except that the priming paradigm of mortality was changed and search for meaning was included as an additional moderating variable. State anxiety was measured as the dependent variable in both studies. Results of Study 1 showed that, while the benevolent creative task could buffer anxiety in the mortality salience condition, the malevolent creative task did not have the same effect. Furthermore, there was a significant interaction between mortality salience, type of creative task, and search for meaning in life on anxiety. In Study 2, the buffering function of benevolent creativity was more intense for participants with a higher level of search for meaning. Together, these findings reveal the influence of different types of creative tasks on individual anxiety levels under death priming conditions and the moderating effect of search for meaning in this relationship. Further, they suggest the need to focus on the role of creativity in terror management.

Updated diagnosis, treatment and prevention of COVID-19 in children: experts' consensus statement (condensed version of the second edition).

In the early February, 2020, we called up an experts' committee with more than 30 Chinese experts from 11 national medical academic organizations to formulate the first edition of consensus statement on diagnosis, treatment and prevention of coronavirus disease 2019 (COVID-19) in children, which has been published in this journal. With accumulated experiences in the diagnosis and treatment of COVID-19 in children, we have updated the consensus statement and released the second edition recently. The current version in English is a condensed version of the second edition of consensus statement on diagnosis, treatment and prevention of COVID-19 in children. In the current version, diagnosis and treatement criteria have been optimized, and early identification of severe and critical cases is highlighted. The early warning indicators for severe pediatric cases have been summarized which is utmost important for clinical practice. This version of experts consensus will be valuable for better prevention, diagnosis and treatment of COVID-19 in children worldwide.