A Network Analysis of Brief Measure of Perceived Courtesy and Affiliate Stigma During COVID-19 in Hubei China

Purpose: The current study aims to test perceived affiliate and courtesy stigma in Hubei province China during the early periods of COVID-19 by using network analysis. Method: In this study, 4,591 participants (3,034 female, mean age = 26.64) from the Hubei Province of China were recruited to conduct network analysis. Results: The network analysis found network connections between Estranged - Blamed, Shamed - No Strong Point, and Rejected - Plague were the strongest. The most important stigma features (nodes) of COVID-19 (i.e. Plague, No Strong Point, Discriminated, and Disgusting). Discussion and Conclusions: This study uncovered the most central features of perceived affiliate and courtesy stigma on COVID-19, proposing these features (and associations between features) could be prioritized for anti-stigma interventions for the COVID-19 pandemic. © 2023 Taylor & Francis.

52-Week Risankizumab Subcutaneous Maintenance Dosing Is Efficacious and Well Tolerated in Patients With Moderate to Severe Crohn’s Disease Who Had Delayed Response to 12-Weeks IV Risankizumab Induction

Introduction: In patients with moderate to severe Crohn's disease (CD), the ADVANCE and MOTIVATE phase 3 induction studies showed intravenous (IV) risankizumab (RZB), an anti-p19 interleukin-23 inhibitor, to be superior to placebo (PBO) for achieving clinical and endoscopic endpoints at Week (Wk) 12.1 Here, we evaluated the long-term efficacy and safety of RZB during the FORTIFY maintenance study in patients with delayed clinical response to IV RZB induction. [...]patients receiving RZB SC (180 mg or 360 mg) also achieved endoscopic response (36.7%, 45.5%), endoscopic remission (40.0%, 42.4%), deep remission (40.0%, 39.4%), ulcer free endoscopy (27.6%, 24.2%), and the combined endpoint of SF/APS clinical remission + endoscopic response (23.3%, 36.4%). [...]a dose-response trend was observed, with numerically higher response rates observed with RZB 360 mg SC relative to 180 mg SC for most outcomes, including clinical remission (CDAI and SF/APS), CDAI clinical response, enhanced clinical response, endoscopic response, endoscopic remission, and the composite endpoint of SF/APS clinical remission + endoscopic response. Efficacy and Safety after 52-Weeks Maintenance SC RZB Dosing in Delayed Responders (NRI-NCa) Responder Group Treatment Group, n (%) [95% CI] CDAI Clinical Response Enhanced Clinical Response CDAI Clinical Remission SF/APS Clinical Remission Endoscopic Response Ulcer Free Endoscopy Endoscopic Remission SF/APS Clinical Remission and Endoscopic Response Deep Remission RZB 180 mg SC delayed responders, Wk 24 53.3 (6/30) [35.5, 71.2] 56.7 (17/30) [38.9, 74.4] 53.3 (16/30) [35.5, 71.2] 43.3 (13/30) [25.6, 61.1] 36.7 (11/30) [19.4, 53.9] 27.6 (8/29) [11.3, 43.9] 40.0 (12/30) [22.5, 57.5] 23.3 (7/30) [8.2, 38.5] 40.0 (12/30) [22.5, 57.5] RZB 360 mg SC delayed responders, Wk 24 75.8 (25/33) [61.1, 90.4] 66.7 (22/33) [50.6, 82.8] 66.7 (22/33) [50.6, 82.8] 54.5 (18/33) [37.6, 71.5] 45.5 (15/33) [28.5, 62.4] 24.2 (8/33) [9.6, 38.9] 42.4 (14/33) [25.6, 59.3] 36.4 (12/33) [20.0, 52.8] 39.4 (13/33) [22.7, 56.1] Responder Group Treatment Group, (E/100PYs) Deaths Serious infections All treatment emergent adverse events AE related to COVID-19 Serious AE Hepatic events Injection site reactions AE leading to discontinuation of study drug Crohn's Disease RZB 180 mg SC (N=31) (PYs=27.5) delayed responders, Wk 24 0 0 132 (479.8) 0 6 (21.8) 0 6 (21.8) 2 (7.3) 7 (25.4) RZB 360 mg SC (N=33) (PYs=32.1) delayed responders, Wk 24 0 1 (3.1) 83 (258.9) 0 4 (12.5) 1 (3.1) 2 (6.2) 0 7 (21.8)

Metagenomic Next-Generation Sequencing Reveals the Profile of Viral Infections in Kidney Transplant Recipients During the Covid-19 Pandemic

Purpose: To study the clinical application of metagenomic next-generation sequencing (mNGS) in the detection of viral infections in kidney transplant recipients (KTRs) during the COVID-19 pandemic. Method(s): Using mNGS techniques, 50 human fluid samples of KTRs were detected in Henan Province People's Hospital between May 2020 to May 2021, including 20 bronchoalveolar lavage fluid (BALF) samples, 21 urine samples and 9 blood samples. The detected nucleic acid sequences were compared and analyzed with the existing viral nucleic acid sequences in the database, and the virus infection spectrum of KTRs was drawn. Result(s): The viral nucleic acids of 15 types of viruses were detected in 96.00% (48/50) of the samples, of which 11 types of viruses were in BALF (95.00%, 19/20), and the dominant viruses were torque teno virus (TTV) (65.00%;13/20), cytomegalovirus (CMV) (45.00%;9/20) and human alphaherpesvirus 1 (25.00%;5/20). 12 viruses (95.24%, 20/21) were detected in the urine, and the dominant viruses were TTV (52.38%;11/21), JC polyomavirus (52.38%;11/21), BK polyomavirus (42.86%;9/21), CMV (33.33%;7/21) and human betaherpesvirus 6B (28.57%;6/21). 7 viruses were detected in the blood (100.00%, 9/9), and the dominant virus was TTV (100.00%;9/9). Four rare viruses were detected in BALF and urine, including WU polyomavirus, primate bocaparvovirus 1, simian virus 12, and volepox virus. Further analysis showed that TTV infection with high reads indicated a higher risk of acute rejection (P<0.05). Conclusion(s): mNGS detection reveals the rich virus spectrum of infected persons after kidney transplantation, and improves the detection rate of rare viruses. TTV may be a new biomarker for predicting rejection. (Figure Presented).

Understanding the Necessity and Economic Benefits of Lockdown Measures to Contain COVID-19

Since the outbreak of the coronavirus disease 2019 (COVID-19), the issue of how to maintain economic development while containing the epidemic has become a significant concern for decision-makers. Though lockdown measures are verified to be very effective in containing the epidemic, its economic costs and other influences have not been fully explored. As a result, decision-makers in many countries are still hesitant to include the lockdown measure in an intervention strategy in response to COVID-19. To address this issue, we propose a universal computational experiment approach for policy evaluation and adjustment based on the Artificial societies, Computational experiments, Parallel execution (ACP) concept. First, we innovatively construct a model via observable CO<inline-formula> <tex-math notation="LaTeX">$_2$</tex-math> </inline-formula> emissions, which is able to estimate the economic costs affected by nonpharmaceutical interventions. Furthermore, based on the population movement data, a risk source model is proposed to estimate the local transmission risk for any prefectures outside the epicenter. Finally, we integrate the data models in a high-resolution agent-based artificial society and carry out large-scale computational experiments supported by the Tianhe supercomputer. Policy adjustments and evaluations are carried out in four cities: Wenzhou, Guangzhou, Beijing, and Wuhan. Our research findings show important implications for policy-making: 1) the local transmission of a city can be almost contained if lockdowns are adopted immediately when the risk index is larger than 1.645, 1.960, or 2.576 at the 90%, 95%, or 99% confidence interval, respectively;2) if lockdowns are required, in-advance lockdown measures facilitate mitigation efficacy and reduce economic loss;and 3) lockdowns lasting for 7–14 days in a prefecture would be effective in controlling the spread of the epidemic. The duration of the measure should be prolonged with the increment of the initial transmission risk. IEEE

Risankizumab as induction therapy for Crohn's disease: results from the phase 3 ADVANCE and MOTIVATE induction trials.

BACKGROUND: Risankizumab, an interleukin (IL)-23 p19 inhibitor, was evaluated for safety and efficacy as induction therapy in patients with moderately to severely active Crohn's disease. METHODS: ADVANCE and MOTIVATE were randomised, double-masked, placebo-controlled, phase 3 induction studies. Eligible patients aged 16-80 years with moderately to severely active Crohn's disease, previously showing intolerance or inadequate response to one or more approved biologics or conventional therapy (ADVANCE) or to biologics (MOTIVATE), were randomly assigned to receive a single dose of intravenous risankizumab (600 mg or 1200 mg) or placebo (2:2:1 in ADVANCE, 1:1:1 in MOTIVATE) at weeks 0, 4, and 8. We used interactive response technology for random assignment, with stratification by number of previous failed biologics, corticosteroid use at baseline, and Simple Endoscopic Score for Crohn's disease (SES-CD). All patients and study personnel (excluding pharmacists who prepared intravenous solutions) were masked to treatment allocation throughout the study. Coprimary endpoints were clinical remission (defined by Crohn's disease activity index [CDAI] or patient-reported outcome criteria [average daily stool frequency and abdominal pain score]) and endoscopic response at week 12. The intention-to-treat population (all eligible patients who received at least one dose of study drug in the 12-week induction period) was analysed for efficacy outcomes. Safety was assessed in all patients who received at least one dose of study drug. Both trials were registered on ClinicalTrials.gov, NCT03105128 (ADVANCE) and NCT03104413 (MOTIVATE), and are now complete. FINDINGS: Participants were enrolled between May 10, 2017, and Aug 24, 2020 (ADVANCE trial), and Dec 18, 2017 and Sept 9, 2020 (MOTIVATE trial). In ADVANCE, 931 patients were assigned to either risankizumab 600 mg (n=373), risankizumab 1200 mg (n=372), or placebo (n=186). In MOTIVATE, 618 patients were assigned to risankizumab 600 mg (n=206), risankizumab 1200 mg (n=205), or placebo (n=207). The primary analysis population comprised 850 participants in ADVANCE and 569 participants in MOTIVATE. All coprimary endpoints at week 12 were met in both trials with both doses of risankizumab (p values ≤0·0001). In ADVANCE, CDAI clinical remission rate was 45% (adjusted difference 21%, 95% CI 12-29; 152/336) with risankizumab 600 mg and 42% (17%, 8-25; 141/339) with risankizumab 1200 mg versus 25% (43/175) with placebo; stool frequency and abdominal pain score clinical remission rate was 43% (22%, 14-30; 146/336) with risankizumab 600 mg and 41% (19%, 11-27; 139/339) with risankizumab 1200 mg versus 22% (38/175) with placebo; and endoscopic response rate was 40% (28%, 21-35; 135/336) with risankizumab 600 mg and 32% (20%, 14-27; 109/339) with risankizumab 1200 mg versus 12% (21/175) with placebo. In MOTIVATE, CDAI clinical remission rate was 42% (22%, 13-31; 80/191) with risankizumab 600 mg and 40% (21%, 12-29; 77/191) with risankizumab 1200 mg versus 20% (37/187) with placebo; stool frequency and abdominal pain score clinical remission rate was 35% (15%, 6-24; 66/191) with risankizumab 600 mg and 40% (20%, 12-29; 76/191) with risankizumab 1200 mg versus 19% (36/187) with placebo; and endoscopic response rate was 29% (18%, 10-25; 55/191) with risankizumab 600 mg and 34% (23%, 15-31; 65/191) with risankizumab 1200 mg versus 11% (21/187) with placebo. The overall incidence of treatment-emergent adverse events was similar among the treatment groups in both trials. Three deaths occurred during induction (two in the placebo group [ADVANCE] and one in the risankizumab 1200 mg group [MOTIVATE]). The death in the risankizumab-treated patient was deemed unrelated to the study drug. INTERPRETATION: Risankizumab was effective and well tolerated as induction therapy in patients with moderately to severely active Crohn's disease. FUNDING: AbbVie.

[Survey of possible aerosol transmission of a COVID-19 epidemic caused by 2019-nCoV Delta variant].

Objective: To investigate the epidemiological characteristics and the transmission chain of a family clustering of COVID-19 cases caused by severe acute respiratory 2019-nCoV Delta variant in Changping district of Beijing. Methods: Epidemiological investigation was conducted and big data were used to reveal the exposure history of the cases. Close contacts were screened according to the investigation results, and human and environmental samples were collected for nucleic acid tests. Positive samples were analyzed by gene sequencing. Results: On November 1, 2021, a total of 5 COVID-19 cases caused by 2019-nCoV Delta variant were reported in a family detected through active screening. The infection source was a person in the same designated isolation hotel where the first case of the family cluster was isolated from 22 to 27, October. The first case was possibly infected through aerosol particles in the ventilation duct system of the isolation hotel. After the isolation discharge on October 27, and the first case caused secondary infections of four family members while living together from October 27 to November 1, 2021. Conclusion: 2019-nCoV Delta variant is prone to cause family cluster, and close attention needs to be paid to virus transmission through ventilation duct system in isolation hotels.

[Survey on source of infection of the first local outbreak caused by SARS-CoV-2 Alpha variant in China].

Objective: To investigate the epidemiological characteristics and the chain of infection of a local outbreak, which was the first outbreak caused by severe acute respiratory syndrome corona virus 2 Alpha variant in China and occurred in Daxing district, Beijing. Methods: Epidemiological investigation and big data technology were used to verify the exposure points of the cases. Close contacts were traced from the exposure points, and their human and environmental samples were collected for nucleic acid tests. Serum samples were collected from key persons for antibody detection. Results: A total of 33 corona virus disease 2019(COVID-19) cases were reported in the local outbreak, from January 17, 2021 to January 29, 2021 in Daxing district, Beijing, and there was epidemiological association in 32 cases. Except for one case who was infected in the workplace, other cases were all infected in the community and family. All cases involved 14 families, of which 6 families were all infected. The attack rate of all family members was 69%(33/48), and the secondary attack rate was 56%(19/34). There was no obvious source of infection found after the investigation of entry-exit personnel and goods. Conclusion: The first outbreak caused by severe acute respiratory syndrome corona virus 2 Alpha variant in China is found and handled in time, and thus the scope of influence is limited, but the family clustering characteristics are more obvious than previous outbreaks.

Modeling human travel and social contact with multi-layer networks for epidemic prediction

It is a key issue to reasonably represent human travel and social contact in epidemic models. Various measures were applied to develop the models of human mobility and contact in a long range or a short range, such as Brown movement, random walks, spatial networks, gravity models, contact networks. We proposed a method of representing human daily movement and social contact by using multi-layer networks with temporal edge weights. We combined bipartite networks with social networks to describe human daily trip and social contact, respectively. Temporal edge weights of multi-layer networks were employed to denote the propensity of individual movement and contact. We also verified our models and parameters by incorporating human daily travel and contact regularities, as well as comparing experimental results with human behavior statistical laws. At last, we applied a Chinese university campus as a case study to investigate students' daily travel and social contact, and studied the transmission and control strategies of COVID-19 virus. We found stricter control strategies are needed to mitigate the transmission of COVID-19 virus in a university. Once a patient case emerges in a university, it is better to close the campus and quarantine all students. Partial control strategies such as quarantining a part of students and buildings cannot achieve a great effect of mitigating the transmission of COVID-19 virus. Our works are beneficial for the practitioners in the field of computational epidemiology. © 2021 IEEE.

[Relationship between respiratory viral load of cases of COVID-19 and secondary attack risk in close contacts].

Objective: To analyze the relationship between the cycle threshold (Ct) values of N gene of COVID-19 cases and the secondary attack risk in close contacts, and identify the relationship between respiratory viral load and infectivity in COVID-19 cases. Methods: The COVID-19 cases with records of Ct values of N gene within 0-7 days of onset were selected, and their close contacts were recruited as the subjects of study. We collected the information of close contacts, including name, gender, age, isolation mode, exposure mode and outcome (whether they were infected with SARS-CoV-2 or not) and other variables. Multivariate logistic regression models were used to identify the relationship between Ct values of N gene of COVID-19 cases and secondary attack risk in close contacts. Results: A total of 1 618 close contacts were recruited, in whom 77 were confirmed as symptomatic or asymptomatic COVID-19 patients with overall secondary attack rate of 4.8%. The multivariate logistic regression analysis indicated that eating together (OR=2.741, P=0.054), living together (OR=9.721, P<0.001), non-centralized isolation (OR=18.437, P<0.001) and COVID-19 case's values of N gene within 0-7 days of onset being <20 (OR=8.998, P=0.004) or 20-25 (OR=3.547, P=0.032) were significantly associated with higher likelihood of being infected with SARS-CoV-2 in close contacts. Conclusion: The results indicated that positive relationship exists between respiratory viral load and infectivity in COVID-19 cases, suggesting that Ct values of N gene can be used as an early warning indicator for the management of close contacts of COVID-19 cases.

Analysis of the impact of covid-19 on the coupling of the material flow and capital flow in a closed-loop supply chain

The complex and changeable external social and economic environment has a significant impact on the sustainable development of the closed-loop supply chain. In particular, the occurrence of uncertain emergencies increases the risk of interruption of the closed-loop supply chain, making it insufficient to analyze its complex changes from the perspective of material flow alone. Based on this analysis, the paper constructs a closed-loop supply chain material flow and capital flow coupling system composed of manufacturers, sellers and recyclers to explore the impact of material flow sudden interruption on the closed-loop supply chain system when an uncertain emergency occurs. In this paper, based on the closed-loop supply chain system coupled with logistics and capital flow, a system dynamics simulation model was established by using Vensim simulation software to analyze the impact of COVID-19 epidemic on manufacturers, sellers and recyclers under five scenarios. The results show that when COVID-19 outbreaks occur, the material flow of each main enterprise in the closed-loop supply chain is more easily influenced than the capital flow. At the same time, it can be found that the recyclers in the main enterprises of the closed-loop supply chain are more easily influenced by the material flow. The model constructed in this paper has applicability and can be used for related studies of closed-loop supply chain under other emergencies, but the scene design should be carried out according to the characteristics of emergencies themselves. © 2021 Production Engineering Institute. All rights reserved.