Impact of Pandemic Outbreak and Targeted Required Reserve Ratio Cut Policy on Stock Return Rate: Evidence from China

This study analyzed the impact of COVID-19 outbreak and targeted required reserve ratio cut policy on stock returns of Chinese listed companies. This paper uses the data of 3,449 A-share listed companies from February 3, 2020 to December 31, 2020 for research, the empirical results showed that stock prices of private enterprises with stronger debt-paying ability and looser financing constraints, and state-owned enterprises with less supply chain credit risks performed better, in the central and western regions, enterprises with stronger solvency and looser financing constraints have better stock price performance during the early stages of pandemic. After the implementation of the targeted RRR cut policy, the stock prices of enterprises with poor solvency, private enterprises, and enterprises in central and western regions with strong financing constraints, state-owned enterprises, and enterprises in eastern region with high credit risks all showed significant reversals, and the stock prices reflected the effect of the targeted RRR cut policy in the short and medium term. Over time, the pandemic has been controlled, and the resumption of work and production has freed most enterprises from financial difficulties. However, due to sporadic outbreaks, large private enterprises and eastern enterprises with strong risk resistance and loose financing constraints enjoy better stock price performance. This study is helpful for enterprises to understand the value of financial flexibility and solvency and provides a reference for enterprises to make financial decisions: how to balance the benefits and costs of solvency. © Tian Wang, Fang Fang and Linhao Zheng, 2023.

Sex differences in COVID-19 susceptibility – Reductionistic and holistic perspectives

Infection with SARS-CoV-2, the coronavirus responsible for the COVID-19 pandemic, is associated with different clinical outcomes in men and women. Rates of hospitalization and mortality are higher in men, but late post-COVID complications may be more frequent in women. A variety of differences in comorbidities, behavior, and biology between males and females, in particular sex-related differences in the immune system, have been implicated. This review discusses how the integration of holistic and reductionistic research perspectives is providing a comprehensive understanding of the impact of sex on COVID-19 susceptibility and underscores the need to incorporate sex-specific reporting and analysis in future research. © 2023 Elsevier Inc. All rights reserved.

General Surgery Resident Case Numbers During the Covid-19 Pandemic

Introduction: The COVID-19 pandemic has had widespread effects on the healthcare system. For trainees, one particular detriment has been the cancellation of elective operations, reducing clinical experience and procedural volumes. Measures instituted to combat the pandemic have resulted in decreased cancellation of elective cases to varying degrees. The aim of this study is to evaluate the ongoing effect of the pandemic on resident operative volume. Method(s): Operative case numbers of general surgical graduates in 2019, 2020, and 2021 were extracted from the Accreditation Council for Graduate Medical Education case logs. Data included mean total cases/graduate and means for individual case types. Data was considered by overall number of cases and cases performed as surgeon chief. Analysis of variance was employed to compare groups with p<0.05 considered significant. Result(s): Mean total major cases differed significantly among groups with reduced volume noted for 2020 graduates but no difference in volume between 2019 and 2021 graduates (1070.5+/-150 vs 1054.8+/-155 vs 1074.1+/-164, p=0.0041). This same pattern was noted for surgeon chief total cases (288.6+/-69 vs 264.4+/-67 vs 286.2+/-73, p<0.0001) as well as several major general surgery subcategories including cases involving the stomach, small intestine, large intestine, biliary system, among others. Conclusion(s): Despite continued reduction in and alteration of elective surgery practice, improved pandemic measures have allowed for increased surgical volume. This has translated to increased operative experience for graduating surgical trainees that are comparable to case numbers that preceded the pandemic. Ramifications for the 2020 graduating cohort as well subsequent cohorts require continued evaluation.

[Clinical characteristics and short-term prognosis of 22 cases with SARS-CoV-2 infection associated acute encephalopathy].

Objective: To investigate the clinical features and short-term prognosis of patients with SARS-CoV-2 infection associated acute encephalopathy (AE). Methods: Retrospective cohort study. The clinical data, radiological features and short-term follow-up of 22 cases diagnosed with SARS-CoV-2 infection associated AE in the Department of Neurology, Beijing Children's Hospital from December 2022 to January 2023 were retrospectively analyzed. The patients were divided into cytokine storm group, excitotoxic brain damage group and unclassified encephalopathy group according to the the clinicopathological features and the imaging features. The clinical characteristics of each group were analyzed descriptively. Patients were divided into good prognosis group (≤2 scores) and poor prognosis group (>2 scores) based on the modified Rankin scale (mRS) score of the last follow-up. Fisher exact test or Mann-Whitney U test was used to compare the two groups. Results: A total of 22 cases (12 females, 10 males) were included. The age of onset was 3.3 (1.7, 8.6) years. There were 11 cases (50%) with abnormal medical history, and 4 cases with abnormal family history. All the enrolled patients had fever as the initial clinical symptom, and 21 cases (95%) developed neurological symptoms within 24 hours after fever. The onset of neurological symptoms included convulsions (17 cases) and disturbance of consciousness (5 cases). There were 22 cases of encephalopathy, 20 cases of convulsions, 14 cases of speech disorders, 8 cases of involuntary movements and 3 cases of ataxia during the course of the disease. Clinical classification included 3 cases in the cytokine storm group, all with acute necrotizing encephalopathy (ANE); 9 cases in the excitotoxicity group, 8 cases with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and 1 case with hemiconvulsion-hemiplegia syndrome; and 10 cases of unclassified encephalopathy. Laboratory studies revealed elevated glutathione transaminase in 9 cases, elevated glutamic alanine transaminase in 4 cases, elevated blood glucose in 3 cases, and elevated D-dimer in 3 cases. Serum ferritin was elevated in 3 of 5 cases, serum and cerebrospinal fluid (CSF) neurofilament light chain protein was elevated in 5 of 9 cases, serum cytokines were elevated in 7 of 18 cases, and CSF cytokines were elevated in 7 of 8 cases. Cranial imaging abnormalities were noted in 18 cases, including bilateral symmetric lesions in 3 ANE cases and "bright tree appearance" in 8 AESD cases. All 22 cases received symptomatic treatment and immunotherapy (intravenous immunoglobulin or glucocorticosteroids), and 1 ANE patient received tocilizumab. The follow-up time was 50 (43, 53) d, and 10 patients had a good prognosis and 12 patients had a poor prognosis. No statistically significant differences were found between the two groups in terms of epidemiology, clinical manifestations, biochemical indices, and duration of illness to initiate immunotherapy (all P>0.05). Conclusions: SARS-CoV-2 infection is also a major cause of AE. AESD and ANE are the common AE syndromes. Therefore, it is crucial to identify AE patients with fever, convulsions, and impaired consciousness, and apply aggressive therapy as early as possible.

Modeling for understanding of coronavirus disease-2019 (COVID-19) spread and design of an isolation room in a hospital

We have modeled the transmission of coronavirus 2019 in the isolation room of a patient suffering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the Royal Brompton Hospital in London. An adaptive mesh computational fluid dynamics model was used for simulation of three-dimensional spatial distribution of SARS-CoV-2 in the room. The modeling set-up is based on data collected in the room during the patient stay. Many numerical experiments have been carried out to provide an optimal design layout of the overall isolation room. Our focus has been on (1) the location of the air extractor and filtration rates, (2) the bed location of the patient, and (3) consideration of the health and safety of the staff working in the area. © 2023 Author(s).

Credit Risk Evaluation Model of Small-Micro Enterprises for Rural Commercial Bank Based on XGBoost and Random Forest

As an important pillar of the real economy, small-micro enterprises are facing many difficulties in operation under the dual impact of the global economic downturn and the COVID-19 epidemic. And they are in urgent need of external financing to tide over the difficulties. The purpose of rural commercial bank is to serve small and medium-sized enterprises and agriculture, rural areas and farmers. Therefore, the financing of rural commercial bank is crucial for the development of small-micro enterprises. However, due to unstable development mode, imperfect management mechanism and other reasons, small-micro enterprises usually have high credit risk, which brings great challenges to the loan risk control of rural commercial bank. Effective evaluation of credit risk of small-micro enterprises is the basis of rural commercial bank's loan decision-making and an important issue concerned by theory and practice. This paper studies the credit risk evaluation model of rural commercial bank for small-micro enterprises. Firstly, a set of credit risk evaluation indicator system combining financial and behavioral indicators is constructed, which expands the disadvantages of traditional research that only considers financial indicators is too one-sided. Secondly, XGBoost model is used to screen indicators and build a credit risk evaluation model of small-micro enterprises based on improved random forest. Finally, the effectiveness of the model is verified by comparing with other traditional models, and the experiment proves that the introduction of behavioral indicators can significantly improve the effectiveness of the model. © 2022 ACM.

Examining the Area Agencies on Aging nutrition program in response to the COVID-19

Background & aims. During the COVID-19 pandemic in the U.S., Area Agencies on Aging (AAA) became an essential source for older adults to maintain a healthy life after social isolation. It has developed different programs in response to the COVID-19 outbreak, such as home delivered meals to support older adults’ nutrition supply. The purpose of this study was to examine how well AAA has managed such important nutrition plans facing the COVID-19 changes. Methods. We integrated three databases, including 49 weeks (6 April 2020-14 March 2021) 33 Planning and Service Area (PSA) meal data, PSAs’ key characteristics from the California Department of Aging, and the COVID-19 cases from the California Department of Public Health. We examined the association between the number of meals and people served and the COVID-19 cases and PSA features, using the univariate analysis and the random effect model. Results. We observed a positive relationship between the number of meals served and the number of the COVID-19 cases, however, not the number of people served. We found a negative relationship between the number of rural older adults with both the number of meals served and people served. Additionally, non-English-speaking and minority played a positive and negative role respectively as to the number of meals served. Conclusions. These results indicated that the AAA should cover a wider population, especially in rural areas experiencing a shortage of volunteers in the pandemic, urging the collaboration with high-tech and third-party companies to improve delivery efficiency. © 2022, Pacini Editore S.p.A./AU-CNS. All rights reserved.

CONFIDENCE LEVEL of A MOTION FEEDBACK SYSTEM for ANALYZING EXERCISE TRAINING EFFICACY

The increase in aged population is a global trend. Inculcating healthy behaviors such as regular exercises in the elderly has a significant impact on the financial and medical burden globally. Moreover, air pollution and the outbreak of the coronavirus disease 19 (COVID-19) pose a serious threat to public health. In order to improve the health conditions of the population, this study developed a motion feedback system named MoveV that can be used for several indoor training exercises. This system provides instant motion feedback by synchronizing exercise training videos on the website using a motion analysis algorithm that is applicable on smartphones, and a cloud database platform is used to record health behaviors. Feature extraction is performed based on force intensity, motion velocity, and exercise direction. The resultant accuracy of the motion feedback system was tested by a motion science expert and presented as the confidence level. For perfect movement, a confidence level of up to 90.5% was achieved, indicating that the MoveV system was able to record users' exercise frequency and distinguish whether the user was performing well in the exercise movements. The proposed system is convenient and does not incur additional expenditure by purchasing any new device. Furthermore, it provides visual and voice feedback, companionship, and exercise motivation to the users, all of which are important factors when using online exercise platforms.

Lightweight-blockchain based privacy-preserving data aggregation for epidemic disease surveillance

As the COVID-19 pandemic is raging worldwide, epidemic surveillance helps prevent the spread of the epidemic. Protecting the privacy of patients and data providers in the monitoring system can relieve them of their concerns about the leakage of private information, thereby improving the epidemic data collection capabilities of the system. In this article, we propose a lightweight-blockchain based privacy-preserving data aggregation scheme (LBPDA) for epidemic disease surveillance, which can aggregate data without relying on a trusted third party. Especially, to protect data privacy in the data aggregation process, the case count data is aggregated based on the Paillier cryptosystem's homomorphism. Besides, to reduce the time and storage overhead, we improved the adopted Hyperledger Fabric, thus lightening the data aggregation process. Finally, we simulated the proposed scheme and analyzed its security and performance to verify its feasibility and effectiveness. The results showed that the proposed scheme could meet the government department's requirements to aggregate patient case count data for epidemic disease surveillance while protecting the privacy of patients and data providers. Moreover, we also proved that the lightweight of blockchain is effective by comparison. © 2021, Science China Press. All right reserved.

Improving the Development of Public Health Emergency Preparedness and Response System via Reinforcing Primary Care in Pandemic and Non-pandemic Periods

Background: Since the outbreak of COVID-19, the ability to manage public health emergencies in mega-cities has been put on the policy agenda, and the role of primary care in public health system is critical. Objective: To explore the status, problems and challenges of practical exploration of Shanghai's primary care in responding to COVID-19, providing policy recommendations and decision-making basis for improving the public health emergency system. Methods: From June to September 2020, a qualitative study was conducted using group interviews with administrators and healthcare professionals selected from 10 representative community health centers(CHCs) in suburban, fringe and urban areas in Shanghai's 5 districts for exploring major tasks shouldered by the CHCs, organizational structure of the CHCs, actual tasks performed by the CHCs, internal collaboration, major problems in service delivery during the pandemic, and recommendations, and with directors, as well as professionals responsible for information, healthcare management and quality control, public emergency management and infectious disease containment selected from health commissions and centers for disease control and prevention in the districts, for exploring the functions and roles of CHCs during the pandemic and their weaknesses in anti-pandemic actions, anti-pandemic supports from health commissions and centers for disease control and prevention for CHCs, and ideas about actions of primary care in pandemic and non-pandemic periods. The interviews with individuals from three kinds of affiliations were guided using different types of semi-structured outlines developed by our research team. Results: The interviews revealed that during the pandemic, the CHCs gave emergency responses to COVID-19, participated in regional collaboration for COVID-19 containment, delivered in-hospital COVID-19 screening and triage services while providing routine medical services, and continued to offer family doctor services. Four issues were found to be addressed: insufficient healthcare resources and workers, insufficient services targeting psychological influence of COVID-19, unsatisfied internal coordination and multi-departmental management, and lack of appropriate mechanisms incentivizing healthcare workers and invigorating primary care. Conclusion: In view of the challenges in fighting COVID-19 faced by primary care, it is recommended to take actions on the basis of appropriately balancing the delivery of routine primary care services and public health services, and tasks during pandemic and non-pandemic periods, and appropriately coordinating with higher level departments, as well as developing incentive programs according to the local conditions as a supplement for the government programs. Copyright © 2021 by the Chinese General Practice.

Mavrilimumab improves outcomes in phase 2 trial in non-mechanically-ventilated patients with severe covid-19 pneumonia and systemic hyperinflammation

Background: Granulocyte/macrophage-colony stimulating factor (GM-CSF) is a cytokine both vital to lung homeostasis and important in regulating inflammation and autoimmunity1,2,3 that has been implicated in the pathogenesis of respiratory failure and death in patients with severe COVID-19 pneumonia and systemic hyperinflammation. 4-6 Mavrilimumab is a human anti GM-CSF receptor α monoclonal antibody capable of blocking GM-CSF signaling and downregulating the inflammatory process. Objectives: To evaluate the effect of mavrilimumab on clinical outcomes in patients hospitalized with severe COVID-19 pneumonia and systemic hyperinflammation. Methods: This on-going, global, randomized, double-blind, placebo-controlled seamless transition Phase 2/3 trial was designed to evaluate the efficacy and safety of mavrilimumab in adults hospitalized with severe COVID-19 pneumonia and hyperinflammation. The Phase 2 portion comprised two groups: Cohort 1 patients requiring supplemental oxygen therapy without mechanical ventilation (to maintain SpO2 ≥92%) and Cohort 2 patients requiring mechanical ventilation, initiated ≤48 hours before randomization. Here, we report results for Phase 2, Cohort 1: 116 patients with severe COVID-19 pneumonia and hyperinflammation from USA, Brazil, Chile, Peru, and South Africa;randomized 1:1:1 to receive a single intravenous administration of mavrilimumab (10 or 6 mg/kg) or placebo. The primary efficacy endpoint was proportion of patients alive and free of mechanical ventilation at Day 29. Secondary endpoints included [1] time to 2-point clinical improvement (National Institute of Allergy and Infectious Diseases COVID-19 ordinal scale), [2] time to return to room air, and [3] mortality, all measured through Day 29. The prespecified evidentiary standard was a 2-sided α of 0.2 (not adjusted for multiplicity). Results: Baseline demographics were balanced among the intervention groups;patients were racially diverse (43% non-white), had a mean age of 57 years, and 49% were obese (BMI ≥ 30). All patients received the local standard of care: 96% received corticosteroids (including dexamethasone) and 29% received remdesivir. No differences in outcomes were observed between the 10 mg/kg and 6 mg/ kg mavrilimumab arms. Results for these groups are presented together. Mavrilimumab recipients had a reduced requirement for mechanical ventilation and improved survival: at day 29, the proportion of patients alive and free of mechanical ventilation was 12.3 percentage points higher with mavrilimumab (86.7% of patients) than placebo (74.4% of patients) (Primary endpoint;p=0.1224). Mavrilimumab recipients experienced a 65% reduction in the risk of mechanical ventilation or death through Day 29 (Hazard Ratio (HR) = 0.35;p=0.0175). Day 29 mortality was 12.5 percentage points lower in mavrilimumab recipients (8%) compared to placebo (20.5%) (p=0.0718). Mavrilimumab recipients had a 61% reduction in the risk of death through Day 29 (HR= 0.39;p=0.0726). Adverse events occurred less frequently in mavrilimumab recipients compared to placebo, including secondary infections and thrombotic events (known complications of COVID-19). Thrombotic events occurred only in the placebo arm (5/40 [12.5%]). Conclusion: In a global, diverse population of patients with severe COVID-19 pneumonia and hyperinflammation receiving supplemental oxygen therapy, corticosteroids, and remdesivir, a single infusion of mavrilimumab reduced progression to mechanical ventilation and improved survival. Results indicate mavrilimumab, a potent inhibitor of GM-CSF signaling, may have added clinical benefit on top of the current standard therapy for COVID-19. Of potential importance is that this treatment strategy is mechanistically independent of the specific virus or viral variant.

Research progress in anti-coronavirus effect and safety of chloroquine

Coronavirus, identified as a zoonotic pathogen, can cause pulmonary infections and even a pandemic. Corona Virus Disease 2019 (COVID-19), which was induced by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), struck the world in December 2019. There is no specific drug for coronavirus. As a classical antimalarial drug, chloroquine has been proved to have antiviral activity by changing the pH of endocytosis, via autophagy reactions and by changing the glycosylation mode of the virus envelope. At the cellular level, chloroquine has inhibitory effects on SARS-CoV, Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-2. Recent clinical research results are beginning to show that chloroquine can improve the success rate and prognosis. Chloroquine has been used less clinically in recent years due to the many adverse reactions it causes. The safety of chloroquine used in coronavirus infection requires in-depth evaluation. This article summarizes research progress in the anti-coronavirus effect and safety of chloroquine in order to provide reference for its clinical application. © 2020 Chinese Journal of Pharmacology and Toxicology. All rights reserved.

Clinical efficacy of traditional Chinese medicine Lianhua Qingwen Granules in 42 suspected cases of children with Corona Virus Disease 2019

Objective: To evaluate the clinical efficacy of traditional Chinese medicine Lianhua Qingwen Granules in treating suspected cases of children with Corona Virus Disease 2019. Methods: Clinical retrospective study method was used to collect 83 cases of common type children who met the diagnostic criteria of suspected cases of Corona Virus Disease 2019 and were admitted to Xiangyang No.1 People's Hospital from January 28, 2020 to March 31. Among them, 42 patients in the treatment group received routine treatment (antiviral and symptomatic support treatment, combined with antibacterial treatment for infected patients) combined with traditional Chinese medicine Lianhua Qingwen Granules. The control group of 41 patients received routine treatment only. Clinical data were collected after 5 d of treatment, and the disappearance of main symptoms (fever and cough), the duration of fever, and other single symptoms (cough, nasal obstruction, runny nose, shortness of breath, muscle pain, and gastrointestinal symptoms) were compared between the two groups. Results: The disappearance rates of fever and cough in the treatment group were 83.3% and 57.9%, respectively, and those in the control group were 51.2% and 30.3%, respectively. The treatment group was significantly better than the control group (P<0.05). The disappearance rates of phlegm, shortness of breath and digestive tract symptoms in the treatment group were 66.7%, 100% and 87.5%, respectively, and those in the control group were 20%, 60% and 28.6%, respectively, with significant increases (P<0.05). Conclusion: Traditional Chinese medicine Lianhua Qingwen Granules can significantly improve fever, cough, phlegm, shortness of breath and gastrointestinal symptoms in children suspected of Corona Virus Disease 2019, providing preliminary clinical evidence for the prevention and treatment of pediatric cases.