Association of delayed chemoradiotherapy with elevated Epstein-Barr virus DNA load and adverse clinical outcome in nasopharyngeal carcinoma treatment during the COVID-19 pandemic: a retrospective study.

BACKGROUND: To summarize the impact of radiotherapy (RT) and chemotherapy delays on patients with nasopharyngeal carcinoma (NPC) during the COVID-19 pandemic. METHODS: We retrospectively included 233 patients with stage II-IVa NPC treated with RT and chemotherapy between December 11, 2019 and March 11, 2020. The outcomes were elevation in the EBV DNA load between two adjacent cycles of chemotherapy or during RT, and 1-year disease-free survival (DFS). RESULTS: RT delay occurred in 117 (50%) patients, and chemotherapy delay occurred in 220 (94%) patients. RT delay of ≥ 6 days was associated with a higher EBV DNA elevation rate (20.4% vs. 3.6%, odds ratio [OR] = 6.93 [95% CI = 2.49-19.32], P < 0.001), and worse 1-year DFS (91.2% vs. 97.8%, HR = 3.61 [95% CI = 1.37-9.50], P = 0.006), compared with on-schedule RT or delay of < 6 days. Chemotherapy delay of ≥ 10 days was not associated with a higher EBV DNA elevation rate (12.5% vs. 6.8%, OR = 1.94 [95% CI = 0.70-5.40], P = 0.20), or worse 1-year DFS (93.8% vs. 97.1%, HR = 3.73 [95% CI = 0.86-16.14], P = 0.059), compared with delay of < 10 days. Multivariable analyses showed RT delay of ≥ 6 days remained an independent adverse factor for both EBV DNA elevation and DFS. CONCLUSION: To ensure treatment efficacy for patients with nonmetastatic NPC, initiation of RT should not be delayed by more than 6 days; the effect of chemotherapy delay requires further investigation.

Detection of co-infection of porcine circovirus and porcine epidemic diarrhea virus

In this study, 650 tissue samples which were collected from 16 pig farms in Hubei Province, were used to detect porcine circovirus (PCV) and Porcine epidemic diarrhea virus (PEDV). The results showed that the positive rates of PCV1, PCV2, PCV3 and PEDV single infection were 1.08%, 4.15%, 2.46% and 6.46%, respectively. In the double infections, PEDV+PCV2 had the highest positive rate of 3.54%, followed by PCV2+PCV3, with a positive rate of 1.54%. In multiple infections, PEDV+PCV2+PCV3 had the highest positive rate of 2.00%. The results indicated that the positive rates of PEDV and PCV were decreased compared with the previous studies, but the prevalence of PEDV and PCV was still wide in Hubei Province, and most of which were co-infection.

Mechanism of COVID-19 Causing ARDS: Exploring the Possibility of Preventing and Treating SARS-CoV-2.

Novel coronavirus pneumonia (COVID-19) is spreading worldwide, causing great harm and stress to humans. Since patients with novel coronavirus (SARS-CoV-2) have a high probability of developing acute respiratory distress syndrome (ARDS) in severe cases, the pathways through which SARS-CoV-2 causes lung injury have become a major concern in the scientific field. In this paper, we investigate the relationship between SARS-CoV-2 and lung injury and explore the possible mechanisms of COVID-19 in ARDS from the perspectives of angiotensin-converting enzyme 2 protein, cytokine storm, activation of the immune response, triggering of Fas/FasL signaling pathway to promote apoptosis, JAK/STAT pathway, NF-κB pathway, type I interferon, vitamin D, and explore the possibility of prevention and treatment of COVID-19. To explore the possibility of SARS-CoV-2, and to provide new ideas to stop the development of ARDS in COVID-19 patients.

Reflection in the Context of the Epidemic: Does Death Anxiety Have a Positive Impact? The Role of Self-Improvement and Mental Resilience.

Public health emergencies can trigger individual death anxiety. Most previous studies focus on the negative effects of death anxiety via the Western materialistic view, neglecting both the positive aspects of death anxiety within the Chinese cultural background and the positive effects of death anxiety upon environmental consumption. By implementing the unique Chinese cultural background for the concepts of justice and interests, this study explores the positive influence of individual death anxiety on altruistic environmental consumption during the COVID-19 crisis by analyzing personal life reviews and other sources. The results show that (1) under the guidance of the correct concept of justice and benefit, individuals with high death anxiety during the epidemic period not only enhance their self-esteem through positive self-perception and social evaluation, but they are more inclined to benefit from other environmental consumption behaviors and attain a symbolic self-survival; and (2) during the epidemic period, mental resilience, as a transformation mechanism of external defense and the internal growth of death psychology, can directly affect altruistic environmental consumption by consumers without relying on external standards. In the context of the Chinese culture's concept of justice and interests, this study enriches the knowledge of fear management theory and the positive impact of death anxiety on environmental consumption. The introduction of mental resilience as a boundary condition has important theoretical and practical significance within the study of consumer behavior in public health emergencies and post-epidemic economic recovery.

Multi-Scale Sparse Graph Convolutional Network For the Assessment of Parkinsonian Gait

Automated assessment of patients with Parkinson's disease (PD) is urgently required in clinical practice to improve the diagnostic efficiency and objectivity and to remotely monitor the motor disorder symptoms and general health of these patients, especially in view of the travel restrictions due to the recent coronavirus epidemic. Gait motor disorder is one of the critical manifestations of PD, and automated assessment of gait is vital to realize automated assessment of PD patients. To this end, we propose a novel two-stream spatial-temporal attention graph convolutional network (2s-ST-AGCN) for video assessment of PD gait motor disorder. Specifically, the skeleton sequence of human body is extracted from videos to construct spatial-temporal graphs of joints and bones, and a two-stream spatial-temporal graph convolutional network is then built to simultaneously model the static spatial information and dynamic temporal variations. The multi-scale spatial-temporal attention-aware mechanism is also designed to effectively extract the discriminative spatial-temporal features. The deep supervision strategy is then embedded to minimize classification errors, thereby guiding the weight update process of the hidden layer to promote significant discriminative features. Besides, two model-driven terms are integrated into this deep learning framework to strengthen multi-scale similarity in the deep supervision and realize sparsification of discriminative features. Extensive experiments on the clinical video dataset show that the proposed model exhibits good performance with an accuracy of 65.66% and an acceptable accuracy of 98.90%, which is much better than that of the existing sensor- and vision-based methods for Parkinsonian gait assessment. Thus, the proposed method is potentially useful for assessing PD gait motor disorder in clinical practice.

Application of the Internet Platform in Monitoring Chinese Public Attention to the Outbreak of COVID-19.

Objectives: The internet data is an essential tool for reflecting public attention to hot issues. This study aimed to use the Baidu Index (BDI) and Sina Micro Index (SMI) to confirm correlation between COVID-19 case data and Chinese online data (public attention). This could verify the effect of online data on early warning of public health events, which will enable us to respond in a more timely and effective manner. Methods: Spearman correlation was used to check the consistency of BDI and SMI. Time lag cross-correlation analysis of BDI, SMI and six case-related indicators and multiple linear regression prediction were performed to explore the correlation between public concern and the actual epidemic. Results: The public's usage trend of the Baidu search engine and Sina Weibo was consistent during the COVID-19 outbreak. BDI, SMI and COVID-19 indicators had significant advance or lag effects, among which SMI and six indicators all had advance effects while BDI only had advance effects with new confirmed cases and new death cases. But compared with the SMI, the BDI was more closely related to the epidemic severity. Notably, the prediction model constructed by BDI and SMI can well fit new confirmed cases and new death cases. Conclusions: The confirmed associations between the public's attention to the outbreak of COVID and the trend of epidemic outbreaks implied valuable insights into effective mechanisms of crisis response. In response to public health emergencies, people can through the information recommendation functions of social media and search engines (such as Weibo hot search and Baidu homepage recommendation) to raise awareness of available disease prevention and treatment, health services, and policy change.

Research and Prospect Analysis of Sports Consumption Willingness Based on Public Health Emergencies

In 2020, the sudden outbreak of coronavirus disease 2019 (COVID-19) has had a great impact on the health and life of people all over the world, and the sports industry is facing unprecedented challenges due to its participation and strong clustering. Based on the questionnaire survey, literature analysis, and other research methods, this study introduces the stimulus-organism-response (SOR) theory, takes the sports and consumption of Kunshan citizens as the research subject, and draws lessons from the structural equation model (SEM) to build a theoretical model of sports consumption characteristics and future consumption willingness. The results of empirical analysis show that physical sports consumption has been greatly affected by the epidemic, but because people realize the importance of sports, the willingness of residents to consume sports increases, and the venue and other factors affect the ornamental and participating sports consumption willingness decreases. At the same time, the restrictive factors, such as lower educational background, increased age, and lack of time, make the sports consumption willingness of this characteristic group significantly lower than that of other citizens. This study puts forward some suggestions for relevant government departments to improve the sports consumption willingness of citizens. In order to expand the development prospect of sports industry from a long-term perspective, it can provide reference for the development of sports consumption.

Plasma 1,3-ß-d-glucan levels predict adverse clinical outcomes in critical illness.

BACKGROUNDThe fungal cell wall constituent 1,3-ß-d-glucan (BDG) is a pathogen-associated molecular pattern that can stimulate innate immunity. We hypothesized that BDG from colonizing fungi in critically ill patients may translocate into the systemic circulation and be associated with host inflammation and outcomes.METHODSWe enrolled 453 mechanically ventilated patients with acute respiratory failure (ARF) without invasive fungal infection and measured BDG, innate immunity, and epithelial permeability biomarkers in serially collected plasma samples.RESULTSCompared with healthy controls, patients with ARF had significantly higher BDG levels (median [IQR], 26 pg/mL [15-49 pg/mL], P < 0.001), whereas patients with ARF with high BDG levels (≥40 pg/mL, 31%) had higher odds for assignment to the prognostically adverse hyperinflammatory subphenotype (OR [CI], 2.88 [1.83-4.54], P < 0.001). Baseline BDG levels were predictive of fewer ventilator-free days and worse 30-day survival (adjusted P < 0.05). Integrative analyses of fungal colonization and epithelial barrier disruption suggested that BDG may translocate from either the lung or gut compartment. We validated the associations between plasma BDG and host inflammatory responses in 97 hospitalized patients with COVID-19.CONCLUSIONBDG measurements offered prognostic information in critically ill patients without fungal infections. Further research in the mechanisms of translocation and innate immunity recognition and stimulation may offer new therapeutic opportunities in critical illness.FUNDINGUniversity of Pittsburgh Clinical and Translational Science Institute, COVID-19 Pilot Award and NIH grants (K23 HL139987, U01 HL098962, P01 HL114453, R01 HL097376, K24 HL123342, U01 HL137159, R01 LM012087, K08HK144820, F32 HL142172, K23 GM122069).

Chemical composition and pharmacological mechanism of Qingfei Paidu Decoction and Ma Xing Shi Gan Decoction against Coronavirus Disease 2019 (COVID-19): In silico and experimental study.

The Coronavirus Disease 2019 (COVID-19) pandemic has become a huge threaten to global health, which raise urgent demand of developing efficient therapeutic strategy. The aim of the present study is to dissect the chemical composition and the pharmacological mechanism of Qingfei Paidu Decoction (QFPD), a clinically used Chinese medicine for treating COVID-19 patients in China. Through comprehensive analysis by liquid chromatography coupled with high resolution mass spectrometry (MS), a total of 129 compounds of QFPD were putatively identified. We also constructed molecular networking of mass spectrometry data to classify these compounds into 14 main clusters, in which exhibited specific patterns of flavonoids (45 %), glycosides (15 %), carboxylic acids (10 %), and saponins (5 %). The target network model of QFPD, established by predicting and collecting the targets of identified compounds, indicated a pivotal role of Ma Xing Shi Gan Decoction (MXSG) in the therapeutic efficacy of QFPD. Supportively, through transcriptomic analysis of gene expression after MXSG administration in rat model of LPS-induced pneumonia, the thrombin and Toll-like receptor (TLR) signaling pathway were suggested to be essential pathways for MXSG mediated anti-inflammatory effects. Besides, changes in content of major compounds in MXSG during decoction were found by the chemical analysis. We also validate that one major compound in MXSG, i.e. glycyrrhizic acid, inhibited TLR agonists induced IL-6 production in macrophage. In conclusion, the integration of in silico and experimental results indicated that the therapeutic effects of QFPD against COVID-19 may be attributed to the anti-inflammatory effects of MXSG, which supports the rationality of the compatibility of TCM.

Screening and molecular modeling evaluation of food peptides to inhibit key targets of COVID-19 virus

Peptide drugs, especially food-derived peptides, have a variety of functional activities including antiviral and may also have a therapeutic effect on COVID-19. In this study, comparing with the reported drugs, 79 peptides were found to bind to the key targets of COVID-19 virus with higher non-covalent interaction, while among them, six peptides showed high non-covalent interactions with the three targets, which may inhibit the COVID-19 virus. In the simulation, peptides of nine to 10 amino acids with a hydrophilic amino acid and acidic amino acid in the middle and aromatic amino acids on the side showed higher binding to angiotensin-converting enzyme 2 (ACE2). Peptides of five to six amino acids with a basic amnio acid in the head, acidic amnio acid in the neck, hydrophobicity group in the middle, and basic amino acids in the tail showed higher binding to COVID-19 virus main protease (M^pro), while those with basic amino acids and acidic amino acids in the two sides and aromatic amino acids in the middle might have stronger interaction with COVID-19 virus RNA-dependent RNA polymerase (RdRp).

SARS-CoV-2 hijacks folate and one-carbon metabolism for viral replication.

The recently identified Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the cause of the COVID-19 pandemic. How this novel beta-coronavirus virus, and coronaviruses more generally, alter cellular metabolism to support massive production of ~30 kB viral genomes and subgenomic viral RNAs remains largely unknown. To gain insights, transcriptional and metabolomic analyses are performed 8 hours after SARS-CoV-2 infection, an early timepoint where the viral lifecycle is completed but prior to overt effects on host cell growth or survival. Here, we show that SARS-CoV-2 remodels host folate and one-carbon metabolism at the post-transcriptional level to support de novo purine synthesis, bypassing viral shutoff of host translation. Intracellular glucose and folate are depleted in SARS-CoV-2-infected cells, and viral replication is exquisitely sensitive to inhibitors of folate and one-carbon metabolism, notably methotrexate. Host metabolism targeted therapy could add to the armamentarium against future coronavirus outbreaks.

Factors Affecting Public Adoption of COVID-19 Prevention and Treatment Information During an Infodemic: Cross-sectional Survey Study.

BACKGROUND: With the spread of COVID-19, an infodemic is also emerging. In public health emergencies, the use of information to enable disease prevention and treatment is incredibly important. Although both the information adoption model (IAM) and health belief model (HBM) have their own merits, they only focus on information or public influence factors, respectively, to explain the public's intention to adopt online prevention and treatment information. OBJECTIVE: The aim of this study was to fill this gap by using a combination of the IAM and the HBM as the framework for exploring the influencing factors and paths in public health events that affect the public's adoption of online health information and health behaviors, focusing on both objective and subjective factors. METHODS: We carried out an online survey to collect responses from participants in China (N=501). Structural equation modeling was used to evaluate items, and confirmatory factor analysis was used to calculate construct reliability and validity. The goodness of fit of the model and mediation effects were analyzed. RESULTS: The overall fitness indices for the model developed in this study indicated an acceptable fit. Adoption intention was predicted by information characteristics (ß=.266, P<.001) and perceived usefulness (ß=.565, P<.001), which jointly explained nearly 67% of the adoption intention variance. Information characteristics (ß=.244, P<.001), perceived drawbacks (ß=-.097, P=.002), perceived benefits (ß=.512, P<.001), and self-efficacy (ß=.141, P<.001) jointly determined perceived usefulness and explained about 81% of the variance of perceived usefulness. However, social influence did not have a statistically significant impact on perceived usefulness, and self-efficacy did not significantly influence adoption intention directly. CONCLUSIONS: By integrating IAM and HBM, this study provided the insight and understanding that perceived usefulness and adoption intention of online health information could be influenced by information characteristics, people's perceptions of information drawbacks and benefits, and self-efficacy. Moreover, people also exhibited proactive behavior rather than reactive behavior to adopt information. Thus, we should consider these factors when helping the informed public obtain useful information via two approaches: one is to improve the quality of government-based and other official information, and the other is to improve the public's capacity to obtain information, in order to promote truth and fight rumors. This will, in turn, contribute to saving lives as the pandemic continues to unfold and run its course.

C1q Complement/Tumor Necrosis Factor-Associated Proteins in Cardiovascular Disease and COVID-19.

With continually improving treatment strategies and patient care, the overall mortality of cardiovascular disease (CVD) has been significantly reduced. However, this success is a double-edged sword, as many patients who survive cardiovascular complications will progress towards a chronic disorder over time. A family of adiponectin paralogs designated as C1q complement/tumor necrosis factor (TNF)-associated proteins (CTRPs) has been found to play a role in the development of CVD. CTRPs, which are comprised of 15 members, CTRP1 to CTRP15, are secreted from different organs/tissues and exhibit diverse functions, have attracted increasing attention because of their roles in maintaining inner homeostasis by regulating metabolism, inflammation, and immune surveillance. In particular, studies indicate that CTRPs participate in the progression of CVD, influencing its prognosis. This review aims to improve understanding of the role of CTRPs in the cardiovascular system by analyzing current knowledge. In particular, we examine the association of CTRPs with endothelial cell dysfunction, inflammation, and diabetes, which are the basis for development of CVD. Additionally, the recently emerged novel coronavirus (COVID-19), officially known as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has been found to trigger severe cardiovascular injury in some patients, and evidence indicates that the mortality of COVID-19 is much higher in patients with CVD than without CVD. Understanding the relationship of CTRPs and the SARS-CoV-2-related damage to the cardiovascular system, as well as the potential mechanisms, will achieve a profound insight into a therapeutic strategy to effectively control CVD and reduce the mortality rate.

Frontline Science: COVID-19 infection induces readily detectable morphologic and inflammation-related phenotypic changes in peripheral blood monocytes.

Excessive monocyte/macrophage activation with the development of a cytokine storm and subsequent acute lung injury, leading to acute respiratory distress syndrome (ARDS), is a feared consequence of infection with COVID-19. The ability to recognize and potentially intervene early in those patients at greatest risk of developing this complication could be of great clinical utility. In this study, we performed flow cytometric analysis of peripheral blood samples from 34 COVID-19 patients in early 2020 in an attempt to identify factors that could help predict the severity of disease and patient outcome. Although we did not detect significant differences in the number of monocytes between patients with COVID-19 and normal healthy individuals, we did identify significant morphologic and functional differences, which are more pronounced in patients requiring prolonged hospitalization and intensive care unit (ICU) admission. Patients with COVID-19 have larger than normal monocytes, easily identified on forward scatter (FSC), side scatter analysis by routine flow cytometry, with the presence of a distinct population of monocytes with high FSC (FSC-high). On more detailed analysis, these CD14+ CD16+ , FSC-high monocytes show features of mixed M1/M2 macrophage polarization with higher expression of CD80+ and CD206+ compared with the residual FSC-low monocytes and secretion of higher levels of IL-6, IL-10, and TNF-α, when compared with the normal controls. In conclusion, the detection and serial monitoring of this subset of inflammatory monocytes using flow cytometry could be of great help in guiding the prognostication and treatment of patients with COVID-19 and merits further evaluation.

Diverse clinical processes of 16 COVID-19 cases who concentrated infection in the same workplace in Beijing, China: An observational study.

ABSTRACT: Since December 2019, an outbreak of COVID-19 sweeping the world. Understanding the clinical and SARS-CoV-2 dynamic changes of mild and ordinary patients of COVID-19, so as to provide basis for the prevention and control of COVID-19.On February 1st, 2020, 16 SARS-CoV-2 RNA positive patients diagnosed in the same site in Beijing. The patients symptoms, signs, medication, and SARS-CoV-2 results were recorded.Of the 16 patients, 12 were female. Although they were infected at the same time in the same workplace, their clinical processes were very different and can be roughly divided into three different types: persistent sputum positive, persistent stool positive and persistent both positive. In 7 patients with mild clinical manifestations, the median days of SARS-CoV-2 RNA negative conversion in sputum samples were significantly later than those with obvious lung injury (27 days [range: 18 to 36]; 17 days, [range 6 to 25], P = .021). The negative conversion of SARS-CoV-2 RNA in stool was significant later than in sputum.There were various clinical manifestations after SARS-CoV-2 infection, even if they were infected by the same source of infection in the same place. The presence of SARS-CoV-2 virus RNA in stool samples was longer than that in respiratory tract.

A Study on the Causal Process of Virtual Reality Tourism and Its Attributes in Terms of Their Effects on Subjective Well-Being during COVID-19.

In the landscape of Covid-19 pandemic, people's well-being, to some extent, can be affected through virtual reality tourism because it has the opportunity to enhance their level of well-being and destination recovery. To verify this empirically an investigation was conducted among people who used Quanjingke, the largest tourism-related virtual reality website in China, during the pandemic. The specific the aim of this paper is to prove the effectiveness of virtual reality tourism in promoting people's subjective well-being. Hence, an integrated model with the constructs of peripheral attribute, core attribute and pivotal attribute, presence, perceived value, satisfaction, and subjective well-being was proposed and tested. The results indicate that attributes of virtual reality tourism have a positive effect on presence during virtual reality experiences, which positively influences perceived value. The values of virtual reality tourism perceived by tourists result in their satisfaction. Eventually, it was found that tourists' subjective well-being is improved due to their satisfaction with virtual reality tourism. Practical suggestions are also provided based on the findings.

The Internet Hospital as a Telehealth Model in China: Systematic Search and Content Analysis.

BACKGROUND: The internet hospital is an innovative organizational form and service mode under the tide of internet plus in the Chinese medical industry. It is the product of the interaction between consumer health needs and supply-side reform. However, there has still been no systematic summary of its establishment and definition, nor has there been an analysis of its service content. OBJECTIVE: The primary purpose of this study was to understand the definition, establishment, and development status of internet hospitals. METHODS: Data on internet hospitals were obtained via the Baidu search engine for results up until January 1, 2019. Based on the results of the search, we obtained more detailed information from the official websites and apps of 130 online hospitals and formed a database for descriptive analysis. RESULTS: By January 2019, the number of registered internet hospitals had expanded to approximately 130 in 25 provinces, accounting for 73.5% of all provinces or province-level municipalities in China. Internet hospitals, as a new telehealth model, are distinct but overlap with online health, telemedicine, and mobile medical. They offer four kinds of services-convenience services, online medical services, telemedicine, and related industries. In general, there is an underlying common treatment flowchart of care in ordinary and internet hospitals. There are three different sponsors-government-led integration, hospital-led, and enterprise-led internet hospitals-for which stakeholders have different supporting content and responsibilities. CONCLUSIONS: Internet hospitals are booming in China, and it is the joint effort of the government and the market to alleviate the coexistence of shortages of medical resources and wasted medical supplies. The origin of internet hospitals in the eastern and western regions, the purpose of the establishment initiator, and the content of online and offline services are different. Only further standardized management and reasonable industry freedom can realize the original intention of the internet hospital of meeting various health needs.

Author Correction: Near-real-time monitoring of global CO2 emissions reveals the effects of the COVID-19 pandemic.

A Correction to this paper has been published: https://doi.org/10.1038/s41467-020-20254-5.

Near-real-time monitoring of global CO2 emissions reveals the effects of the COVID-19 pandemic.

The COVID-19 pandemic is impacting human activities, and in turn energy use and carbon dioxide (CO2) emissions. Here we present daily estimates of country-level CO2 emissions for different sectors based on near-real-time activity data. The key result is an abrupt 8.8% decrease in global CO2 emissions (-1551 Mt CO2) in the first half of 2020 compared to the same period in 2019. The magnitude of this decrease is larger than during previous economic downturns or World War II. The timing of emissions decreases corresponds to lockdown measures in each country. By July 1st, the pandemic's effects on global emissions diminished as lockdown restrictions relaxed and some economic activities restarted, especially in China and several European countries, but substantial differences persist between countries, with continuing emission declines in the U.S. where coronavirus cases are still increasing substantially.