Content and sentiment surveillance (CSI): A critical component for modeling modern epidemics.

Comprehensive surveillance systems are the key to provide accurate data for effective modeling. Traditional symptom-based case surveillance has been joined with recent genomic, serologic, and environment surveillance to provide more integrated disease surveillance systems. A major gap in comprehensive disease surveillance is to accurately monitor potential population behavioral changes in real-time. Population-wide behaviors such as compliance with various interventions and vaccination acceptance significantly influence and drive the overall epidemic dynamics in the society. Original infoveillance utilizes online query data (e.g., Google and Wikipedia search of a specific content topic such as an epidemic) and later focuses on large volumes of online discourse data about the from social media platforms and further augments epidemic modeling. It mainly uses number of posts to approximate public awareness of the disease, and further compares with observed epidemic dynamics for better projection. The current COVID-19 pandemic shows that there is an urgency to further harness the rich, detailed content and sentiment information, which can provide more accurate and granular information on public awareness and perceptions toward multiple aspects of the disease, especially various interventions. In this perspective paper, we describe a novel conceptual analytical framework of content and sentiment infoveillance (CSI) and integration with epidemic modeling. This CSI framework includes data retrieval and pre-processing; information extraction via natural language processing to identify and quantify detailed time, location, content, and sentiment information; and integrating infoveillance with common epidemic modeling techniques of both mechanistic and data-driven methods. CSI complements and significantly enhances current epidemic models for more informed decision by integrating behavioral aspects from detailed, instantaneous infoveillance from massive social media data.

COVID-19 Vaccination Intention and Factors Associated with Hesitance and Resistance in the Deep South: Montgomery, Alabama.

Using COVID-19-related survey data collected from residents in the city of Montgomery, Alabama, this study assessed the prevalence of COVID-19 vaccine acceptance, hesitance, and resistance, and identified factors associated with COVID-19 vaccine hesitance and resistance. To analyze the survey data (n = 1000), a consolidation approach (machine learning modeling and multinomial logistic regression modeling) was used to identify predictors of COVID-19 vaccine hesitancy and resistance. The prevalence of vaccine acceptance, hesitancy, and resistance was 62%, 23%, and 15%, respectively. Female gender and a higher level of trust that friends and family will provide accurate information about the COVID-19 vaccine were positively associated with vaccine hesitancy. Female gender and higher trust that social media will provide accurate information about COVID-19 were positively associated with vaccine resistance. Factors positively associated with COVID-19 vaccine hesitance and resistance in the study's geographical area are worrisome, especially given the high burden of chronic diseases and health disparities that exist in both Montgomery and the Deep South. More research is needed to elucidate COVID-19 vaccination attitudes and reasons for non-acceptance of the COVID-19 vaccine. Efforts to improve acceptance should remain a priority in this respective geographical area and across the general population.

Associations between Public Fear of COVID-19 and Number of COVID-19 Vaccinations: A County-Level Longitudinal Analysis.

BACKGROUND AND PURPOSE: A large number of COVID-19 infections and deaths and the ensuing socioeconomic problems created widespread public fear around COVID-19. Fear around COVID-19 greatly influences people's attitudes towards receiving the COVID-19 vaccines. The purpose of this study is examining (a) the impact of the public fear of COVID-19 (PFC) on the number of COVID-19 vaccinations at the county level; (b) the interaction effect between the PFC and per capita income, unemployment rates, and COVID-19 vaccines incentive policies, on the number of COVID-19 vaccinations at the county level. METHOD: This is a longitudinal analysis across states in the U.S. by using county-level data of 2856 counties from 1 February to 1 July. Random-effects models were adopted to analyze the associations between the PFC and the number of COVID-19 vaccinations. RESULT: the PFC was positively associated with the number of COVID-19 vaccinations at county-level, as PFC increases from 0 to 300, the predicted vaccination number increases from 10,000 to 230,000. However, the associations were divergent when the PFC interacts with county-level per capita income, unemployment rates, and incentive policies. CONCLUSION: public fear is an important indicator for the county-level vaccination numbers of COVID-19. However, it is critical to consider public fear and socioeconomic factors when making policies that aim to increase COVID-19 vaccination rates.

Associations between Bonus and Lottery COVID-19 Vaccine Incentive Policies and Increases in COVID-19 Vaccination Rates: A Social Epidemiologic Analysis.

The objectives of this longitudinal study were to analyze the impact of COVID-19 vaccine incentive policies (e.g., bonuses and lottery entries) on county-level COVID-19 vaccination rates, and to examine the interactive effects between COVID-19 vaccine incentive policies and socioeconomic factors on COVID-19 vaccination rates. Using publicly available data, county-level COVID-19 vaccination rates and socioeconomic data between January 2021 and July 2021 were extracted and analyzed across counties in the United States (US)-an analysis of 19,992 observations over time. Pooled ordinary least squares (OLS) analysis was employed to longitudinally examine associations with COVID-19 vaccination rates, and four random-effects models were developed to analyze interaction effects. Bonus incentive policies were effective in counties with a high per capita income, high levels of education, and a high percentage of racial minorities, but not in counties with high unemployment. Lottery incentive policies were effective in counties with a high percentage of racial minorities, but not in counties with high per capita income, high levels of education, and high unemployment. County-level socioeconomic factors should be considered ahead of implementing incentive policies, versus a blanket approach, to avoid the unintentional misuse of economic resources for futile COVID-19 vaccination outcomes.

Dynamic Changes in Ascorbic Acid Content during Fruit Development and Ripening of Actinidia latifolia (an Ascorbate-Rich Fruit Crop) and the Associated Molecular Mechanisms.

Actinidia latifolia is one of the very few kiwifruit genotypes with extremely high ascorbic acid (AsA) content. However, a transcriptome atlas of this species is lacking. The accumulation of AsA during fruit development and ripening and the associated molecular mechanisms are still poorly understood. Herein, dynamic changes in AsA content at six different stages of A. latifolia fruit development and ripening were determined. AsA content of A. latifolia fruit reached 1108.76 ± 35.26 mg 100 g-1 FW at full maturity. A high-quality, full-length (FL) transcriptome of A. latifolia was successfully constructed for the first time using third-generation sequencing technology. The transcriptome comprises 326,926 FL non-chimeric reads, 15,505 coding sequences, 2882 transcription factors, 18,797 simple sequence repeats, 3328 long noncoding RNAs, and 231 alternative splicing events. The genes involved in AsA biosynthesis and recycling pathways were identified and compared with those in different kiwifruit genotypes. The correlation between the AsA content and expression levels of key genes in AsA biosynthesis and recycling pathways was revealed. LncRNAs that participate in AsA-related gene expression regulation were also identified. Gene expression patterns in AsA biosynthesis and metabolism exhibited a trend similar to that of AsA accumulation. Overall, this study paves the way for genetic engineering to develop kiwifruits with super-high AsA content.

An Epidemiologic Analysis of Associations between County-Level Per Capita Income, Unemployment Rate, and COVID-19 Vaccination Rates in the United States.

The purpose of this longitudinal study was to examine associations between per capita income, unemployment rates, and COVID-19 vaccination rates at the county-level across the United States (U.S.), as well as to identify the interaction effects between county-level per capita income, unemployment rates, and racial/ethnic composition on COVID-19 vaccination rates. All counties in the U.S. that reported COVID-19 vaccination rates from January 2021 to July 2021 were included in this longitudinal study (n = 2857). Pooled ordinary least squares (OLS) with fixed-effects were employed to longitudinally examine economic impacts on racial/ethnic disparities on county-level COVID-19 vaccination rates. County-level per capita income and county-level unemployment rates were both positively associated with county-level COVID-19 vaccination rates across the U.S. However, the associations were divergent in the context of race/ethnicity. Public health efforts to bolster COVID-19 vaccination rates are encouraged to consider economic factors that are associated with decreases in COVID-19 vaccination rates.

Vaping, SARS-CoV-2, and Multisystem Inflammatory Syndrome: A Perfect Storm.

The use of electronic cigarettes (e-cigarettes) and vaping among adolescents has risen exponentially in the last decade. E-cigarette flavors has driven adolescents to use these convenient, USB-like devices, designed to create a desired social image, while being seemingly unaware of the serious health consequences of their behavior. Vaping impacts protective pulmonary barriers by attenuating the mucociliary clearance and by increasing peribronchial inflammation and fibrosis. The recent SARS-CoV-2 (COVID-19) pandemic has been characterized by a plethora of unusual disease presentations. Among them, a unique presentation seen exclusively in children and adolescents was multisystem inflammatory syndrome (MIS-C). Seventy percent of adolescents who had MIS-C also had acute respiratory distress syndrome (ARDS), and we speculate that there may exist common denominator that links MIS-C and adolescents: the use of e-cigarettes. The virus targets the angiotensin converting receptor (ACE receptor), and studies have shown nicotine-based e-cigarettes or vaping cause oxidative stress and resulting in the upregulation of ACE2, which might worsen ARDS in MIS-C. Our mini-review highlights that adolescents using e-cigarette have alterations in their pulmonary defenses against SARS-CoV-2: an upregulation of the ACE2 receptors, the primary target of SARS-CoV-2. Their compromised immune system makes them more uniquely vulnerable to Covid-19 related MIS-C, increasing their risk for ARDS and related morbidities. Currently, studies have shown an association between MIS-C and vaping, we speculate that adolescents who vape/smoke might be especially vulnerable to serious respiratory symptoms if they develop a hyper-inflammatory state MIS-C.

Factors Associated with Symptoms of Depression and Psychological Distress during the COVID-19 Pandemic.

The objective of this study was to examine factors associated with symptoms of depression and psychological distress during the COVID-19 pandemic in China. Convenience sampling and snowball sampling were used to recruit a sample of adults in China (n = 2130) from 14 February 2020 to 3 March 2020 to complete an online survey. Linear regression was used to examine the predictors of symptoms of depression and psychological distress. Living in a non-urban area and the number of confirmed cases in their city of residence were positively associated with symptoms of depression. Female gender, not being married, practicing social distancing, the amount of time spent daily on social media searching for and reading information on COVID-19, the number of confirmed cases of COVID-19 in their city of residence, and having confirmed or suspected cases of COVID-19 in personal networks were positively associated with psychological distress. Social distancing is a widely used public health approach for population-wide virus-containment of COVID-19. However, reductions in population-wide psychological well-being are inadvertent consequences of social distancing. There is an emerging need to negate factors that increase adverse mental health vulnerabilities during the COVID-19 pandemic.

Factors influencing social distancing to prevent the community spread of COVID-19 among Chinese adults.

The global outbreak of the coronavirus disease 2019 (COVID-19) in 2020 has been an international public health threat. Early strong social distancing efforts is needed to stop transmission of the virus. The purpose of the present study is to identify individual and environmental factors related to individuals' compliance with the recommended social distancing, as well as the moderating role of social media in influencing individuals' implementation of social distancing. A total of 2130 Chinese adults were surveyed in March 2020 during the COVID-19 pandemic. Logistic regression analyses were performed to ascertain the predictors of social distancing. Overall, the majority of respondents (95.6%) reported compliance with social distancing. Women were more likely to practice social distancing compared to men (odds ratio [OR] = 3.12, 95% confidence interval [CI] = 1.93-5.02). Psychological distress, depressive symptoms, and social media were significant predictors of social distancing after controlling for other individual and environmental factors. Social media moderated the effects of psychological distress on social distancing (OR = 0.96, 95% CI = 0.94-0.99). Findings from the study indicates that mental health status and social media are influential factors of social distancing, which have significant implications in enhancing the effectiveness of prevention strategies to contain the spread of COVID-19.

Development and Validation of a Prognostic Risk Score System for COVID-19 Inpatients: A Multi-Center Retrospective Study in China.

Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. Hospitalized patients of COVID-19 suffer from a high mortality rate, motivating the development of convenient and practical methods that allow clinicians to promptly identify high-risk patients. Here, we have developed a risk score using clinical data from 1479 inpatients admitted to Tongji Hospital, Wuhan, China (development cohort) and externally validated with data from two other centers: 141 inpatients from Jinyintan Hospital, Wuhan, China (validation cohort 1) and 432 inpatients from The Third People's Hospital of Shenzhen, Shenzhen, China (validation cohort 2). The risk score is based on three biomarkers that are readily available in routine blood samples and can easily be translated into a probability of death. The risk score can predict the mortality of individual patients more than 12 d in advance with more than 90% accuracy across all cohorts. Moreover, the Kaplan-Meier score shows that patients can be clearly differentiated upon admission as low, intermediate, or high risk, with an area under the curve (AUC) score of 0.9551. In summary, a simple risk score has been validated to predict death in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); it has also been validated in independent cohorts.

A Cross-Sectional Analysis of Tobacco Use and Concurrent Alcohol and Substance Use Among Patients Living with HIV/HCV Co-infection: Findings from a Large Urban Tertiary Center.

This study aimed to assess the prevalence of and factors associated with tobacco use among patients living with HIV/HCV co-infection. Patient reported outcomes (PROs) were analyzed of patients living with HIV/HCV co-infection (n = 313) who presented for clinical evaluation and treatment of HCV between 2013 and 2017 at a university-affiliated HIV/HCV Co-infection Clinic. The prevalence of tobacco use in patients living with HIV/HCV co-infection was 48%. Compared to non-smokers, a higher proportion of tobacco smokers had substance use disorders and concurrent alcohol and substance use. In the multivariate analysis, concurrent alcohol and substance use was positively associated with tobacco use. The findings suggest clinical interventions are urgently needed to reduce tobacco use among patients living with HIV/HCV co-infection-a doubly-vulnerable immunocompromised population. Otherwise, failed efforts to dedicate resources and targeted behavioral interventions for this respective population will inhibit survival-especially considering the recent and evolving COVID-19 pandemic.

Psychological Status and Influencing Factors of Hospital Medical Staff During the COVID-19 Outbreak.

BACKGROUND: The aim of this study was to analyze the psychological status of and its influencing factors in health care workers (HCWs) during the coronavirus disease 2019 (COVID-19) outbreak so as to provide sufficient theory and scientific basis for the formulation and implementation of relevant policies and measures in improving the psychological status of HCWs. METHOD: During February 1 to February 20, 2020, 1,002 members of the HCWs from Xi'an and Wuhan completed a 12-item questionnaire regarding pressure about the COVID-19 influenza pandemic, along with the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scale was divided by three points. The positive group was scored more than 3. All data were analyzed by SPSS. RESULTS: More than half of the participants (61.1%) reported psychological distress. The HCWs have sufficient information about the COVID-19 symptoms, prognosis, treatment, infection route, and preventive measures (medians ranged from 6/9 to 8/9). Female, engaged in clinic work less than 7 years, married person, and working in Wuhan were risk factors affecting the psychological status of HCWs (P < 0.05). CONCLUSION: Psychological distress is common in HCWs during the COVID-19 outbreak. Hospitals and relevant departments should provide psychological support to HCWs, and strict infection control measures should be developed.