Government-Enterprise Collusion and the Effectiveness of Environmental Regulations: Implications for Public Health.

Effective environmental management will create a win-win situation for building an ecological civilization with the potential to control the COVID-19 pandemic. From the perspective of government-enterprise collusion (GEC), this study analyzes the moderating effects of the officials' promotion incentives and turnover on the effectiveness of environmental regulations utilizing a panel dataset on 276 cities in China from 2003 to 2019. The study reveals the following empirical results: First, promotion incentives positively moderate the relationship between environmental regulations and environmental pollution, mainly air pollution; results for water pollution are not significant. Compared with general cities, the positive moderating effect of promotion incentives in high-level cities is weaker and the negative moderating effect is more potent. Additionally, the moderating effect of promotion incentives is predominantly positive in the new developmental stage from 2013 to 2019. Second, the negative moderating effect of officials' turnover on the effectiveness of environmental regulations is mainly observed for water pollution but not evident for air pollution. Compared with high-level cities, officials' turnover in general cities is more conducive to the effectiveness of environmental regulations. These findings provide beneficial insights for promoting green growth by improving official governance and destroying GEC.

Sequelae of long COVID, known and unknown: A review of updated information.

Over three years have passed since the COVID-19 pandemic started. The dangerousness and impact of COVID-19 should definitely not be ignored or underestimated. Other than the symptoms of acute infection, the long-term symptoms associated with SARS-CoV-2 infection, which are referred to here as "sequelae of long COVID (LC)", are also a conspicuous global public health concern. Although such sequelae were well-documented, the understanding of and insights regarding LC-related sequelae remain inadequate due to the limitations of previous studies (the follow-up, methodological flaws, heterogeneity among studies, etc.). Notably, robust evidence regarding diagnosis and treatment of certain LC sequelae remain insufficient and has been a stumbling block to better management of these patients. This awkward situation motivated us to conduct this review. Here, we comprehensively reviewed the updated information, particularly focusing on clinical issues. We attempt to provide the latest information regarding LC-related sequelae by systematically reviewing the involvement of main organ systems. We also propose paths for future exploration based on available knowledge and the authors' clinical experience. We believe that these take-home messages will be helpful to gain insights into LC and ultimately benefit clinical practice in treating LC-related sequelae.

Ocular Adverse Events after Inactivated COVID-19 Vaccination.

PURPOSE: To report the clinical characteristics of ocular adverse events that have occurred, in China, after vaccination with inactivated COVID-19 vaccines. METHODS: A retrospective cross-sectional observational study was conducted of ocular disorders that occurred within 15 days from any dose of an inactivated COVID-19 vaccine. Information on gender, age, the interval between the vaccination and ocular symptoms, laterality, duration of the ocular symptoms, primary visual acuity, and clinical diagnosis were retrospectively collected. RESULTS: Twenty-four patients were involved in the study, including 15 females and 9 males, with a mean age of 41 ± 16 years (range of 8-71 years). The patients all denied a prior history of COVID-19 infection. Ocular adverse events occurred after the first dose of vaccine in 18 patients and, after the second or third doses, in six patients. The interval between vaccination with the inactivated COVID-19 vaccine and ocular symptoms was 6 ± 5 days; six patients were bilaterally involved and 18 patients were unilaterally involved. Regarding the diagnosis, 10 patients were diagnosed with white dot syndrome (WDS), 9 patients were diagnosed with uveitis, and 5 patients were diagnosed with retinal vascular disorders. The ages of patients with WDS were younger than those with uveitis or retinal vascular disorders (32 ± 10 vs. 48 ± 18, p < 0.05). For patients diagnosed with WDS, the best-corrected visual acuity (BCVA) was 0.74 ± 0.73 LogMAR. For patients diagnosed with retinal vascular disorders or uveitis, the BCVA was 1.44 ± 1.26 LogMAR. There was no significant difference (p > 0.05). CONCLUSIONS: A relationship cannot be established between inactivated COVID-19 vaccines and ocular disorders; therefore, further investigation of the clinical spectrum of ocular adverse events after vaccination with an inactivated COVID-19 vaccine is necessary.

Does the creation of healthy cities promote municipal solid waste management? Empirical research in 284 cities in China.

In the context of the COVID-19 pandemic, the creation of healthy cities has become an important measure to deal with global public diseases and public health emergencies, and has had a profound impact on the management of municipal solid waste (MSW). This study exploits the Healthy Cities pilot (HCP) program established in 2016 as a natural experiment, and evaluates its impact on MSW management using the difference-in-difference (DID) method. The estimates show that the collection amount and harmless treatment capacity of MSW were increased by 15.66 and 10.75%, respectively, after the cities were established as pilot healthy cities. However, the harmless treatment rate was decreased by 3.544. This conclusion remains valid in a series of robustness tests, including parallel trend test, placebo test, propensity score matching (PSM)-DID, eliminating the interference of other policies, and eliminating the non-randomness of the policy. Mechanism analysis shows that the HCP program increased the collection amount and harmless treatment capacity of MSW by increasing the expenditure on MSW treatment. However, after a city was established as a pilot healthy city, the unsustainable high expenditure of local government on municipal sanitation led to the decrease in the harmless treatment rate of MSW. Moreover, heterogeneity analysis shows that the HCP program had a stronger impact on MSW management in cities with higher administrative levels, more obvious location advantages, and a larger size. Therefore, it is advisable to use the creation of healthy cities as an important tool to gradually improve MSW management, so as to realize the coordinated development of city construction and human health.

The Impact of COVID-19 Pandemic on the Clinical Practice Patterns in Atrial Fibrillation: A Multicenter Clinician Survey in China.

The COVID-19 pandemic has severely impacted healthcare systems worldwide. This study investigated cardiologists' opinions on how the COVID-19 pandemic impacted clinical practice patterns in atrial fibrillation (AF). A multicenter clinician survey, including demographic and clinical questions, was administered to 300 cardiologists from 22 provinces in China, in April 2022. The survey solicited information about their treatment recommendations for AF and their perceptions of how the COVID-19 pandemic has impacted their clinical practice patterns for AF. The survey was completed by 213 cardiologists (71.0%) and included employees in tertiary hospitals (82.6%) and specialists with over 10 years of clinical cardiology practice (53.5%). Most respondents stated that there were reductions in the number of inpatients and outpatients with AF in their hospital during the pandemic. A majority of participants stated that the pandemic had impacted the treatment strategies for all types of AF, although to different extents. Compared with that during the assumed non-pandemic period in the hypothetical clinical questions, the selection of invasive interventional therapies (catheter ablation, percutaneous left atrial appendage occlusion) was significantly decreased (all p < 0.05) during the pandemic. There was no significant difference in the selection of non-invasive therapeutic strategies (the management of cardiovascular risk factors and concomitant diseases, pharmacotherapy for stroke prevention, heart rate control, and rhythm control) between the pandemic and non-pandemic periods (all p > 0.05). The COVID-19 pandemic has had a profound impact on the clinical practice patterns of AF. The selection of catheter ablation and percutaneous left atrial appendage occlusion was significantly reduced, whereas pharmacotherapy was often stated as the preferred option by participating cardiologists.

Extensive neutralization against SARS-CoV-2 variants elicited by Omicron-specific subunit vaccine as a heterologous booster

To overcome the increased risk of SARS-CoV-2 reinfection or post-vaccination infection caused by the Omicron variant, Omicron-specific vaccines were considered a potential strategy. We reported the increased magnitude and breadth of antibody response against VOCs elicited by post-vaccination Delta and Omicron infection, compared to WT infection without vaccination. Then, in mouse models, three doses of Omicron-RBD immunization elicited comparable neutralizing antibody (NAb) titers with three doses of WT-RBD immunization, but the neutralizing activity was not cross-active. By contrast, a heterologous Omicron-RBD booster following two doses of WT-RBD immunization increased the NAb titers against Omicron by 9 folds than the homologous WT-RBD booster. Moreover, it retains neutralization against both WT and current VOCs. Results suggest that Omicron-specific subunit booster shows its advantages in the immune protection from both WT and current VOCs and that SARS-CoV-2 vaccines including two or more virus lineages might improve the NAb response. Graphical

SIS Epidemic Propagation on Scale-Free Hypernetwork

The hypergraph offers a platform to study structural properties emerging from more complicated and higher-order than pairwise interactions among constituents and dynamical behavior, such as the spread of information or disease. Considering the higher-order interaction between multiple nodes in the system, the mathematical model of infectious diseases spreading on simple scale-free networks is extended to hypernetworks based on hypergraphs. A SIS propagation model based on reaction process strategy in a universal scale-free hypernetwork is constructed, and the theoretical and simulation analysis of the model is carried out. Using mean field theory, the analytical expressions between infection density and hypernetwork structure parameters as well as propagation parameters in steady state are given. Through individual-based simulation, the theoretical results are verified and the infectious disease spread process under the structure of the hypernetwork and simple scale-free network is compared and analyzed. It becomes apparent that infectious diseases are easier to spread on the hypernetworks, showing the clear clustering characteristics of epidemic spread. Furthermore, the influence of the hypernetwork structure and model parameters on the propagation process is studied. The results of this paper are helpful in further studying the propagation dynamics on the hypernetworks. At the same time, it provides a certain theoretical basis for the current COVID-19 prevention and control in China and the prevention of infectious diseases in the future.

Spatiotemporal evolution of online attention to vaccines since 2011: An empirical study in China.

Since the outbreak of Coronavirus Disease 2019 (COVID-19), the Chinese government has taken a number of measures to effectively control the pandemic. By the end of 2021, China achieved a full vaccination rate higher than 85%. The Chinese Plan provides an important model for the global fight against COVID-19. Internet search reflects the public's attention toward and potential demand for a particular thing. Research on the spatiotemporal characteristics of online attention to vaccines can determine the spatiotemporal distribution of vaccine demand in China and provides a basis for global public health policy making. This study analyzes the spatiotemporal characteristics of online attention to vaccines and their influencing factors in 31 provinces/municipalities in mainland China with Baidu Index as the data source by using geographic concentration index, coefficient of variation, GeoDetector, and other methods. The following findings are presented. First, online attention to vaccines showed an overall upward trend in China since 2011, especially after 2016. Significant seasonal differences and an unbalanced monthly distribution were observed. Second, there was an obvious geographical imbalance in online attention to vaccines among the provinces/municipalities, generally exhibiting a spatial pattern of "high in the east and low in the west." Low aggregation and obvious spatial dispersion among the provinces/municipalities were also observed. The geographic distribution of hot and cold spots of online attention to vaccines has clear boundaries. The hot spots are mainly distributed in the central-eastern provinces and the cold spots are in the western provinces. Third, the spatiotemporal differences in online attention to vaccines are the combined result of socioeconomic level, socio-demographic characteristics, and disease control level.

Relationship between stress response and depression in vocational medical school students in the COVID-19 epidemic: A moderated mediation model.

To investigate the relationship between stress response and depression in vocational medical school students at the initial stage of COVID-19 epidemic, and to explore the mediating role of meaning in life and the moderating role of prosocial behavior. The COVID-19 Stress Response Questionnaire, the Meaning in Life Questionnaire, the Prosocial Behavior Scale and the Depression Scale, were used to investigate 3526 vocational medical school students. The results showed that: (1) The relationship between stress response and depression in vocational medical school students was partially mediated by presence of meaning and search for meaning. Stress response has indirect effect on depression of vocational medical school students through meaning in life. (2) Prosocial behavior moderated the relationship between meaning in life and depression. Specifically, meaning in life has a more significant effect on depression for college students with higher levels of prosocial behavior.

Digital Technology, Knowledge Level, and Food Safety Governance: Implications for National Healthcare System.

Exploring the intrinsic relationship between digital technology and the efficiency of food safety supervision contributes to a better understanding of the role of digital technology in food safety supervision and how to maximize its influence. This study employed sample data from 31 regions in China between 2015 and 2017 for an empirical analysis of the correlation between the two and to examine the moderating effects of the knowledge levels of food producers and consumers. The results show that the development of digital technology contributes to enhancing the efficiency of food safety supervision. In this process, the higher the knowledge level of consumers, the greater the positive promotional effect of digital technology. On the contrary, when the knowledge level of producers is higher, it is not conducive to enhancing the effect of digital technology on the efficiency of food safety supervision. The author holds the view that this is related to the fact that employees in the food production and manufacturing industry have insufficient moral and legal knowledge. This not only limits the effect of digital technology on enhancing the efficiency of food safety supervision, but also opens the door to illegal production for some unprincipled producers. The policy implications are that digital technology should be used to improve food safety supervision, the moral and legal knowledge of food producers should be improved, and consumers should be encouraged to use digital technology more in the pursuit of food safety. Implications for national healthcare system would be also discussed in our paper.

Has COVID-19 Changed China's Digital Trade?-Implications for Health Economics.

Digital technologies have played a significant role in the defense against the COVID-19 pandemic. This development raises the question of whether digital technologies have helped Chinese exports recover quickly and even grow. To answer this question, we study monthly data on Chinese exports to 40 countries/regions from January 2019 to June 2020 and covering 97 product categories. The study takes the COVID-19 outbreak as a natural experiment and treats digital trade products as the treatment group. Using a generalized difference-in-differences (DID) approach, we empirically investigate how this major global public health crisis and digital trade have influenced Chinese exports. Our empirical analysis reveals that the COVID-19 pandemic has inhibited China's export trade overall, digital trade has significantly promoted trade, and the supply mechanism has played a significant role in promoting the recovery of exports. Heterogeneity tests on destination countries/regions reveal that digital trade has significantly promoted exports to countries/regions with different income levels, with a more significant effect on low-risk destinations than on high-risk destinations. The sector heterogeneity test demonstrates that digital trade has enhanced the export recovery of sectors dealing in necessities for pandemic prevention. Other robustness tests, including parallel trend and placebo tests, support the above conclusions. Finally, we extend the research conclusions and discuss their implication for health economics and the practice of fighting COVID-19.

Has COVID-19 Changed China's Digital Trade?—Implications for Health Economics

Digital technologies have played a significant role in the defense against the COVID-19 pandemic. This development raises the question of whether digital technologies have helped Chinese exports recover quickly and even grow. To answer this question, we study monthly data on Chinese exports to 40 countries/regions from January 2019 to June 2020 and covering 97 product categories. The study takes the COVID-19 outbreak as a natural experiment and treats digital trade products as the treatment group. Using a generalized difference-in-differences (DID) approach, we empirically investigate how this major global public health crisis and digital trade have influenced Chinese exports. Our empirical analysis reveals that the COVID-19 pandemic has inhibited China's export trade overall, digital trade has significantly promoted trade, and the supply mechanism has played a significant role in promoting the recovery of exports. Heterogeneity tests on destination countries/regions reveal that digital trade has significantly promoted exports to countries/regions with different income levels, with a more significant effect on low-risk destinations than on high-risk destinations. The sector heterogeneity test demonstrates that digital trade has enhanced the export recovery of sectors dealing in necessities for pandemic prevention. Other robustness tests, including parallel trend and placebo tests, support the above conclusions. Finally, we extend the research conclusions and discuss their implication for health economics and the practice of fighting COVID-19.

Kinetic Characteristics of Neutralizing Antibody Responses Vary among Patients with COVID-19.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic continues to present a major challenge to public health. Vaccine development requires an understanding of the kinetics of neutralizing antibody (NAb) responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: In total, 605 serum samples from 125 COVID-19 patients (from January 1 to March 14, 2020) varying in age, sex, severity of symptoms, and presence of underlying diseases were collected, and antibody titers were measured using a micro-neutralization assay with wild-type SARS-CoV-2. RESULTS: NAbs were detectable approximately 10 days post-onset (dpo) of symptoms and peaked at approximately 20 dpo. The NAb levels were slightly higher in young males and severe cases, while no significant difference was observed for the other classifications. In follow-up cases, the NAb titer had increased or stabilized in 18 cases, whereas it had decreased in 26 cases, and in one case NAbs were undetectable at the end of our observation. Although a decreasing trend in NAb titer was observed in many cases, the NAb level was generally still protective. CONCLUSION: We demonstrated that NAb levels vary among all categories of COVID-19 patients. Long-term studies are needed to determine the longevity and protective efficiency of NAbs induced by SARS-CoV-2.

Neurosurgery resumption in Wuhan during the early post-epidemic period: what should we pay attention to?

COVID-19 has spread globally, causing a pandemic and medical interruptions. As more countries control the epidemic, the resumption of work is imperative. However, asymptomatic carriers become the main source of infection. After several months of recovery, Wuhan had much experience with facing the challenge of work resumption. The purpose of this study was to investigate the safety of the resumption strategies, as well as the outcome of the resumption efforts, in the early post-epidemic period. A retrospective study was conducted in patients admitted between April 8 and June 30 to the neurosurgery department of Tongji Hospital, Wuhan. The medical information, past medical history, COVID-19 tests, laboratory parameters, CT results, and management were reviewed and recorded. 768 patients were admitted to the neurosurgery department at Tongji Hospital, and none of them became new infections. Our department recovered to 70% efficiency one month after the resumption of work. Two patients were found to have asymptomatic infections in the outpatient department. Two patients who recovered from COVID-19 underwent the surgery without recurrence of COVID-19. Tumor patients accounted for more than 50% of the surgery patients in the early period. It is feasible and helpful to follow our strict admission algorithm in the early post-epidemic period, even though the challenges of asymptomatic infectors exist. Two COVID-19 tests in 3 days are suggested within the early period. Protective downgrades should be based on the testing of asymptomatic patients in the area. Recovered COVID-19 patients can undergo surgery without recurrence.

Dealing with pandemics: An investigation of the effects of COVID-19 on customers' evaluations of hospitality services.

The hospitality industry is highly vulnerable to pandemics. However, little is known about how pandemics alter travelers' evaluations of hospitality services. Therefore, this study investigates the changes in travelers' expectations and perceptions of hotel services during different stages of the novel coronavirus 2019 (COVID-19) pandemic. 98,163 Chinese hotel reviews were collected and scrutinized via text mining and sentiment analysis techniques to derive new implications for service optimization. The results reveal shifts in consumers' evaluations well beyond hygienic requirements. Insights obtained from this research can help guide hospitality practice in organizing its priorities during acute pandemic situations and adjusting to possibly longer-lasting shifts in consumer preferences.

Cardiac T1 and T2 Mapping Showed Myocardial Involvement in Recovered COVID-19 Patients Initially Considered Devoid of Cardiac Damage.

BACKGROUND: Myocardial injury has been found using magnetic resonance imaging in recovered coronavirus disease 2019 (COVID-19) patients unselected or with ongoing cardiac symptoms. PURPOSE: To evaluate for the presence of myocardial involvement in recovered COVID-19 patients without cardiovascular symptoms and abnormal serologic markers during hospitalization. STUDY TYPE: Prospective. POPULATION: Twenty-one recovered COVID-19 patients and 20 healthy controls (HC). FIELD STRENGTH/SEQUENCE: 3.0 T, cine, T2-weighted imaging, T1 mapping, and T2 mapping. ASSESSMENT: Cardiac ventricular function includes end-diastolic volume, end-systolic volume, stroke volume, cardiac output, left ventricle (LV) mass, and ejection fraction (EF) of LV and right ventricle (RV), and segmental myocardial T1 and T2 values were measured. STATISTICAL TESTS: Student's t-test, univariate general linear model test, and chi-square test were used for analyses between two groups. Ordinary one-way analyses of variance or Kruskal-Wallis H test were used for analyses between three groups, followed by post-hoc analyses. RESULTS: Fifteen (71.43%) COVID-19 patients had abnormal magnetic resonance findings, including raised myocardial native T1 (5, 23.81%) and T2 values (10, 47.62%), decreased LVEF (1, 4.76%), and RVEF (2, 9.52%). The segmental myocardial T2 value of COVID-19 patients (49.20 [46.1, 54.6] msec) was significantly higher than HC (48.3 [45.2, 51.7] msec) (P < 0.001), while the myocardial native T1 value showed no significant difference between COVID-19 patients and HC. The myocardial T2 value of serious COVID-19 patients (52.5 [48.1, 57.1] msec) was significantly higher than unserious COVID-19 patients (48.8 [45.9, 53.8] msec) and HC (48.3 [45.2, 51.7]) (P < 0.001). COVID-19 patients with abnormally elevated D-dimer, C-reactive protein, or lymphopenia showed higher myocardial T2 values than without (all P < 0.05). DATA CONCLUSION: Cardiac involvement was observed in recovered COVID-19 patients with no preexisting cardiovascular disease, no cardiovascular symptoms, and elevated serologic markers of myocardial injury during the whole course of COVID-19. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 5.

Prevalence of Kidney Injury and Associations with Critical Illness and Death in Patients with COVID-19.

BACKGROUND AND OBJECTIVES: Coronavirus disease 2019 is spreading rapidly across the world. This study aimed to assess the characteristics of kidney injury and its association with disease progression and death of patients with coronavirus disease 2019. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is a retrospective study. Two representative cohorts were included. Cohort 1 involved severe and critical patients with coronavirus disease 2019 from Wuhan, China. Cohort 2 was all patients with coronavirus disease 2019 in Shenzhen city (Guangdong province, China). Any kidney injury was defined as the presence of any of the following: hematuria, proteinuria, in-hospital AKI, or prehospital AKI. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) creatinine criteria. The primary outcome was death at the end of follow-up. The secondary outcome was progression to critical illness during the study period. RESULTS: A total of 555 patients were enrolled; 42% of the cases (229 of 549) were detected with any kidney injury, 33% of the cases (174 of 520) were detected with proteinuria, 22% of the cases (112 of 520) were detected with hematuria, and 6% of the cases (29 of 520) were detected with AKI. Of the 29 patients with AKI, 21 cases were recognized as in-hospital AKI, and eight were recognized as prehospital AKI. Altogether, 27 (5%) patients died at the end of follow-up. The death rate was 11% (20 of 174) in patients with proteinuria, 16% (18 of 112) in patients with hematuria, and 41% (12 of 29) in the AKI settings. Multivariable Cox regression analysis showed that proteinuria (hazard ratio, 4.42; 95% confidence interval, 1.22 to 15.94), hematuria (hazard ratio, 4.71; 95% confidence interval, 1.61 to 13.81), and in-hospital AKI (hazard ratio, 6.84; 95% confidence interval, 2.42 to 19.31) were associated with death. Among the 520 patients with noncritical illness at admission, proteinuria (hazard ratio, 2.61; 95% confidence interval, 1.22 to 5.56) and hematuria (hazard ratio, 2.50; 95% confidence interval, 1.23 to 5.08) were found to be associated with progression to critical illness during the study period. CONCLUSIONS: Kidney injury is common in coronavirus disease 2019, and it is associated with poor clinical outcomes. PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_09_18_CJN04780420.mp3.