Subsidy strategy for reserving flexible capacity of emergency supply production

This paper investigates a government's subsidy strategy for motivating a manufacturer to set up a flexible production line for emergency supplies. Four subsidy strategies are proposed to ensure a desired service level in case of an emergency: zero subsidy, a fixed subsidy, a marginal subsidy, and a hybrid subsidy. We develop a game theoretical model to examine how the government can induce a manufacturer to set up a flexible production line that can respond promptly to an emergency, based on the manufacturer's cost structure (fixed and marginal costs). We find that when the marginal profit of an emergency product is higher than that of the manufacturer's regular product, a fixed (marginal) subsidy is the dominant strategy if the manufacturer's fixed (marginal) cost is high, while a hybrid subsidy strategy is dominant if both costs are high. When the marginal profit of an emergency product is lower than that of the manufacturer's regular product, neither a fixed subsidy nor a zero subsidy will be the dominant strategy. We also find that a marginal subsidy can ensure the effectiveness of the strategy, while a fixed subsidy helps improve strategy efficiency. We use government subsidy strategies implemented for Chinese COVID-19 emergency supplies as examples to demonstrate the effectiveness and efficiency of the subsidy strategies under the proposed framework. We also extend the discussion by considering the manufacturer's social consciousness.

Preoperative evaluation and timing of surgery for adult patients after covid-19 infection: Recommendations of peking union medical college hospital (2023).

With the adjustment of China's epidemic prevention and control guidelines regarding coronavirus disease of 2019(COVID-19), the preoperative evaluation and timing of surgery for patients after COVID-19 infection have become the focus of attention for both healthcare workers and patients. Based on the latest study and related clinical experience, Peking Union Medical College Hospital (PUMCH) has therefore compiled this multidisciplinary, evidence-based recommendation for concise, individualized, and practical preoperative evaluation and timing of surgery for patients after COVID-19 infection. The recommendations emphasize patients' COVID-19 infection history, the severity of symptoms, and medical/physiologic recovery status during preoperative evaluation. The determination of appropriate length of time between recovery from COVID-19 and surgery/procedure should take into account of patients' underlying health conditions, the severity of the COVID-19 infection course, and the types of surgery and anesthesia scheduled, to minimize postoperative complications. The recommendations are intended to aid healthcare workers in evaluating these patients, scheduling them for the optimal timing of surgery, and optimizing perioperative management and postoperative recovery.Copyright © 2023, Peking Union Medical College Hospital. All rights reserved.

Bioactive compounds of Jingfang Granules against SARS-CoV-2 virus proteases 3CLpro and PLpro.

OBJECTIVE: Jingfang Granules have been recommended for the prevention and treatment of corona virus disease 2019 (COVID-19). Through chemical analysis and bioactivity evaluation, this study aims to elucidate the potential effective components of Jingfang Granules. METHOD(S): The inhibitory acti-vities of Jingfang Granules extract against 3-chymotrypsin-like protease (3CLpro), papain like protease (PLpro), spike protein receptor-binding domain (S-RBD) and human cyclooxygenase-2 (COX-2) were evaluated using enzyme assay. The antitussive effects were evaluated using the classical ammonia-induced cough model. The chemical constituents of Jingfang Granules were qualitatively and quantitatively analyzed by liquid chromatography-mass spectrometry (LC/MS). The 3CLpro and PLpro inhibitory activities of the major compounds were determined by enzyme assay, molecular docking, and site-directed mutagenesis. RESULT(S): Jingfang Granules exhibited 3CLpro and PLpro inhibitory activities, as well as COX-2 inhibitory and antitussive activities. By investigating the MS/MS behaviors of reference standards, a total of fifty-six compounds were characterized in Jingfang Granules. Sixteen of them were unambiguously identified by comparing with reference standards. The contents of the 16 major compounds were also determined, and their total contents were 2 498.8 mug/g. Naringin, nodakenin and neohesperidin were three dominating compounds in Jingfang Granules, and their contents were 688.8, 596.4 and 578.7 mug/g, respectively. In addition, neohesperidin and naringin exhibited PLpro inhibitory activities, and the inhibition rates at 8 mumol/L were 53.5% and 46.1%, respectively. Prim-O-glucosylcimifugin showed significant inhibitory activities against 3CLpro and PLpro, and the inhibitory rates at 8 mumol/L were 76.8% and 78.2%, respectively. Molecular docking indicated that hydrogen bonds could be formed between prim-O-glucosylcimifugin and amino acid residues H163, E166, Q192, T190 of 3CLpro (binding energy, -7.7 kcal/mol) and K157, D164, R166, E167, T301 of PLpro(-7.3 kcal/mol), respectively. Site-directed mutagenesis indicated amino acid residue K157 was a key active site for the interaction between prim-O-glucosylcimifugin and PLpro. CONCLUSION(S): Prim-O-glucosylcimifugin, neohesperidin, and naringin as the major compounds from Jingfang Granules could inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus proteases 3CLpro and PLpro. The results are valuable for rational clinical use of Jingfang Granules.

ID: 219407 The Cardiac Patient and Neuromodulation, When Anticoagulation Dictates the Intervention

Introduction: Patients with cardiac comorbidities present unique challenges for undergoing interventional pain procedures. Consensus guidelines on safe anticoagulation management are categorized by procedure, patient specific bleeding risk factors, and class of anticoagulation (Table 1, Table 2).1 Specifically, some procedures occur in close proximity to the spinal cord, require large gauge needles and styletted leads, while others are in compressible locations with minimal tissue disruption. Further, pain-induced hypercoagulation increases the risk of thrombo-vascular events.1 This accentuates the importance of interdisciplinary perioperative coordination with the prescribing cardiologist. Case: A 71-year-old male with past-medical-history of CABG, bilateral femoral-popliteal bypass, atrial fibrillation on apixaban and ticagrelor, and multiple cardiac stents presented with intermittent shooting axial back pain radiating to right buttock, lateral thigh, and calf, worsened with activity. MRI demonstrated thoracic myelomalacia, multi-level lumbar disc herniation, and moderate central canal stenosis. An initial multi-model treatment approach utilizing pharmacologic agents, physical therapy, ESI's, and RFA failed to alleviate symptoms. After extensive discussion with his cardiologist, he was scheduled for a three-day SCS trial. Ticagrelor and apixaban were held throughout the 3-day trial and for 5 and 3 days prior, respectively, while ASA was maintained. Successful trial with tip placement at T6 significantly improved function and pain scores (Figure 1). Upon planned percutaneous implant, the cardiologist recommended against surgical implantation and holding anticoagulation. Alternatively, the patient underwent bilateral lumbar medial branch PNS implant with sustained improvement in lower back symptoms. However, he contracted COVID, resulting in delayed lead explanation (>60 days) without complication. Conclusion(s): Interventional pain practice advisories are well established for anticoagulation use in the perioperative period.1,2 However, there is limited high-quality research on the appropriate length to hold anticoagulation prior to surgery for high thrombotic risk patients. Collegial decision making with the cardiologist was required to avoid deleterious procedural complications. However, they may be unfamiliar with the nuances between interventions or between trial and implant. Prospective studies have shown that low risk procedures, such as the PNS, may not require holding anticoagulants.3 Other case data has demonstrated post-SCS epidural hematoma with ASA use after being held for 1-week prior to surgery. Our patient was unable to undergo SCS implant and instead elected for a lower risk procedure with excellent efficacy. 4 However, delayed PNS lead extraction due to COVID19 hospitalization presented further risk of infection and lead fracture.5 PNS may prove to be an appropriate treatment option for patients who are anticoagulated and are not SCS candidates. Disclosure: Elliot Klein, MD,MPH: None, Clarence Kong, MD: None, Shawn Sidharthan, MD: None, Peter Lascarides, DO: None, Yili Huang, DO: NoneCopyright © 2023

Continuity of Early Intervention Services in New York City During the COVID-19 Pandemic

In response to COVID-19, the New York City Early Intervention (EI) Program rapidly transitioned from in-person to teletherapy services. We describe the timing of service resumption among children who received EI services between March 1 and March 17, 2020. The proportion of children who transitioned to teletherapy-only was 25% as of March 24, rising to 78% by July 6. By December 31, 2020, 87% of the cohort had resumed either teletherapy or in-person services. Child age, race, language, and neighborhood poverty all predicted service resumption timing. Children with a diagnosis of autism spectrum disorder were more likely to transition to teletherapy, and children with only 1-2 domains of delay were more likely to discontinue services altogether. Continuity of EI services during the COVID-19 public health emergency was a critical priority. Timely policy changes facilitated swift return to services and avoided exacerbation of the long-standing racial disparities in access to EI services. © 2023, University Library System, University of Pittsburgh. All rights reserved.

Asian Pacific Journal of Tropical Medicine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China: An online cross-sectional study

Objective: To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China. Method(s): An online cross-sectional study was conducted among parents of teenagers in Zhejiang, China from May 1 to 31, 2022. Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences (SPSS) program. Result(s): A total of 11115 (96.11%) participants and 11449 (99.00%) of their children in Zhejiang, China had been vaccinated against COVID-19. Children whose parents did not receive COVID-19 vaccination were 19 times (aOR 18.96, 95%CI 12.36-29.08) more likely to be unvaccinated than their counterparts. In addition, children with no previous influenza vaccination, those whose parents doubted the COVID-19 vaccine's safety or effectiveness, were 6.11 times (aOR 6.11, 95%CI 2.80-13.34), 8.27 times (aOR 8.27, 95%CI 5.33-12.83), and 2.69 times (aOR 2.69, 95%CI 1.11-6.50) more likely to be unvaccinated than their counterparts, respectively. COVID-19 vaccine uptake varied between different sociodemographic groups. However, the odds of receiving the COVID-19 vaccine decreased as age and education level increased. The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination (53.78%), followed by safety concerns about the vaccine (13.56%), not knowing where to get vaccinated (6.44%), and concerns about fertility issues (5.56%). Conclusion(s): Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang, China, the elderly and highly educated people had lower COVID-19 vaccine uptake. It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups. Furthermore, with vaccination rates at such a high level, the pandemic is still ongoing, and public confidence in vaccines may decline. Thus, sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public. Copyright © 2023 Asian Pacific Journal of Tropical Medicine.

Performance and Early Results from the Earth Surface Mineral Dust Source Investigation (EMIT) Imaging Spectroscopy Mission

The Earth Surface Mineral Dust Source Investigation (EMIT) acquires new observations of the Earth from a state-of-the-art, optically fast F/1.8 visible to short wavelength infrared imaging spectrometer with high signal-to-noise ratio and excellent spectroscopic uniformity. EMIT was launched to the International Space Station from Cape Canaveral, Florida, on July 14, 2022 local time. The EMIT instrument is the latest in a series of more than 30 imaging spectrometers and testbeds developed at the Jet Propulsion Laboratory, beginning with the Airborne Imaging Spectrometer that first flew in 1982. EMIT's science objectives use the spectral signatures of minerals observed across the Earth's arid and semi-arid lands containing dust sources to update the soil composition of advanced Earth System Models (ESMs) to better understand and reduce uncertainties in mineral dust aerosol radiative forcing at the local, regional, and global scale, now and in the future. EMIT has begun to collect and deliver high-quality mineral composition determinations for the arid land regions of our planet. Over 1 billion high-quality mineral determinations are expected over the course of the one-year nominal science mission. Currently, detailed knowledge of the composition of the Earth's mineral dust source regions is uncertain and traced to less than 5,000 surface sample mineralogical analyses. The development of the EMIT imaging spectrometer instrumentation was completed successfully, despite the severe impacts of the COVID-19 pandemic. The EMIT Science Data System is complete and running with the full set of algorithms required. These tested algorithms are open source and will be made available to the broader community. These include calibration to measured radiance, atmospheric correction to surface reflectance, mineral composition determination, aggregation to ESM resolution, and ESM runs to address the science objectives. In this paper, the instrument characteristics, ground calibration, in-orbit performance, and early science results are reported. © 2023 IEEE.

Exploration of potential mechanism of SARS-CoV-2 induced immune inflammatory response leading to progression of atherosclerosis and prediction of traditional Chinese medicine for preventing and treating based on bioinformatics.

Objective To explore the core targets and important pathways of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) induced atherosclerosis (AS) progression from the perspective of immune inflammation, so as to predict the potential prevention and treatment of traditional Chinese medicine (TCM). Methods Microarray data were obtained from the Gene Expression Omnibus (GEO) database for coronavirus disease 2019 (COVID-19) patients and AS patients, and the "limmar" and "Venn" packages were used to screen out the common differentially expressed genes (DEGs) genes in both diseases. The gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) analyses were performed on the common DEGs to annotate their functions and important pathways. The two gene sets were scored for immune cells and immune function to assess the level of immune cell infiltration. The protein-protein interaction (PPI) network was constructed by STRING database, and the CytoHubba plug-in of Cytoscape was used to identify the hub genes. Two external validation datasets were introduced to validate the hub genes and obtain the core genes. Immuno-infiltration analysis and gene set enrichment analysis (GSEA) were performed on the core genes respectively. Finally the potential TCM regulating the core genes were predicted by Coremine Medical database. Results A total of 7898 genes related to COVID-19, 471 genes related to AS progression;And 51 common DEGs, including 32 highly expressed genes and 19 low expressed genes were obtained. GO and KEGG analysis showed that common DEGs, which were mainly localized in cypermethrin-encapsulated vesicles, platelet alpha particles, phagocytic vesicle membranes and vesicles, were involved in many biological processes such as myeloid differentiation factor 88 (MyD88)-dependent Toll-like receptor signaling pathway transduction, interleukin-8 (IL-8) production and positive regulation, IL-6 production and positive regulation to play a role in regulating nicotinamide adenine dinucleotide phosphate oxidase activity, Toll-like receptor binding and lipopeptide and glycosaminoglycan binding through many biological pathways, including Toll-like receptor signaling pathways, neutrophil extracellular trap formation, complement and coagulation cascade reactions. The results of immune infiltration analysis demonstrated the state of immune microenvironment of COVID-19 and AS. A total of 5 hub genes were obtained after screening, among which Toll-like receptor 2 (TLR2), cluster of differentiation 163 (CD163) and complement C1q subcomponent subunit B (C1QB) genes passed external validation as core genes. The core genes showed strong correlation with immune process and inflammatory response in both immune infiltration analysis and GSEA enrichment analysis. A total of 35 TCMs, including Chuanxiong (Chuanxiong Rhizoma), Taoren (Persicae Semen), Danggui (Angelicae Sinensis Radix), Huangqin (Scutellariae Radix), Pugongying (Taraxaci Herba), Taizishen (Pseudostellariae Radix), Huangjing (Polygonati Rhizoma), could be used as potential therapeutic agents. Conclusion TLR2, CD163 and C1QB were the core molecules of SARS-CoV-2-mediated immune inflammatory response promoting AS progression, and targeting predicted herbs were potential drugs to slow down AS progression in COVID-19 patients.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.

Surrogate Marker Assessment Using Mediation and Instrumental Variable Analyses in a Case-Cohort Design

The identification of surrogate markers for gold standard outcomes in clinical trials enables future cost-effective trials that target the identified markers. Due to resource limitations, these surrogate markers may be collected only for cases and for a subset of the trial cohort, giving rise to what is termed the case-cohort design. Motivated by a COVID-19 vaccine trial, we propose methods of assessing the surrogate markers for a time-to-event outcome in a case-cohort design by using mediation and instrumental variable (IV) analyses. In the mediation analysis we decomposed the vaccine effect on COVID-19 risk into an indirect effect (the effect mediated through the surrogate marker such as neutralizing antibodies) and a direct effect (the effect not mediated by the marker), and we propose that the mediation proportions are surrogacy indices. In the IV analysis we aimed to quantify the causal effect of the surrogate marker on disease risk in the presence of surrogatedisease confounding which is unavoidable even in randomized trials. We employed weighted estimating equations derived from nonparametric maximum likelihood estimators (NPMLEs) under semiparametric probit models for the time-to-disease outcome. We plugged in the weighted NPMLEs to construct estimators for the aforementioned causal effects and surrogacy indices, and we determined the asymptotic properties of the proposed estimators. Finite sample performance was evaluated in numerical simulations. Applying the proposed mediation and IV analyses to a mock COVID-19 vaccine trial data, we found that 84.2% of the vaccine efficacy was mediated by 50% pseudovirus neutralizing antibody and that neutralizing antibodies had significant protective effects for COVID-19 risk.

COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China: An online cross-sectional study

Objective: To examine COVID-19 vaccine uptake and its determinants among teenagers and their parents in Zhejiang, China. Methods: An online cross-sectional study was conducted among parents of teenagers in Zhejiang, China from May 1 to 31, 2022. Data were interpreted via univariate and multivariate analyses using the statistical package for the social sciences (SPSS) program. Results: A total of 11115 (96.11%) participants and 11449 (99.00%) of their children in Zhejiang, China had been vaccinated against COVID-19. Children whose parents did not receive COVID-19 vaccination were 19 times (aOR 18.96, 95%CI 12.36-29.08) more likely to be unvaccinated than their counterparts. In addition, children with no previous influenza vaccination, those whose parents doubted the COVID-19 vaccine's safety or effectiveness, were 6.11 times (aOR 6.11, 95%CI 2.80-13.34), 8.27 times (aOR 8.27, 95%CI 5.33-12.83), and 2.69 times (aOR 2.69, 95%CI 1.11-6.50) more likely to be unvaccinated than their counterparts, respectively. COVID-19 vaccine uptake varied between different sociodemographic groups. However, the odds of receiving the COVID-19 vaccine decreased as age and education level increased. The main refusal reasons claimed by participants were that they had medical conditions that may not qualify them for vaccination (53.78%), followed by safety concerns about the vaccine (13.56%), not knowing where to get vaccinated (6.44%), and concerns about fertility issues (5.56%). Conclusions: Despite a highly encouraging level of COVID-19 vaccine uptake in Zhejiang, China, the elderly and highly educated people had lower COVID-19 vaccine uptake. It is suggested that tailored health education strategies should be taken to increase the COVID-19 vaccine uptake in such groups. Furthermore, with vaccination rates at such a high level, the pandemic is still ongoing, and public confidence in vaccines may decline. Thus, sufficient evidence-based information regarding COVID-19 vaccines should be provided to the public.

Trends for Opioid Prescriptions and the Impact of the Covid-19 Pandemic among Patients with Rheumatic and Musculoskeletal Diseases between 2006 and 2021

Background/Aims Rheumatic and musculoskeletal diseases (RMDs) are some of the most common indications for prescribed opioids. It is unclear how opioid prescribing has changed in the UK for RMDs, especially during the COVID-19 pandemic with limited healthcare access and cancelled elective-surgical interventions, which could impact prescribing in either direction. We aimed to investigate trends in opioid prescribing in RMDs and assess the impact of the pandemic in the UK. Methods Adult patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (AxSpA), systemic lupus erythematosus (SLE), osteoarthritis (OA) and fibromyalgia with opioid prescriptions between 01/Jan/2006-31/Aug/2021 without prior cancer in the UK Clinical Practice Research Datalink (CPRD) were included. We calculated ageand gender-standardised yearly rates of people with opioid prescriptions between 2006-2021, and identified change points in trends by checking whether the rate of change of standardised rates crossed zero. For people with opioid prescriptions, monthly measures of mean morphine milligram equivalents (MME)/day were calculated between 2006-2021. To assess the impact of the pandemic, we fitted regression models to the monthly number of people with opioid prescriptions between Jan/2015-Aug/2021. The time coefficient reflects the trend pre-pandemic and the interaction term coefficient represents the change in the trend during the pandemic. Results We included 1,313,519 patients: 36,932 with RA, 12,649 with PsA, 6,811 with AxSpA, 6,423 with SLE, 1,255,999 with OA, and 66,944 with fibromyalgia. People with opioid prescriptions increased from 2006 to 2018 for OA, to 2019 for RA, AxSpA and SLE, to 2020 for PsA, and to 2021 for fibromyalgia, and all plateaued/decreased afterwards. OA patients on opioids increased from 466.8/10,000 persons in 2006 to a peak of 703.0 in 2018, followed by a decline to 575.3 in 2021. From 2006 to 2021, there was a 4.5-fold increase in fibromyalgia opioid users (17.7 vs.78.5/10,000 persons). In this period, MME/day increased for all RMDs, with the highest for fibromyalgia (>=35). During COVID-19 lockdowns, RA, PsA and fibromyalgia showed significant changes in the trend of people with opioid prescriptions. With a decreasing trend for RA (-0.001,95%CI=-0.002,-0.001) and a decreasing-to-flat curve for PsA (0.0010,95%CI=0.0006,0.0015) prepandemic until Feb/2020, the trends changed by -0.005 (95%CI=-0.008,-0.002) for RA and -0.003 (95%CI=-0.006,-0.0003) for PsA, leading to steeper decreasing trends during the pandemic (Mar/2020-Aug/2021). Fibromyalgia, conversely, had an increasing trend (0.009,95%CI=0.008,0.009) pre-pandemic, and this trend started decreasing by -0.009 (95%CI=-0.011,-0.006) during the pandemic. Conclusion The plateauing/decreasing trend of people with opioid prescriptions in RMDs after 2018 may reflect the efforts to tackle the rising opioid prescribing in UK primary care. Of all RMDs, fibromyalgia patients had the highest MME/day throughout the study period. COVID-19 lockdowns contribute to fewer people on opioids for most RMDs, reassuring there was no sudden increase in opioid prescribing during the pandemic.

Real world experience of drug-drug interactions for HCV patients receiving pan-genotypic direct-acting antivirals in the era of COVID-19 pandemic

Background and Aims: The treatment of chronic hepatitis C (CHC) has evolved from genotype-specific to pan-genotypic direct acting antivirals (DAAs) with high efficacy and safety. However, drug-drug interactions (DDIs) must be avoided when used in combination with other medications, especially with the possible concomitant use of COVID-19 infection antivirals during the COVID-19 pandemic. This study aimed to access the potential DDIs of concomitant drugs with pan-genotypic DAAs and COVID-19 infection antivirals, and actual incidence of DDIs in real-world experience. Method(s): From January 2022 to October 2022, consecutive 116 HCV patients receiving pan-genotypic DAAs were retrospectively enrolled in Taipei Veterans General Hospital. The number of comedications and their potential DDIs with three pan-genotypic DAA regimens and three COVID-19 infection antivirals were analyzed. The actual incidence of DDIs during DAAs treatment were also investigated. Result(s): The mean age was 60.9 years old, with male predominant (55.2%). Of them, 12 (10.3%) patients had cirrhosis, and 24 (20.7%) patients had diabetes mellitus. Most patients were within Child-Pugh class A (109/116, 94.0%). The distribution of HCV genotypes was 8.6% in GT 1a, 36.2% in GT 1b, 39.7% in GT 2, 6.9% in GT 6, and 8.6% in indeterminate genotype, respectively. Of them, 43 (37.1%) patients received GLE/PIB, 69 (59.5%) received SOF/VEL 7plusmn;RBV, and 4 (3.4%) received SOF/VEL/VOX as DAAs regimen. Noteworthy, four patients had COVID-19 infection during DAAs treatment course. The rates of ETVR and SVR12 were 97.6% and 95.3%. The mean number of concomitant medications was 2.01. The distribution of concomitant drugs was 64.7% with no concomitant drug, 11.2% with 1-3 drugs, 11.2% with 4-6 drugs, 9.5% with 7-9 drugs, and 3.4% had more than 9 drugs, respectively. In potential contraindicated (red) DDI class, GLE/PIB was the most prevalent (7.3%), followed by SOF/VEL/VOX (6.4%), and SOF/VEL (1.8%) for non-cirrhosis and compensated cirrhosis patients;and no red DDI occurred in decompensated cirrhosis patients. In addition, the percentage of patients without potential DDIs was higher with SOF/VEL (79.8%) than with the other regimens. The potential red DDIs were predominantly with lipid-lowering agents for DAAs. For potential red DDI class with COVID-19 infection antivirals, Nirmatrelvir/Ritonavir was the most prevalent (6%), followed by Remdesivir (0.9%), and no potential DDIs with Molnupiravir. For COVID-19 antivirals, the potential red DDIs was mainly with central nervous system drugs. Finally, the actual incidence of DDIs during DAAs treatment showed no red DDI occurred for all patients, and GLE/PIB was the most prevalent (93%) of no potential DDIs. Conclusion(s): The potential DDIs between these comedications differed, with the most potential DDIs occurring with GLE/PIB and Nirmatrelvir/Ritonavir. After careful assessment of comedications and their potential DDIs, the actual incidence of DDIs could be reduced, and optimize safety in real-world practice.

REACTOGENICITY AMONG PEOPLE LIVING WITH HIV AFTER mRNA-1273 VACCINE IN UBUNTU STUDY

Background: The tolerability of mRNA COVID-19 vaccines among people living with HIV (PLWH) has been understudied in vaccine trials. CoVPN 3008 (Ubuntu) is the largest multicenter Phase 3 efficacy trial of mRNA vaccines in sub-Saharan Africa. Method(s): We enrolled adults age >=18 years living with HIV or another comorbidity associated with severe COVID-19. Previously vaccinated individuals were excluded. Baseline testing included HIV, CD4 count and HIV viral load (VL) (if HIV+), anti-SARS-CoV-2 antibodies, and nasal swab SARS-CoV-2 nucleic acid amplification test (NAAT). All participants receive vaccinations at months 0 and 6, and SARS-CoV-2 seronegative individuals also receive vaccination at month 1. This analysis includes mRNA-1273 vaccinations at months 0 and 1. Reactogenicity (solicited adverse events [AEs]) was assessed among a representative subset of participants (Safety Subset, SS) for 7 days post-vaccination. Baseline characteristics associated with moderate/severe reactogenicity events were assessed by univariate and multivariate logistic regression. Result(s): 14002 participants were enrolled in the trial (1510 into the SS) at 46 sites from 2 Dec 2021 to 9 Sep 2022. At baseline in the SS, 71% (1065) were female, median age 38 years (IQR 32-46), and median BMI 25.0 (IQR 20.7-30.2). 73% (1108) were SARS-CoV-2 seropositive, and 8.7% (131) had a positive nasal NAAT swab. 16% (197) had a history of tuberculosis. 84% (1267) were PLWH, with median CD4 count of 614 cells/muL (IQR 414-861);7.8% had CD4 count < 200. 21% (238) had detectable HIV VL (>=50 copies/mL), with median VL 1660 (IQR 182-23932). 14% (172/1262) and 12% (64/542) of PLWH reported moderate/severe reactogenicity after the 1st and 2nd vaccination (Figure), with no hospitalizations. Female PLWH and CD4 count >500 had 35% (p=0.03) and 44% (p=0.04) increased odds of moderate/severe reactogenicity, respectively. Other baseline characteristics were not associated with the odds of reporting moderate/severe reactogenicity among PLWH after 1st vaccination. Similar trends were seen after the 2nd vaccination, but none reached statistical significance. In multivariate models, female sex remained associated with increased odds of moderate/severe reactogenicity after the 2nd vaccination. Conclusion(s): Similar to observations in HIV-negative populations, mRNA-1273 was well tolerated by PLWH with more reactogenicity in females. Impaired inflammatory responses among participants with CD4 counts < 500 cell/muL may explain less moderate/severe reactions.

Comparison of the Effectiveness of Different Covid-19 Vaccines among Plwh

Background: Previous studies have demonstrated promising serologic responses in PLWH receiving a third dose of vaccine against SARS-CoV-2. However, real-world clinical effectiveness, especially during the pandemic caused by B.1.1.529 variant, remains less investigated. Method(s): PLWH seeking HIV care at our hospital from 2021/6 to 2022/6 were included and advised to receive the third dose of COVID-19 vaccine. Individuals were excluded from this study if they had been previously diagnosed with COVID-19. Different types of COVID-19 vaccines were available in the vaccination program, including BNT162b2, mRNA-1273 (either 50 or 100 mug), MVC-COV1901 and NVX-CoV2373 vaccines. PLWH were screening for the occurrence of COVID-19 through the reporting system of notifiable diseases of Taiwan CDC, and were tested for anti-nucleocapsid (anti-N) IgG every 1 to 3 months. Participants were followed for 180 days until the fourth dose of COVID-19 vaccination, occurrence of SARS-CoV-2 infection, seroconversion of anti-N IgG, death, or loss to follow-up, whichever occurred first. Result(s): 1,496 PLWH were included: 631 (42.2%) receiving 100 mug mRNA-1273 vaccine, 468 (31.3%) 50 mug mRNA-1273 vaccine, and 328 (21.9%) BNT162b2 vaccine, 65 (4.3%) MVC-COV1901 vaccine, and 4 (0.3%) NVX-CoV2373 vaccine for the third dose of SARS-CoV-2 vaccination. 297 (19.9%) PLWH were diagnosed with COVID-19 during the follow-up period, including 92 (14.6%) who received 100 mug mRNA-1273, 111 (23.7%) 50 mug mRNA-1273, 79 (24.1%) BNT162b2 and 15 (21.7%) either MVC-COV1901 or NVX-CoV2373;in addition, 98 PLWH had seroconversion of anti-N IgG during follow-up, including 23, 50, 19 and 6 PLWH who received 100 mug mRNA-1273, 50 mug mRNA-1273, BNT162b2, and either MVC-COV1901 or NVX-CoV2373, respectively. Similar rates of new infection with SARS-CoV-2 or seroconversion of anti-N IgG were demonstrated regardless the vaccine type of the third dose (log-rank test, p=0.46). Factors associated with a diagnosis of SARS-CoV-2 infection and seroconversion of anti-N IgG included an age >50 years (aOR, 0.67;95% CI, 0.49-0.91) and newly infected with hepatitis C virus (HCV) (aOR, 1.41;95% CI, 1.09-1.83). Conclusion(s): Our study demonstrated that clinical effectiveness of the third dose of different vaccines available to PLWH was similar in preventing SARSCoV- 2 infection or seroconversion of anti-N IgG Taiwan. PLWH aged less than 50 years and those with newly diagnosed HCV infection were at higher risk of acquiring COVID-19. Kaplan-Meier survival curve for acquiring COVID-19 or seroconversion of anti-N IgG in PLWH receiving different COVID-19 vaccination of the third dose (log-rank test, 4 groups, p = 0.46).

NF-Heart: A Near-field Non-contact Continuous User Authentication System via Ballistocardiogram

The increasingly remote workforce resulting from the global coronavirus pandemic has caused unprecedented cybersecurity concerns to organizations. Considerable evidence has shown that one-pass authentication fails to meet security needs when the workforce work from home. The recent advent of continuous authentication (CA) has shown the potential to solve this predicament. In this paper, we propose NF-Heart, a physiological-based CA system utilizing a ballistocardiogram (BCG). The key insight is that the BCG measures the body's micro-movements produced by the recoil force of the body in reaction to the cardiac ejection of blood, and we can infer cardiac biometrics from BCG signals. To measure BCG, we deploy a lightweight accelerometer on an office chair, turning the common chair into a smart continuous identity "scanner". We design multiple stages of signal processing to decompose and transform the distorted BCG signals so that the effects of motion artifacts and dynamic variations are eliminated. User-specific fiducial features are then extracted from the processed BCG signals for authentication. We conduct comprehensive experiments on 105 subjects in terms of verification accuracy, security, robustness, and long-term availability. The results demonstrate that NF-Heart achieves a mean balanced accuracy of 96.45% and a median equal error rate of 3.83% for CA. The proposed signal processing pipeline is effective in addressing various practical disturbances.

CRISIS: Cyber-Physical Social Distancing Based on Multi-Modal Data From Mobile Devices

Multi-modal sensors on mobile devices (e.g., smart watches and smartphones) have been widely used to ubiquitously perceive human mobility and body motions for understanding social interactions between people. This work investigates the correlations between the multi-modal data observed by mobile devices and social closeness among people along their trajectories. To close the gap between cyber-world data distances and physical-world social closeness, this work quantifies the cyber distances between multi-modal data. The human mobility traces and body motions are modeled as cyber signatures based on ambient Wi-Fi access points and accelerometer data observed by mobile devices that explicitly indicate the mobility similarity and movement similarity between people. To verify the merits of modeled cyber distances, we design the localization-free CybeR-physIcal Social dIStancing (CRISIS) system that detects if two persons are physically non-separate (i.e., not social distancing) due to close social interactions (e.g., taking similar mobility traces simultaneously or having a handshake with physical contact). Extensive experiments are conducted in two small-scale environments and a large-scale environment with different densities of Wi-Fi networks and diverse mobility and movement scenarios. The experimental results indicate that our approach is not affected by uncertain environmental conditions and human mobility with an overall detection accuracy of 98.41% in complex mobility scenarios. Furthermore, extensive statistical analysis based on 2-dimensional (2D) and 3-dimensional (3D) mobility datasets indicates that the proposed cyber distances are robust and well-synchronized with physical proximity levels. © 2002-2012 IEEE.

The effect of major public emergencies on technology-based SMEs: Survival crisis and relief paths

This paper explores the impact of major unexpected public event on the survivability of technology-based small and medium-sized enterprises and the role of external support policies and internal adjustment strategies in mitigating the shock. Using data on Growth Enterprise Market listed companies for 2018–2021, we found that COVID-19 outbreaks caused severe survival pressure on technology-based SMEs, which we see mainly in the reduction of development capacity, operation capacity, profitability, and debt servicing capacity. Additionally, we find that both external support policies and internal adjustment strategies can effectively mitigate the negative impact of COVID-19 on the viability of technology-based SMEs. © 2023 Elsevier Inc.

Fake news in a time of plague: Exploring individuals' online information management in the COVID-19 era

Online health information is critical during pandemics. Previous research has focused on examining antecedents or consequences of particular information behaviors (e.g., seeking, sharing), but the process by which one information behavior influences or transforms into other information behaviors remains poorly understood. Guided by theories of information behavior and the literature on online misinformation, this study proposes an interaction model of online information behaviors that theorizes relationships among online information scanning, misinformation exposure, misinformation elaboration, information sharing, and information avoidance. Conducting a two-wave representative panel survey in Hong Kong during the COVID-19 pandemic (N = 1501), we found that online information scanning at Wave 1 had a direct, positive impact on misinformation exposure and information sharing at Wave 2, while it did not have an impact on information avoidance at Wave 2. Additionally, misinformation exposure was positively related to both information sharing and information avoidance at Wave 2. Importantly, we underlined that evaluations of crisis-related misinformation are aided by misinformation elaboration, which plays a moderating role in catalyzing appropriate information behaviors. Results of this study could help scholars and practitioners propose evidence-based interventions for enhancing the public's ability to manage crisis information on the Internet in times of heightened uncertainty. © 2023 Elsevier Ltd

This work was supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under award number P50NS108676 and Moore Foundation

The increasingly remote workforce resulting from the global coronavirus pandemic has caused unprecedented cybersecurity concerns to organizations. Considerable evidence has shown that one-pass authentication fails to meet security needs when the workforce work from home. The recent advent of continuous authentication (CA) has shown the potential to solve this predicament. In this paper, we propose NF-Heart, a physiological-based CA system utilizing a ballistocardiogram (BCG). The key insight is that the BCG measures the body's micro-movements produced by the recoil force of the body in reaction to the cardiac ejection of blood, and we can infer cardiac biometrics from BCG signals. To measure BCG, we deploy a lightweight accelerometer on an office chair, turning the common chair into a smart continuous identity "scanner". We design multiple stages of signal processing to decompose and transform the distorted BCG signals so that the effects of motion artifacts and dynamic variations are eliminated. User-specific fiducial features are then extracted from the processed BCG signals for authentication. We conduct comprehensive experiments on 105 subjects in terms of verification accuracy, security, robustness, and long-term availability. The results demonstrate that NF-Heart achieves a mean balanced accuracy of 96.45% and a median equal error rate of 3.83% for CA. The proposed signal processing pipeline is effective in addressing various practical disturbances. © 2023 ACM.

Delicious promoter of the restaurant business: measuring impact of supply chain, brand personality and CSR on brand equity development

Purpose: The purpose of this study was to discuss the importance of customer-based brand equity (CBBE) and identify the critical attributes of how to develop CBBE during the most difficult time of the COVID-19 pandemic. Design/methodology/approach: This study collected 386 restaurant managers' viewpoints to examine the mutual relationships among CBBE and other critical attributes of corporate social responsibility (CSR), electronic word of mouth (EWOM) and brand personality. Furthermore, structural equation modeling (SEM) was conducted to examine the proposed moderation and mediation hypotheses. Findings: The results show that corporate social responsibility (CSR) mediates the relationship between brand personality and brand image. Furthermore, the mutual relationship among CBBE is discovered in that brand image may indirectly affect brand loyalty through perceived quality and brand awareness. Furthermore, with the reliance on social media, the moderating roles of electronic word of mouth (EWOM) are also revealed that strengthen the indirect effect of brand personality on brand awareness through CSR and brand image. Originality/value: With the increasing attention to CBBE, which aims at tourism destination brand equity, hotel branding from the customer perspective, restaurant managers' viewpoints are not considered. Further, because of the impacts of the COVID-19 pandemic, customers are paying more attention to food safety and food delivery processes, which are important for CSR and connected to CBBE. However, until now, fewer studies have addressed these issues as such. The present study reflects the bidirectional effects of such a comprehensive viewpoint. © 2023, Emerald Publishing Limited.