The reliability and integrity of overall survival data based on follow-up records only and potential solutions to the challenges

Overall survival (OS) is considered the standard clinical endpoint to support effectiveness claims in new drug applications globally, particularly for lethal conditions such as cancer. However, the source and reliability of OS in the setting of clinical trials have seldom been doubted and discussed. This study first raised the common issue that data integrity and reliability are doubtful when we collect OS information or other time-to-event endpoints based solely on simple follow-up records by investigators without supporting material, especially since the 2019 COVID-19 pandemic. Then, two rounds of discussions with 30 Chinese experts were held and 12 potential source scenarios of three methods for obtaining the time of death of participants, including death certificate, death record and follow-up record, were sorted out and analysed. With a comprehensive assessment of the 12 scenarios by legitimacy, data reliability, data acquisition efficiency, difficulty of data acquisition, and coverage of participants, both short-term and long-term recommended sources, overall strategies and detailed measures for improving the integrity and reliability of death date are presented. In the short term, we suggest integrated sources such as public security systems made available to drug inspection centres appropriately as soon as possible to strengthen supervision. Death certificates provided by participants' family members and detailed standard follow-up records are recommended to investigators as the two channels of mutual compensation, and the acquisition of supporting materials is encouraged as long as it is not prohibited legally. Moreover, we expect that the sharing of electronic medical records and the legal disclosure of death records in established health registries can be realized with the joint efforts of the whole industry in the long-term. The above proposed solutions are mainly based on the context of China and can also provide reference for other countries in the world. © 2022 The Authors

[Advances in epidemiology, etiology, and treatment of community-acquired pneumonia].

Community-acquired pneumonia (CAP) is the third leading cause of death worldwide and one of the most commonly infectious diseases. Its epidemiological characteristics vary with host and immune status, and corresponding pathogen spectrums migrate over time and space distribution. Meanwhile, with the outbreak of COVID-19, some unconventional treatment strategies are on the rise. This article reviewed the epidemiological characteristics, pathogen spectrum and treatment direction of CAP in China over the years, and aimed to provide guidance for the diagnosis and treatment of CAP in clinical practice.

Visual method of analyzing COVID-19 case information using spatio-temporal objects with multi-granularity

Coronavirus disease 2019 (COVID-19) is continuing to spread globally and still poses a great threat to human health. Since its outbreak, it has had catastrophic effects on human society. A visual method of analyzing COVID-19 case information using spatio-temporal objects with multi-granularity is proposed based on the officially provided case information. This analysis reveals the spread of the epidemic, from the perspective of spatio-temporal objects, to provide references for related research and the formulation of epidemic prevention and control measures. The case information is ed, descripted, represented, and analyzed in the form of spatio-temporal objects through the construction of spatio-temporal case objects, multi-level visual expressions, and spatial correlation analysis. The rationality of the method is verified through visualization scenarios of case information statistics for China, Henan cases, and cases related to Shulan. The results show that the proposed method is helpful in the research and judgment of the development trend of the epidemic, the discovery of the transmission law, and the spatial traceability of the cases. It has a good portability and good expansion performance, so it can be used for the visual analysis of case information for other regions and can help users quickly discover the potential knowledge this information contains. © 2021, Science in China Press.

ONLINE LEARNING READINESS AND SATISFACTION DURING COVID-19 PANDEMIC AMONG UNIVERSITY STUDENTS IN FOUR ASIAN COUNTRIES

Background and Purpose: Online learning has become a new norm to higher education institutions in the developing countries since COVID-19 pandemic. An overnight shift from conventional physical learning to online learning in this pandemic moment has posed a major challenge to most of the educational institutions. Student's readiness and satisfaction towards online learning activities are important to ensure the effectiveness of this new learning method. Therefore, this study aims to examine the online learning readiness and satisfaction among the university students from four Asian countries during COVID-19 pandemic. The domains of the examinations included student learning preference, self-direction, self-efficacy, and hardware-soft skill support. Methodology: This survey research employed a quantitative approach to gather data. The sample respondents were 1,195 university students from Thailand, Malaysia, Indonesia, and China, selected using a simple random sampling method. Online questionnaires were distributed to the respondents, comprising 37 items including demographic profiles, satisfaction, and online learning readiness assessment. The survey responses were analysed descriptively and inferentially using the Statistical Package for Social Sciences (SPSS) version 21.0. Findings: Results showed that 74.7% of the participants had a middle level of online learning readiness, and only 20.1% had high online learning readiness. The levels of online learning readiness varied among the participating countries. The participants lacked online learning preference, as shown in the lower mean scores compared to the means of self-direction, self-efficacy, and hardware-soft skill supports. For satisfaction, students reflected that online course required improvement, as observed in only 31% satisfaction with the online learning courses provided. The results also revealed that there was a significant positive correlation (r=.383) between online learning readiness and students' satisfaction. Contributions: This study provides preliminary insights into the preparedness of online learning in higher educational institutions in the Asian countries. It implies a potential disruptive impact on the educational system during the pandemic. Such perspectives are crucial for educators to understand students' readiness and perceptions as a means of providing more effective online courses.

Genera of phytopathogenic fungi: GOPHY 4.

This paper is the fourth contribution in the Genera of Phytopathogenic Fungi (GOPHY) series. The series provides morphological descriptions and information about the pathology, distribution, hosts and disease symptoms, as well as DNA barcodes for the taxa covered. Moreover, 12 whole-genome sequences for the type or new species in the treated genera are provided. The fourth paper in the GOPHY series covers 19 genera of phytopathogenic fungi and their relatives, including Ascochyta, Cadophora, Celoporthe, Cercospora, Coleophoma, Cytospora, Dendrostoma, Didymella, Endothia, Heterophaeomoniella, Leptosphaerulina, Melampsora, Nigrospora, Pezicula, Phaeomoniella, Pseudocercospora, Pteridopassalora, Zymoseptoria, and one genus of oomycetes, Phytophthora. This study includes two new genera, 30 new species, five new combinations, and 43 typifications of older names. Taxonomic novelties: New genera: Heterophaeomoniella L. Mostert, C.F.J. Spies, Halleen & Gramaje, Pteridopassalora C. Nakash. & Crous; New species: Ascochyta flava Qian Chen & L. Cai, Cadophora domestica L. Mostert, R. van der Merwe, Halleen & Gramaje, Cadophora rotunda L. Mostert, R. van der Merwe, Halleen & Gramaje, Cadophora vinacea J.R. Úrbez-Torres, D.T. O'Gorman & Gramaje, Cadophora vivarii L. Mostert, Havenga, Halleen & Gramaje, Celoporthe foliorum H. Suzuki, Marinc. & M.J. Wingf., Cercospora alyssopsidis M. Bakhshi, Zare & Crous, Dendrostoma elaeocarpi C.M. Tian & Q. Yang, Didymella chlamydospora Qian Chen & L. Cai, Didymella gei Qian Chen & L. Cai, Didymella ligulariae Qian Chen & L. Cai, Didymella qilianensis Qian Chen & L. Cai, Didymella uniseptata Qian Chen & L. Cai, Endothia cerciana W. Wang. & S.F. Chen, Leptosphaerulina miscanthi Qian Chen & L. Cai, Nigrospora covidalis M. Raza, Qian Chen & L. Cai, Nigrospora globospora M. Raza, Qian Chen & L. Cai, Nigrospora philosophiae-doctoris M. Raza, Qian Chen & L. Cai, Phytophthora transitoria I. Milenkovic, T. Májek & T. Jung, Phytophthora panamensis T. Jung, Y. Balci, K. Broders & I. Milenkovic, Phytophthora variabilis T. Jung, M. Horta Jung & I. Milenkovic, Pseudocercospora delonicicola C. Nakash., L. Suhaizan & I. Nurul Faziha, Pseudocercospora farfugii C. Nakash., I. Araki, & Ai Ito, Pseudocercospora hardenbergiae Crous & C. Nakash., Pseudocercospora kenyirana C. Nakash., L. Suhaizan & I. Nurul Faziha, Pseudocercospora perrottetiae Crous, C. Nakash. & C.Y. Chen, Pseudocercospora platyceriicola C. Nakash., Y. Hatt, L. Suhaizan & I. Nurul Faziha, Pseudocercospora stemonicola C. Nakash., Y. Hatt., L. Suhaizan & I. Nurul Faziha, Pseudocercospora terengganuensis C. Nakash., Y. Hatt., L. Suhaizan & I. Nurul Faziha, Pseudocercospora xenopunicae Crous & C. Nakash.; New combinations: Heterophaeomoniella pinifoliorum (Hyang B. Lee et al.) L. Mostert, C.F.J. Spies, Halleen & Gramaje, Pseudocercospora pruni-grayanae (Sawada) C. Nakash. & Motohashi., Pseudocercospora togashiana (K. Ito & Tak. Kobay.) C. Nakash. & Tak. Kobay., Pteridopassalora nephrolepidicola (Crous & R.G. Shivas) C. Nakash. & Crous, Pteridopassalora lygodii (Goh & W.H. Hsieh) C. Nakash. & Crous; Typification: Epitypification: Botrytis infestans Mont., Cercospora abeliae Katsuki, Cercospora ceratoniae Pat. & Trab., Cercospora cladrastidis Jacz., Cercospora cryptomeriicola Sawada, Cercospora dalbergiae S.H. Sun, Cercospora ebulicola W. Yamam., Cercospora formosana W. Yamam., Cercospora fukuii W. Yamam., Cercospora glochidionis Sawada, Cercospora ixorana J.M. Yen & Lim, Cercospora liquidambaricola J.M. Yen, Cercospora pancratii Ellis & Everh., Cercospora pini-densiflorae Hori & Nambu, Cercospora profusa Syd. & P. Syd., Cercospora pyracanthae Katsuki, Cercospora horiana Togashi & Katsuki, Cercospora tabernaemontanae Syd. & P. Syd., Cercospora trinidadensis F. Stevens & Solheim, Melampsora laricis-urbanianae Tak. Matsumoto, Melampsora salicis-cupularis Wang, Phaeoisariopsis pruni-grayanae Sawada, Pseudocercospora angiopteridis Goh & W.H. Hsieh, Pseudocercospora basitruncata Crous, Pseudocercospora boehmeriigena U. Braun, Pseudocercospora coprosmae U. Braun & C.F. Hill, Pseudocercospora cratevicola C. Nakash. & U. Braun, Pseudocercospora cymbidiicola U. Braun & C.F. Hill, Pseudocercospora dodonaeae Boesew., Pseudocercospora euphorbiacearum U. Braun, Pseudocercospora lygodii Goh & W.H. Hsieh, Pseudocercospora metrosideri U. Braun, Pseudocercospora paraexosporioides C. Nakash. & U. Braun, Pseudocercospora symploci Katsuki & Tak. Kobay. ex U. Braun & Crous, Septogloeum punctatum Wakef.; Neotypification: Cercospora aleuritis I. Miyake; Lectotypification: Cercospora dalbergiae S.H. Sun, Cercospora formosana W. Yamam., Cercospora fukuii W. Yamam., Cercospora glochidionis Sawada, Cercospora profusa Syd. & P. Syd., Melampsora laricis-urbanianae Tak. Matsumoto, Phaeoisariopsis pruni-grayanae Sawada, Pseudocercospora symploci Katsuki & Tak. Kobay. ex U. Braun & Crous. Citation: Chen Q, Bakhshi M, Balci Y, Broders KD, Cheewangkoon R, Chen SF, Fan XL, Gramaje D, Halleen F, Horta Jung M, Jiang N, Jung T, Májek T, Marincowitz S, Milenkovic T, Mostert L, Nakashima C, Nurul Faziha I, Pan M, Raza M, Scanu B, Spies CFJ, Suhaizan L, Suzuki H, Tian CM, Tomsovský M, Úrbez-Torres JR, Wang W, Wingfield BD, Wingfield MJ, Yang Q, Yang X, Zare R, Zhao P, Groenewald JZ, Cai L, Crous PW (2022). Genera of phytopathogenic fungi: GOPHY 4. Studies in Mycology 101: 417-564. doi: 10.3114/sim.2022.101.06.

Study on the risk of death of coagulation index in patients with covid-19

Objective: The aim of this study was to elucidate the association of COVID-19 prognosis with the indexes of inflammation and coagulation. Methods: The clinical data of 103 cases of COVID-19 were retrospectively analyzed. COX regression models and 95% confidence intervals (CIs) were applied to estimate the COVID-19 prognosis. Results: The results showed that C-reactive protein (HR=1.007, p<0.001), procalcitonin (HR=1.013, p=0.006), prothrombin time (HR=1.190, p<0.001), Fibrinogen (HR=0.784, p=0.002) and D-dimer (HR=1.078, p<0.001) is associated with an increased risk of COVID-19 death. Among the inflammation indicators, the maximum area under the ROC curve of NLR is 0.87. In the coagulation index, the maximum area under the ROC curve of PT is 0.84. For the combined indicators of inflammation and coagulation, the area under the ROC curve is 0.89. Conclusions: In conclusion, we found that the length of PT at admission and the level of fibrinogen and D-dimer were related to the risk of COVID-19 death. It may be considered to jointly predict the risk of death of COVID-19 with inflammation and coagulation indicators. © 2021 A. CARBONE Editore. All rights reserved.

Establishment of prediction models for COVID-19 patients in different age groups based on Random Forest algorithm.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has rapidly become a global pandemic. Age is an independent factor in death from the disease, and predictive models to stratify patients according to their mortality risk are needed. AIM: To compare the laboratory parameters of the younger (≤70) and the elderly (>70) groups, and develop death prediction models for the two groups according to age stratification. DESIGN: A retrospective, single-center observational study. METHODS: This study included 437 hospitalized patients with laboratory-confirmed COVID-19 from Tongji Hospital in Wuhan, China, 2020. Epidemiological information, laboratory data and outcomes were extracted from electronic medical records and compared between elderly patients and younger patients. First, recursive feature elimination (RFE) was used to select the optimal subset. Then, two random forest (RF) algorithms models were built to predict the prognoses of COVID-19 patients and identify the optimal diagnostic predictors for patients' clinical prognoses. RESULTS: Comparisons of the laboratory data of the two age groups revealed many different laboratory indicators. RFE was used to select the optimal subset for analysis, from which 11 variables were screened out for the two groups. The RF algorithm were built to predict the prognoses of COVID-19 patients based on the best subset, and the area under ROC curve (AUC) of the two groups is 0.874 (95% CI: 0.833-0.915) and 0.842 (95% CI: 0.765-0.920). CONCLUSION: Two prediction models for COVID-19 were developed in the patients with COVID-19 based on random forest algorithm, which provides a simple tool for the early prediction of COVID-19 mortality.

Original Article A cluster of health care workers with COVID-19 pneumonia caused by SARS-CoV-2

Background: The current outbreak of coronavirus disease 2019 (COVID-19) caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, Hubei, China, spreads across national and international borders. Methods: We prospectively collected medical records of 14 health care workers (HCWs) who were infected with SARS-CoV-2, in neurosurgery department of Wuhan Union Hospital, China. Results: Among the 14 HCWs, 12 were conformed cases, the other 2 were suspected cases. Most of them were either exposed to the two index patients or infected coworkers, without knowing they were COVID-19 patients. There were 4 male and 10 female infected HCWs in this cohort, whose mean age was 36 years (SD, 6 years). The main symptoms included myalgia or fatigue (100%), fever (86%) and dry cough (71%). On admission, 79% of infected HCWs showed leucopenia and 43% lymphopenia. Reduced complement C3 could be seen in 57% of the infected HCWs and IL-6 was significantly elevated in 86% of them. The proportion of lymphocytes subsets, concentrations of immunoglobulins, complement C4, IL-2, IL-4, IL-10, TNF-a and IFN-g were within normal range in these 14 infected HCWs. The most frequent findings on pulmonary computed tomographic images were bilateral multifocal ground-glass opacifications (86%).

Advances in the bioinspired olfactory sensing technology for screening of olfactory dysfunction

The mammalian olfactory system enables to sense and distinguish a large number of odors, which is essential to find food, avoid predators, communicate and reproduce, while the human olfactory system can even avoid potential hazard by discriminating the smell quality. Olfactory dysfunction is a common disease symptom which seriously affects the life quality of patients. In addition, many studies have revealed that olfactory dysfunction can also indicate many other potential diseases, such as neurodegenerative diseases and mental diseases. Olfactory dysfunction is an early common symptom of a variety of diseases, such as inflammation, viral infection, neurodegenerative diseases, and the current epidemic of COVID-19. Researchers have indicated that some patients with certain diseases already have suffered from symptoms of olfactory dysfunction early in the clinic. For instance, one of the early clinical symptoms of SARS-CoV-2 virus infection is the loss of smell. Besides, patients suffered from Alzheimer's disease and Parkinson's disease usually have an increased threshold of olfactory perception and even endure anosmia. Therefore, research on early screening and diagnosis of dysosmia diseases on the basis of olfactory function detection is of great significance to control and slow the disease's progression and to improve the health of human body. At present, olfactory function detection technologies mainly contain olfactory neuropsychological testing, electrophysiological detection, olfaction system structure or functional imaging, etc. Although these technologies have played an important role in the study of dysosmia, there have been no standardized detection indicators established so far. Therefore, the establishment and improvement of early olfactory dysfunction disease diagnosis technology based on the detection of olfactory function requires a novel approach in principle and technology. By utilizing the bionic olfactory sensing technologies such as bioelectronic noses, the olfactory analog sensing system with high sensitivity, high specificity and short response time, and even simulating biological olfactory systems, can be expected to be realized. Based on the current understanding of the mechanism of olfactory dysfunction, our team is committed to breaking through the traditional odor-induced olfactory function detection method. By combining with the bionic olfactory perception technology, three original methods which include olfactory neural network chip, organoid chip and neural interactive olfaction detection technology have been proposed. These three technologies essentially construct and simulate the olfactory nervous system in vitro or in vivo, by means of the sensing technique to detect physiological signals changes that correspond with the alternations in the nervous system. However, the difficulties currently lie in how to determine the characteristic physiological signal, and how to establish the correlation between the characteristic signals and the degree of dysosmia for the ultimate goal of further screening the olfactory dysfunction related diseases through the detection parameters. The clarification of these difficulties and in-depth progress of research will promote the innovation and development of olfactory function detection technology, and provide reliable theoretical technical support and experimental basis. This review comprehensively interpreted the current research status of dysosmia diseases, as well as analyzed the principles of bionic olfactory perception technology and its research progress in the detection and diagnosis of dysosmia and related diseases. With the development of multidisciplinary intersection in the field of biomedical engineering, the transformation and application of cell network chips, organoid bionic chips and braincomputer interaction technology will promote the progress of bionic olfactory perception technology in the research of olfactory dysfunction diseases and the innovation of clinical diseases diagnosis. © 2021, Science Press. All right reserved.

Geotechnical and geoenvironmental engineering education during the pandemic

This paper reports the impact of coronavirus disease 2019 on the practice and delivery of geotechnical and geoenvironmental engineering (GGE) education modules, including lectures, lab sessions, student assessments and research activities, based on the feedback from faculty members in 14 countries/regions around the world. Faculty members have since adopted a series of contingent measures to enhance teaching and learning experience during the pandemic, which includes facilitating active learning, exploring new teaching content related to public health, expanding e-learning resources, implementing more engaged and student-centred assessment and delivering high-impact integrated education and research. The key challenges that faculty members are facing appear to be how to maximise the flexibility of learning and meet physical distancing requirements without compromising learning outcomes, education equity and interpersonal interactions in the traditional face-to-face teaching. Despite the challenges imposed by the pandemic, this could also be a good opportunity for faculty members obliged to lecture, to rethink and revise the existing contents and approaches of professing GGE education. Three future opportunities namely, smart learning, flipped learning and interdisciplinary education, are identified. The changes could potentially provide students with a more resilient, engaged, interactive and technology-based learning environment. © 2021 ICE Publishing: All rights reserved.

Environmental geotechnics: Challenges and opportunities in the post-Covid-19 world

The outbreak of the coronavirus disease 2019 (Covid-19) pandemic not only has created a health crisis across the world but is also expected to impact negatively the global economy and societies at a scale that is maybe larger than that of the 2008 financial crisis. Simultaneously, it has inevitably exerted many negative consequences on the geoenvironment on which human beings depend. The current paper articulates the role of environmental geotechnics in elucidating and mitigating the effects of the current pandemic. It is the belief of all authors that the Covid-19 pandemic presents not only significant challenges but also opportunities for the development of the environmental geotechnics field. This discipline should make full use of geoenvironmental researchers' and engineers' professional skills and expertise to look for development opportunities from this crisis, to highlight the irreplaceable position of the discipline in the global fight against pandemics and to contribute to the health and prosperity of communities, to serve humankind better. In order to reach this goal while taking into account the specificity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the uncertainty of its environmental effects, it is believed that more emphasis should be placed on the following research directions: pathogen-soil interactions;isolation and remediation technologies for pathogen-contaminated sites;new materials for pathogen-contaminated soil;recycling and safe disposal of medical wastes;quantification of uncertainty in geoenvironmental and epidemiological problems;emerging technologies and adaptation strategies in civil, geotechnical and geoenvironmental infrastructures;pandemic-induced environmental risk management;and modelling of pathogen transport and fate in geoenvironment, among others. Moreover, Covid-19 has made it clear to the environmental geotechnics community the importance of urgent international co-operation and of multidisciplinary research actions that must extend to a broad range of scientific fields, including medical and public health disciplines, in order to meet the complexities posed by the Covid-19 pandemic. © 2021 ICE Publishing: All rights reserved.

Analysis of the factors associated with negative conversion of severe acute respiratory syndrome coronavirus 2 rna of coronavirus disease 2019

AIM: To understand the factors associated with negative conversion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA, targeted surveillance and control measures can be taken to provide scientific basis for the treatment of the disease and to improve the prognosis of the disease. METHODS: Using the method of retrospective cohort study, we collected the data of Coronavirus Disease 2019 (COVID-19) patients in Tongji Hospital of Wuhan, China from 10 January to 25 March, 2020. Among the data of 282 cases, 271 patients, according to whether the negative conversion happened, were divided into negative conversion group and control group. We made the quantitative variables into classification;Chi-square test single-factor and Cox regression were used in univariate analysis and extracted 30 meaningful variables, then through the collinearity diagnosis, excluded the existence of collinear variables. Finally, 22 variables were included in Cox regression analysis. RESULTS: The gender distribution was statistically significant between two groups (p < 0.05). While in the negative conversion group, the patients of non-severe group occupied a large proportion (p < 0.001). The median time for the negative conversion group was 17 days, and at the end of the observation period, the virus duration in control group was 24 days (p < 0.05). A total of 55 variables were included in univariate analysis, among which 30 variables were statistically different between the two groups. After screening variables through collinearity diagnosis, 22 variables were included in the Cox regression analysis. Last, lactate dehydrogenase (LDH), age, fibrinogen (FIB), and disease severity were associated with negative conversion of SARS-CoV-2 RNA. CONCLUSION: Our results suggest that in the treatment of COVID-19, focus on the age of more than 65 years old, severe, high level of LDH, FIB patients, and take some targeted treatment, such as controlling of inflammation, reducing organ damage, so as to provide good conditions for virus clearance in the body.

Transportation Activity Patterns of Chinese Population during the COVID-19 Epidemic

In order to understand the travel frequency and transportation modes of the Chinese population during the COVID-19 epidemic, the travel information of 8330 residents in 31 provinces from February 25th to March 14th, 2020 was collected, and the factors influencing the travel frequency and transportation mode were analyzed. According to the severity of the epidemic, 31 provinces were classified, and the difference in residents' transportation modes under different grades were analyzed and compared with those in non-epidemic periods. The results show that: (1) During the COVID-19 epidemic, 75.1% of people had travel activities, among which 5.5% took several trips per day and 17.6% took fewer than one trip per week. Public transportation and taxi with higher risk of infection were chosen by 6.3% and 4.0% of the population, respectively. (2) The travel frequency and transportation modes of Chinese residents during the COVID-19 outbreak may be affected by demographic variables, such as gender, age, urban and rural areas, regions, local or nearby suspected/confirmed cases, and the severity of the epidemic in the provinces. The travel frequency and transportation modes of people in some provinces such as Tibet Autonomous Region and Qinghai Province were less affected by the epidemic, while the travel frequency and transportation modes of residents in Hubei Province changed the most compared with the non-epidemic period. (3) During the COVID-19 epidemic, the proportion of Chinese residents who chose to walk and travel by car (taxi and private car) was much higher than during the non-epidemic period, while the proportion of people who chose public transportation and bicycles or electric bicycle was lower than during the non-epidemic period. This study found that the travel frequency and transportation modes of the Chinese population changed dramatically due to the COVID-19 epidemic. © 2020, Editorial Board, Research of Environmental Sciences. All right reserved.

[Experience in the treatment of burn patients combined with inhalation injury during the epidemic of coronavirus disease 2019].

Objective: To introduce the experience in treating burn patients with inhalation injury during the epidemic of coronavirus disease 2019 (COVID-19). Methods: Six burn patients combined with inhalation injury were hospitalized in Department of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital from February 1 to March 1 in 2020 during the high-incidence period of COVID-19, including 4 males and 2 females, aged 21-63 years, admitted at 2-4 hours after burns, with total burn areas of 1%-20% total body surface area (TBSA) and full-thickness burn areas of 1%-12% TBSA. Among them, 1 case had severe inhalation injury, 2 cases had mild inhalation injury, and 3 cases had moderate inhalation injury. The body temperatures of the patients were normal at the time of admission, with no fever or cough in the past 2 weeks. At admission, chest CT of one patient showed double lower lobes and left upper lobes had multiple slices and slightly high-density shadow of nodules. Chest CT of two patients showed thickening of bilateral lung texture, and the chest CT of remaining patients were normal. After admission, 6 patients were given routine treatment, the medical staffs paid attention to the protection and screened for COVID-19 according to the diagnosis and treatment plan of COVID-19. On post injury day (PID) 1, 3, 6, and 9, vein blood of patients were collected for determination of white blood cell (WBC) count, neutrophil, lymphocyte absolute value, and level of procalcitonin (PCT). Nucleic acid of novel coronavirus was detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction on PID 3 and 6. The temperatures of patients were recorded after admission. The results of chest CT within one week after injury and the prognosis of the patients were recorded. Measurement data distributed normally were expressed as x±s, and measurement data distributed abnormally were expressed as M(P(25), P(75)). Results: (1) On PID 1, 3, 6, and 9, WBC counts of patients were respectively (19.8±3.8)×10(9)/L, (17.2±3.4)×10(9)/L, (13.3±3.1)×10(9)/L, and (11.1±1.6)×10(9)/L, neutrophils of patients were respectively 0.919±0.019, 0.899±0.011, 0.855±0.034, and 0.811±0.035, absolute values of lymphocytes of patients were respectively (0.65±0.18)×10(9)/L, (0.65±0.24)×10(9)/L, (0.91±0.34)×10(9)/L, and (1.23±0.42)×10(9)/L, and PCT values of patients were respectively 0.49 (0.36, 1.64), 0.39 (0.26, 0.73), 0.28 (0.18, 0.33), and 0.12 (0.11, 0.20) ng/mL. The values of WBC and neutrophils of patients were higher than the normal value, showing a downward trend. The absolute values of lymphocyte of patients returned to the normal value from PID 6. The PCT values of patients were higher than the normal value. (2) Nucleic acid test results of novel coronavirus of 6 patients were negative on PID 3 and 6. The temperatures of 6 patients ranged from 36.5 to 38.6 ℃. The typical imaging features of COVID-19 were not found in 6 patients within 1 week after injury by chest CT. After treatment for 14-32 days, 6 patients were cured and discharged. Conclusions: During COVID-19 pandemic, burn patients combined with inhalation injury should be treated under condition of good protection for doctors and nurses. Meanwhile, virus should be actively screened to reduce the risk of COVID-19 infection among doctors and patients.

CT appearances and short-term changes of COVID-19 in subclinical period

Objective: To explore the characteristics and short-term changes of high resolution CT (HRCT) in subclinical stage of COVID-19. Methods: The HRCT images of 17 COVID-19 patients in subclinical stage were analyzed retrospectively in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Wuhan Jinyintan Hospital from January 15 to 31, 2020. There were 4 males and 13 females, age ranged from 25.0 to 51.0 (39.8±7.5) years, who were closely contacted with other COVID-19 patients. The follow-up CT examination was performed within 3 to 6 days after the initial CT examination in all patients. Six patients were treated using anti-virus, anti-inflammation and symptomatic therapy, while the other 11 patients were untreated. The subclinical CT findings and short-term follow-up were analyzed, and the CT changes of short-term follow-up were summarized. Results: The lesions of 17 COVID-19 patients were mainly located at the lower lobes of bilateral lungs (at the left lower lobe in 9 cases and at the right lower lobe in 10 cases in the subclinical stage, at the left lower lobe in 9 cases and at the right lower lobe in 11 cases in the short-term follow-up). The number of involved lung segments increased from 46 in the subclinical stage to 90 in the short-term follow-up. In the subclinical stage, the multiple lesions were found in 13 cases, while in the short-term follow-up, the number of cases with multiple lesions decreased by 7, however the cases with focal lesions increased by 6 and diffuse lesions by 4. The lesions were mainly distributed under the pleura (13 cases) or along the bronchovascular bundle(10 cases). In the short-term follow-up, the lesion in 1 case expanded from the subpleural area to neighbouring bronchovascular bundle. There were 3 main types of the lesions, including ground glass nodule, ground glass opacity and crazy-paving pattern. In the subclinical stage and short-term follow-up, the ground glass opacities were seen in all the 17 cases. In the short-term follow-up, the number of cases with ground glass nodules decreased by 4 and crazy-paving pattern increased by 4. In 6 patients after treatment, the multiple ground glass nodules became single one in 3 cases, and in other 3 cases the multiple ground glass opacities were getting smaller. However, the scope of lesions in 11 patients without treatment enlarged. Conclusion: The HRCT features of the COVID-19 in subcilincal stage have some charicteristics, such as small ground glass nodule, ground glass opacity along the subpleural area or along the bronchovascular bundle, and the great changes can be seen in the short-term follow-up.