Telemedicine's Impact on Diabetes Care during the COVID-19 Pandemic: A Cohort Study in a Large Integrated Healthcare System (preprint)

Introduction: To examine if patients exposed to primary care telemedicine (telephone or video) early in the COVID-19 pandemic had higher rates of downstream HbA1c measurement and improved HbA1c levels in the second year of the pandemic. Research Design and Methods In a cohort of 242, 848 Kaiser Permanente Northern California patients with diabetes, we examined associations between early-pandemic patient-initiated telemedicine visit and downstream HbA1c monitoring and results during the second year of the pandemic. Results Adjusted HbA1c measurement rates were significantly higher among patients with telemedicine exposure in the early-pandemic prior year than those with no visits in the prior year (91.0% testing for patients with video visits, 90.5% for telephone visits, visits, 86.7% for no visits, p < 0.05). Among those with HbA1c measured, the rates of having an HbA1c < 8% in the second year of the COVID-19 pandemic were also statistically significantly higher among patients with telemedicine exposure in the early-pandemic prior year than those with no visits in the prior year (68.5% with HbA1c< 8% for video visits, 67.3% for telephone visits, 66.6% for no visits, p < 0.05). Conclusions Access to telephone and video telemedicine throughout the early COVID-19 pandemic was associated with patients' continued engagement in recommended diabetes care. Although our study analyzed telemedicine use during a pandemic, telemedicine visits may continue to support ongoing health care access and positive clinical outcomes.

Descriptive Knowledge Graph in Biomedical Domain (preprint)

We present a novel system that automatically extracts and generates informative and descriptive sentences from the biomedical corpus and facilitates the efficient search for relational knowledge. Unlike previous search engines or exploration systems that retrieve unconnected passages, our system organizes descriptive sentences as a relational graph, enabling researchers to explore closely related biomedical entities (e.g., diseases treated by a chemical) or indirectly connected entities (e.g., potential drugs for treating a disease). Our system also uses ChatGPT and a fine-tuned relation synthesis model to generate concise and reliable descriptive sentences from retrieved information, reducing the need for extensive human reading effort. With our system, researchers can easily obtain both high-level knowledge and detailed references and interactively steer to the information of interest. We spotlight the application of our system in COVID-19 research, illustrating its utility in areas such as drug repurposing and literature curation.

The impact of maternal work-family conflict on problem behaviors among preschoolers during the COVID-19 epidemic: A moderated mediation model of maternal anxiety and trait mindfulness (preprint)

Background: Work-family conflict (WFC) can increase maternal anxiety and the risk of children’s problem behaviors, but maternal trait mindfulness level moderates this association during the COVID-19 epidemic. While most studies during the epidemic investigated the relationship between WFC and maternal anxiety in developed countries, no studies were found to examine this association in China. Besides, the mediating effects of maternal anxiety and moderating effects of trait mindfulness on the relationship between WFC and preschool children’s problem behaviors are still unclear. So, this study examined the association between mothers’ WFC and preschoolers’ problem behaviors and identified the roles of maternal anxiety as a mediator and trait mindfulness as a moderator during the COVID-19 epidemic. Methods: In this cross-sectional study, a sample of 1068 Chinese preschoolers and their mothers from coastal cities in southern China were investigated. Data were collected using demographic questionnaires, Carlson’s WFC scale, Ma’s Parenting Anxiety Scale, Goodman’s SDQ Scale, and Brown and Ryan’s Trait Mindfulness Scale. Data were analyzed using SPSS 26.0 and Process 3.3. Results: WFC had a positive and direct association with problem behaviors in preschoolers (β=0.118, t-value=3.880, p<0.001). WFC also had a positive and direct association with maternal anxiety (β=0.480, t-value=18.034, p<0.001). And maternal anxiety had a positive and direct association with preschoolers’ problem behaviors (β=0.415, t-value=13.584, p<0.001). The mediating effect value of maternal anxiety between WFC and preschoolers’ problem behaviors was 0.199, and the moderating effect value of trait mindfulness between maternal anxiety and preschoolers’ problem behaviors was -0.078. Conclusions: WFC can be positively associated with preschoolers’ problem behaviors, and maternal anxiety is an important mediator of this association. So, WFC can cause maternal anxiety and lead to more problematic behaviors in children. Therefore, relevant departments should pay attention to this problem and adopt practical strategies to help mothers cope with high levels of work-family conflict, so as to alleviate maternal anxiety and reduce the preschoolers’ problem behaviors. Besides, Maternal anxiety can be positively associated with preschoolers’ problem behaviors, and trait mindfulness is an important moderator of this association. Because trait mindfulness can alleviate the negative effects of maternal anxiety on children, mothers should attend more mindfulness training courses to try to improve their mindfulness level.

Analysis of the epidemiological characteristics of pathogens, changes in inflammatory factors, and prognostic factors in patients with sepsis in the Xinjiang area

Objectives: To investigate the epidemiological characteristics of pathogens and changes in inflammatory factors in patients with sepsis in the Xinjiang area and to analyze factors influencing the prognosis for patients with sepsis.

Visualizing the Knowledge Base and Research Hotspot of Public Health Emergency Management: A Science Mapping Analysis-Based Study

Public health emergency management has been one of the main challenges of social sustainable development since the beginning of the 21st century. Research on public health emergency management is becoming a common focus of scholars. In recent years, the literature associated with public health emergency management has grown rapidly, but few studies have used a bibliometric analysis and visualization approach to conduct deep mining and explore the characteristics of the public health emergency management research field. To better understand the present status and development of public health emergency management research, and to explore the knowledge base and research hotspots, the bibliometric method and science mapping technology were adopted to visually evaluate the knowledge structure and research trends in the field of public health emergency management studies. From 2000 to 2020, a total of 3723 papers related to public health emergency management research were collected from the Web of Science Core Collection as research data. The five main research directions formed are child prevention, mortality from public health events, public health emergency preparedness, public health emergency management, and coronavirus disease 2019 (COVID-19). The current research hotspots and frontiers are climate change, COVID-19 and related coronaviruses. Further research is needed to focus on the COVID-19 and related coronaviruses. This study intends to contribute inclusive support to related academia and industry in the aspects of public health emergency management and public safety research, as well as research hotspots and future research directions.

Impact of the COVID-19 pandemic on visual outcomes of diabetic macular edema patients at a tertiary care veterans affairs center

Purpose There are limited studies on factors that impacted retina clinic patient outcomes during the COVID-19 pandemic. We aimed to evaluate visual and anatomic outcomes in patients with diabetic macular edema (DME) requiring anti-VEGF injections at the veterans’ affairs tertiary care eye clinic in Houston, TX. Methods Patient volume from April 2020 was compared to that of April 2019 to determine attendance changes. To evaluate outcomes, we reviewed patients with DME who had scheduled appointments during April 2020. We tracked changes in central foveal thickness (CFT) and Snellen visual acuity (VA) measurements. Patient outcomes were classified as poor (defined as worsening VA or CFT at follow-up) or good (no worsening of either at follow-up). Regression analysis identified characteristics associated with poor outcomes. Results To prevent the spread of COVID-19, patients were called to reschedule clinic appointments. Attendance frequency decreased from 523 patients in April 2019 to 246 patients in April 2020. 134 patients met inclusion criteria (mean age of 64.7 ± 8.8 years). 19/134 of patients were seen on schedule, 89/134 had delayed appointments (average follow-up interval of 115.2 ± 50.0 days), and 26/134 were lost to follow-up. Patients with delayed appointments had higher odds of poor outcome at follow-up compared to patients seen on schedule (OR = 4.03, 95% CI: 1.14–16.92, p = 0.04). Patient’s baseline visual acuity, macular thickness, comorbidities, and diabetic retinopathy severity, and demographics did not affect visual outcome at follow-up. Conclusions On average, patients were rescheduled to a visit 2.4 months later than their usual visit. Over half these patients experienced worsening of vision or edema. This demonstrates that lapses in care result in worsening of DME. However, there is no clear association between baseline characteristics and risk of disease progression. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-01049-5.

Quality Assessment of Fruits and Vegetables Based on Spatially Resolved Spectroscopy: A Review

Damage occurs easily and is difficult to find inside fruits and vegetables during transportation or storage, which not only brings losses to fruit and vegetable distributors, but also reduces the satisfaction of consumers. Spatially resolved spectroscopy (SRS) is able to detect the quality attributes of fruits and vegetables at different depths, which is of great significance to the quality classification and defect detection of horticultural products. This paper is aimed at reviewing the applications of spatially resolved spectroscopy for measuring the quality attributes of fruits and vegetables in detail. The principle of light transfer in biological tissues, diffusion approximation theory and methodologies are introduced, and different configuration designs for spatially resolved spectroscopy are compared and analyzed. Besides, spatially resolved spectroscopy applications based on two aspects for assessing the quality of fruits and vegetables are summarized. Finally, the problems encountered in previous studies are discussed, and future development trends are presented. It can be concluded that spatially resolved spectroscopy demonstrates great application potential in the field of fruit and vegetable quality attribute evaluation. However, due to the limitation of equipment configurations and data processing speed, the application of spatially resolved spectroscopy in real-time online detection is still a challenge.

Tourists' perceived restorative qualities and post-visit behavioral intention:the mechanism and boundary condition

Studies have shown that contacting with beautiful natural environments improves people's mood and reduces pressure. Environments that facilitate physical and psychological recovery are called restorative environments. Compared with other types of environments, natural sightseeing resorts have the most prominent restorative value, and have attracted the attention of numerous scholars. Tourists' perceived restorative qualities have gradually become a frontier of environmental psychology and tourism studies. However, studies of tourists' perceived restorative qualities are still in their infancy, with limited results regarding various aspects. For example, the development of a tourist restorative perception scale, and the antecedent factors underlying tourists' perceived restorative qualities. Few studies can be found investigating the relationship between tourists' perceived restorative qualities and their post-visit behavioral intention. Post-visit behavioral intention is of great significance in terms of guiding the management and marketing of tourist destinations. The COVID-19 pandemic has led to a sharp decline in the willingness of potential tourists to travel. As consumption by tourists shifts toward the pursuit of greenness and health during the continuation of the epidenic, further improving their satisfaction, stimulating word-ofmouth promotion, and strengthening tourist loyalty through physical and mental recovery experience to enable tourist destinations to enhance their competitive advantage, then to revitalize, has become an issue worthy of investigation. By maintaining close contact with destination environment, tourists can effectively enhance their physical and mental functions, produce a sense of satisfaction and increase positive behavioral intention. Thus, it is important to explore the mechanism underlying tourists' perceived restorative qualities to aid product innovation and marketing promotion, and promote the sustainable development of tourist destinations. On the basis of previous studies, we used attention restoration theory to analyze the impact of tourists' perceived restorative qualities. On the basis of the Mehrabian-Rusell framework, we developed a theoretical integrated model including four constructs:Tourists' perceived restorative qualities, tourist satisfaction, post-visit behavioral intention and tourist involvement. The model was tested using structural equation modeling. All constructs were measured using selfreported, multiple-item scales adopted from previous studies. Data were collected from Kanas, a well known nature-based tourist destination located in Altay, China. The questionnaires were distributed by a group of five people on 1-7 August 2019. A total of 600 questionnaires were distributed, and 547 completed questionnaires were returned. The results were as follows:(1) Tourists' functional perceived restorative qualities(coherence, novelty) directly and positively affect their emotional perceived restorative qualities(fascination, compatibility, escape);(2) Novelty and escape are key factors affecting post-visit behavioral intention, and fascination and compatibility affect post-visit behavioral intention through satisfaction. Furthermore, novelty, compatibility and satisfaction have a multiple chain-mediating effect on the relationship between coherence and post-visit behavioral intention, while compatibility and satisfaction have a multiple chain-mediating effect on the relationship between novelty and post-visit behavioral intention;(3) The influence of fascination and compatibility on satisfaction is positively regulated by tourist involvement;and(4) The effect of tourists' perceived restorative qualities on their post-visit behavioral intention exhibited a three-stage"environmental stimuli perception-emotion-intention"transmission mechanism.In this study, we analyzes the benefits of tourists' perceived restorative qualities, which provides important references for tourism destination managers in relation to environmental optimization, marketing and brand building. T

Antiviral Effects of ABMA and DABMA against Influenza Virus In Vitro and In Vivo via Regulating the Endolysosomal Pathway and Autophagy

Influenza virus is an acute and highly contagious respiratory pathogen that causes great concern to public health and for which there is a need for extensive drug discovery. The small chemical compound ABMA and its analog DABMA, containing an adamantane or a dimethyl-adamantane group, respectively, have been demonstrated to inhibit multiple toxins (diphtheria toxin, Clostridium difficile toxin B, Clostridium sordellii lethal toxin) and viruses (Ebola, rabies virus, HSV-2) by acting on the host’s vesicle trafficking. Here, we showed that ABMA and DABMA have antiviral effects against both amantadine-sensitive influenza virus subtypes (H1N1 and H3N2), amantadine-resistant subtypes (H3N2), and influenza B virus with EC50 values ranging from 2.83 to 7.36 µM (ABMA) and 1.82 to 6.73 µM (DABMA), respectively. ABMA and DABMA inhibited the replication of influenza virus genomic RNA and protein synthesis by interfering with the entry stage of the virus. Molecular docking evaluation together with activity against amantadine-resistant influenza virus strains suggested that ABMA and DABMA were not acting as M2 ion channel blockers. Subsequently, we found that early internalized H1N1 virions were retained in accumulated late endosome compartments after ABMA treatment. Additionally, ABMA disrupted the early stages of the H1N1 life cycle or viral RNA synthesis by interfering with autophagy. ABMA and DABMA protected mice from an intranasal H1N1 challenge with an improved survival rate of 67%. The present study suggests that ABMA and DABMA are potential antiviral leads for the development of a host-directed treatment against influenza virus infection.

Potential inhibitors for blocking the interaction of the coronavirus SARS-CoV-2 spike protein and its host cell receptor ACE2 (preprint)

Background The outbreak of SARS-CoV-2 continues to pose a serious threat to human health and social. The ongoing pandemic of COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made a serious threat to public health and economic stability worldwide. Given the urgency of the situation, researchers are attempting to repurpose existing drugs for treating COVID-19.Methods We first established an anti-coronavirus drug screening platform based on the Homogeneous Time Resolved Fluorescence (HTRF) technology and the interaction between the coronavirus S protein and its host receptor ACE2. Two compound libraries of 2,864 molecules were screened with this platform. Selected candidate compounds were validated by SARS-CoV-2_S pseudotyped lentivirus and ACE2-overexpressing cell system. Molecular docking was used to analyze the interaction between S-protein and compounds.Results We identified three potential anti-coronavirus compounds: tannic acid (TA), TS-1276 (anthraquinone), and TS-984 (9-Methoxycanthin-6-one). Our in vitro validation experiments indicated that TS-984 strongly inhibits the interaction of the coronavirus S-protein and the human cell ACE2 receptor. Additionally, tannic acid showed moderate inhibitory effect on the interaction of S-protein and ACE2.Conclusion This platform is a rapid, sensitive, specific, and high throughput system, and available for screening large compound libraries. TS-984 is a potent blocker of the interaction between the S-protein and ACE2, which might have the potential to be developed into an effective anti-coronavirus drug.

Potential inhibitors for blocking the interaction of the coronavirus SARS-CoV-2 spike protein and its host cell receptor ACE2 (preprint)

ABSTRACT The outbreak of SARS-CoV-2 continues to pose a serious threat to human health and social and economic stability. In this study, we established an anti-coronavirus drug screening platform based on the Homogeneous Time Resolved Fluorescence (HTRF) technology and the interaction between the coronavirus S protein and its host receptor ACE2. This platform is a rapid, sensitive, specific, and high throughput system. With this platform, we screened two compound libraries of 2,864 molecules and identified three potential anti-coronavirus compounds: tannic acid (TA), TS-1276 (anthraquinone), and TS-984 (9-Methoxycanthin-6-one). Our in vitro validation experiments indicated that TS-984 strongly inhibits the interaction of the coronavirus S-protein and the human cell ACE2 receptor. This data suggests that TS-984 is a potent blocker of the interaction between the S-protein and ACE2, which might have the potential to be developed into an effective anti-coronavirus drug. SIGNIFICANCE The ongoing pandemic of COVID-19 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made a serious threat to public health worldwide. Given the urgency of the situation, researchers are attempting to repurpose existing drugs for treating COVID-19. In this present study, we screened two compound libraries of 2,864 molecules and identified a potent inhibitor (TS-984) for blocking the coronavirus S-protein and the human cell ACE2 receptor. TS-984 might have the potential to be developed into an effective anti-coronavirus drug for treating COVID-19.

Low Humoral Immune Response and Ineffective Clearance of SARS-Cov-2 in a COVID-19 Patient With CLL During a 69-Day Follow-Up

Background: A recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), which began in Wuhan, China, with a high level of human-to-human transmission has been reported. There are limited data available on Coronavirus Disease 2019 (COVID-19) patients with hematological malignancies with more than 60 days of follow-up. This study describes the clinical characteristics, including multiple recurrences of COVID-19, in a patient with chronic lymphocytic leukemia (CLL) during 69 days of follow-up. Case Presentation: A 72-year-old female was admitted to hospital isolation after being infected with COVID-19 as part of a family cluster on January 30, 2020. Apart from SARS-Cov-2 virus infection, laboratory results revealed lymphocytosis of uncertain etiology and abnormal distribution of T lymphocytes. On blood smears, small blue lymphocytes with scant cytoplasm were observed, and the presence of high levels of circulating clonal B cells was also demonstrated by flow cytometry. The patient was diagnosed with COVID-19 and CLL. Among her family members, she had the highest viral loads and the fastest progression on lung injury and developed severe pneumonia. Serological results showed she had both 2019-nCoV-specific IgM and IgG antibodies;however, only IgG antibodies were detected in her husband's plasma. Results: A combination regimen of antiviral therapy and high-dose intravenous immunoglobulin (IVIG) in the early stage seemed to be effective for treating CLL and SARS-Cov-2 infection. Because of the low humoral immune response, the CLL patient could not effectively clear the SARS-Cov-2 infection and suffered from recurrence twice during the 69-day follow-up. Conclusion: In CLL, a neoplastic antigen-specific B-cell clone proliferates, and the progeny cells accumulate and outgrow other B cells, leading to immune deficiency. Considering the low humoral immune response and ineffective clearance of SARS-Cov-2 in CLL patients, the follow-up and home quarantine period should be extended. We need further studies to clarify suspending or continuing CLL therapy during COVID infection. For those patients who are prone to progression to severe disease, administering humoral immunity therapies can help to prevent disease progression and quickly meet the cure criteria.

PAGEANT: Personal Access to Genome and Analysis of Natural Traits (preprint)

GWASs have identified numerous genetic variants associated with a wide variety of diseases, yet despite the wide availability of genetic testing the insights that would enhance the interpretability of these results are not widely available to members of the public. As a proof of concept and demonstration of technological feasibility, we developed PAGEANT ( P ersonal A ccess to Ge nome & A nalysis of N atural T raits), usable through Graphical User Interface or command line-based version, aiming to serve as a protocol and prototype that guides the overarching design of genetic reporting tools. PAGEANT is structured across five core modules, summarized by five Qs: (1) Quality assurance of the genetic data; (2) Qualitative assessment of genetic characteristics; (3) Quantitative assessment of health risk susceptibility based on polygenic risk scores and population reference; (4) Query of third-party variant databases (e.g., ClinVAR and PharmGKB); and (5) Quick Response code of genetic variants of interest. Literature review was conducted to compare PAGEANT with academic and industry tools. For 2,504 genomes made publicly available through the 1,000 Genomes Project, we derived their genomic characteristics for a suite of qualitative and quantitative traits. One exemplary trait is susceptibility to COVID-19, based on the most up-to-date scientific findings reported.

Genetically determined serum testosterone level and Covid-19 illness level: A mendelian randomization study (preprint)

Background: It is hypothesized that different levels of hormones especially serum testosterone level could explain the sex differences between men and women on the susceptibility and case fatality rate of COVID-19. However, traditional observational studies that support this hypothesis could not effectively establish the causal effects. Objective: Utilizing recently published genome-wide associations studies (GWAS) on serum Testosterone level and on COVID-19 related phenotypes, we sought to assess the causality through Mendelian Randomization (MR) analyses. We further applied a suite of statistical genomics methods to further explore the biological mechanisms. Results: We found that testosterone level is significantly associated with Covid-19 critical illness. All six MR methods yielded significant associations. There is no significant association between Testosterone and COVID-19 respiratory failure or COVID-19 susceptibility. Conclusion: Based on the GWAS currently available, we provide support for a causal role of Testosterone on COVID-19 critical illness. Nevertheless, we recognize that the COVID-19 susceptibility GWAS effort is still ongoing and there is no such strong locus as CCR5 for HIV discovered for COVID-19.

Correlation of hypocalcemia with poor prognosis of COVID-19 based on cox regression model: an analysis of 2 651 patients

ObjectiveTo investigate whether hypocalcemia is associated with poor prognosis in COVID-19 patients. MethodsA retrospective analysis was performed on 2 651 COVID-19 patients admitted to Wuhan Huoshenshan Hospital from February 4, 2020 to April 11, 2020. They were divided into low and normal calcium groups according to their serum calcium level lower than 2.11 mmol/L or not. Their basic demographic characteristics, results of laboratory tests, treatment, complications and outcomes were analyzed and compared between the 2 groups. COX regression model was used to analyze whether low calcium is an independent risk factors for poor outcomes in COVID-19 patients. ResultsThe low calcium group had significantly higher ratios of mechanical ventilation, extracorporeal membrane oxygenation (ECMO) and ICU occupancy (P<0.05);obviously higher incidences of sepsis, shock, hypoproteinemia, respiratory failure, coagulation disorders, acute kidney injury, acute myocardial injury, acute respiratory distress syndrome (ARDS), and even mortality (P<0.05);and remarkably longer length of hospital stay (P<0.001) when compared with the normal calcium group. The blood calcium level of mild and common, severe, and critical COVID-19 patients was 2.17 (2.11, 2.24), 2.13 (2.04, 2.21), and 2.03 (1.89, 2.18) mmol/L, respectively, and significant differences were seen among the patients (P<0.05). The calcium level was in a decreasing trend with the severity of COVID-19 (P<0.05). The calcium level was statistically lower in the dead patients than those survival [1.97 (1.87, 2.03) vs 2.17 (2.09, 2.23), P<0.001]. Multivariate Cox regression analysis indicated that serum calcium concentration <2.11 mmol/L was an independent risk factor for poor prognosis of COVID-19 (HR=5.695, 95%CI :2.363-13.725, P<0.001). ConclusionLow blood calcium level is an independent risk factor for poor prognosis in COVID-19 patients. Correction for hypocalcemia may be an important strategy to improve the prognosis of COVID-19 patients.

Complete Z-intuitionistic Fuzzy MULTIMOORA Method with AHP and its Application to COVID-19 (preprint)

For emergencies, the reliability of information can not be guaranteed. At the same time, due to the lack of information and knowledge, neither the criteria itself nor the credibility can be given a precise evaluation by decision-makers(DMs). Therefore, we combine intuitionistic fuzzy set and Z-number to get a new class of fuzzy set, complete Z-intuitionistic fuzzy set(CZIFS), and its degenerate form, A-type Z-intuitionistic fuzzy set(AZIFS) and B-type Z-intuitionistic fuzzy set(BZIFS). CZIFS can serve as a reliable tool to depict the hesitant degree both on the ambiguity and reliability of uncertain information. In addition, we introduce the score and accuracy functions and distance measure of complete Z-intuitionistic fuzzy number(CZIFN), with which we have considered both reliability information and DMs' preference on it. Then, we improve traditional MULTIMOORA by developing reference point(RP) model to consider both the risk and profile of alternatives and integrating analytic hierarchy process(AHP) in the process of ranking aggregation method to take into account the preference of DMs on three subordinate rankings. Besides, to solve multicriteria group decision making(MCGDM) problem, we develop improved MULTIMOORA method to the environment of CZIFN. Finally, to illustrate the proposed method, we give a numerical example, solving site selecting of Fangcang shelter hospital for COVID-19.

Clinical characteristics and risk factors affecting outcomes of the patients with severe coronavirus disease 2019

Objective　To investigate the clinical characteristics of severe coronavirus disease 2019 (COVID-19) and explore the relevant risk factors that affect outcomes of the patients. Methods　A retrospective analysis was performed on the data of the patients with severe COVID-19 admitted to the ICU of Huoshenshan Hospital of Wuhan City during the period from February to April, 2019. The patients were classified into survival group and death group. The general data, clinical manifestations, laboratory examinations, and treatments were compared between the 2 groups. Results　A total of 122 severe COVID-19 patients were included in the study, 56 died and the fatality rate was 45.9%. The proportion of comorbidities of coronary heart disease in death group was significantly higher than that in the survival group [19.6%(11/56) vs. 7.6%(5/66), P=0.049]. Compared with patients in the survival group, the platelet count in the death group decreased [190.1(132.3, 245.0)×109/L vs. 217.0(176.0, 262.3)×109/L, P=0.015] and the levels of C-reactive protein and brain natriuretic peptide in the death group increased [37.4(4.3, 125.6) mg/L vs. 8.9(2.7, 51.4) mg/L, P=0.027 and 65.17(18.84, 167.71) pg/ml vs. 16.60(0.01, 67.68) pg/ml, P=0.007]. The prothrombin time and thrombin time in the death group were longer than those in the survival group [14.20(13.22, 15.86) s vs. 13.27(12.16, 14.27) s, P<0.01 and 16.32(15.11, 18.02) s vs. 15.75(14.81, 16.62) s, P=0.037]. Dynamic observation data showed that there were significant differences in neutrophil count, lymphocyte count, neutrophil/lymphocyte ratio and levels of both lactate dehydrogenase and α-hydroxybutyrate dehydrogenase (α-HBDH) between the two groups. ROC curve analysis showed that LDH and α-HBDH were of high value in predicting outcome, and the area under the curve was more than 0.7. Conclusions　We should pay close attention to the changes of blood routine, LDH, and α-HBDH for older patients with underlying diseases. This will help us to identify the patients with high risk of death in the early stage, and take effective treatment measures as early as possible to improve the prognosis.

Research and practice of online emergency teaching based on electronic information technology under the influence of COVID-19

The new crown pneumonia (COVID-19) epidemic in 2020 has spread globally, causing schools around the world to stop routine teaching. Educational institutions in various countries have adopted online teaching methods in response to this crisis. This research, carried out in Human Institute of Information Technology with a number of teachers and students as its subjects, sets out to give statistical analysis upon the students' selections of online teaching platforms as well as their evaluations of online teaching. At the same time, based on the online teaching practice of ?Building Structure?, a certain quantity of research upon the online teaching practice is completed among the students who began their college studies in engineering cost in the year of 2018. According to all these studies, it is evident that multiple factors such as teachers' ages, professions, and the features of various online teaching platforms, can determine which one is used by different individuals. The evaluation results suggest that online teaching is necessary under the impact of the epidemic despite the fact that students may face a series of problems for lack of self-control and other possible reasons. Through practice, an innovative teaching and evaluation method can partially solve the problems found in online teaching and provide useful ideas for creating higher quality teaching on the Internet.