College-level world language faculty background characteristics and their perceptions of online language teaching during the pandemic

The COVID-19 pandemic enabled an unprecedented remote teaching experience for world language faculty who had to move their courses online in spring 2020. Previous studies show that faculty background characteristics affect their perceptions of and experience with online teaching. The present study examined the effect of two college-level world language faculty background characteristics (prior experience with online language teaching and academic rank) on their perceptions of online language teaching during the pandemic (perceived value of online language teaching, self-confidence in online language teaching, and stress felt during the pandemic). A mixed-methods approach was adopted to analyze data collected from a large-scale online questionnaire and follow-up interviews. The results show very complex relationships between college-level world language faculty background characteristics and their perceptions of online language teaching during the pandemic. Based on the findings, the study also provides suggestions for world language faculty professional development to prepare for crisis-prompted and planned online language teaching in the future. © 2023 American Council on the Teaching of Foreign Languages.

A New Pneumonia Detection Model Based on Transformer with Improved Self-Attention Mechanism

Clinical diagnosis based on computed tomography (CT) could be used, as part of diagnosis standard of COVID-19 pneumonia. Addressing the problem that accuracy of CT-based traditional pneumonia classification diagnosis models is relatively low when employed for classification of community-acquired pneumonia (CP), COVID-19 pneumonia (NCP) and normal cases, a new network model is proposed which combines application of Swin Transformer and multi-head axial self-attention (MASA) mechanism, to analyze CT images and make intelligence-assisted diagnosis. The method in detail is to partially replace traditional multi-head self-attention (MSA) mechanism in encoders of Swin Transformer by MASA. The improved model is applied to train and test on commonly used pneumonia CT dataset CC-CCII. The results show that the proposed network outperforms traditional networks ResNet50 and Vision Transformer in indicators of accuracy, sensitivity and F1-measure. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

National team intervention and price efficiency differentiation under the impact of COVID-19

This paper examines how the ‘national team', a direct government investment policy, influences the price efficiency of listed companies in the Shanghai Stock Index (SSE). We find that stocks directly invested in by the national team show greater price efficiency than stocks without direct bailout. We also analyse the impact of the COVID-19 pandemic on this price efficiency differentiation. The data period is divided into two sub-periods, and the results show that the price efficiency of stocks decreased after COVID-19. The reduction in price efficiency is more notable for stocks with direct government investment;the difference observed under national team investment in price efficiency is clearly reduced. Increased pessimistic investor expectations due to the pandemic could explain these changes. Our study provides novel evidence for the policy evaluation of national team intervention and a more detailed explanation about the decrease in financial market efficiency in the post-COVID-19 era. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

[Epidemiological characteristics of an epidemic of 2019-nCoV Omicron variant infection in Beijing].

Objective: To analyze the epidemiological characteristics and transmission chain of an epidemic of COVID-19 in Haidian district, Beijing. Methods: Descriptive epidemiological method was used to analyze the epidemiological characteristics of the epidemic, and field investigation and big data technology were used to analyze the transmission chain of the epidemic. Results: From April 27 to May 13, 2022, an epidemic of COVID-19 occurred in Haidian district. The strains isolated from the cases were identified by whole genome sequencing as Omicron variant (BA.2.2 evolutionary branch). A total of 38 infection cases were detected, including 34 confirmed cases and 4 asymptomatic cases. Most cases were mild ones (88.2%), no severe, critical or death cases occurred. The early clinical symptoms were mainly sore throat (50.0%) and cough (29.4%). The epidemic lasted for 17 days, resulting in 7 generations of the cases and involving 3 community transmissions, 2 working place transmissions and 8 family transmissions; the main infection routes were co-residence (47.6%) and co-space exposure (31.6%). The intergenerational interval M(Q1, Q3)was 3 (1, 6) days. The overall secondary attack rate was 1.5% (37/2 482), and the family secondary attack rate was 36.7% (18/49). Conclusions: The cases in this COVID-19 epidemic caused by Omicron variant had mild clinical symptoms, but the case clustering in families and communities was obvious, the transmission was rapid, and the risk for co-space exposure was high. It is necessary to use information technology to identify close contacts in the local population for the rapid and effective blocking of the epidemic spread.

[Kinetics of SARS-CoV-2-specific antibodies among inactivated COVID-19 vaccine recipients, SARS-CoV-2 natural infection cases, and breakthrough cases].

Between August and September, 2021, this study included 605 SARS-CoV-2 natural infection cases and 589 SARS-CoV-2 breakthrough cases from Nanjing and Yangzhou, as well as 690 inactivated COVID-19 vaccine recipients from Changzhou, China. In SARS-CoV-2 natural infection cases, the age range was 19-91 years (median age: 66 year), and the medians(Q1,Q3) of IgG titers were 0.19 (0.06-1.31), 3.70 (0.76-69.48), 15.31 (2.59-82.16), 4.41 (0.99-31.74), 2.31 (0.75-13.83), 2.28 (0.68-9.94) and 2.80 (1.00-9.53) at one to seven weeks after SARS-CoV-2 infection, respectively. In SARS-CoV-2 breakthrough cases, the age range was 18-76 years (median age: 45 year), and the medians(Q1,Q3)of IgG titers were 1.93 (0.34-26.67), 38.87 (7.90-121.0), 75.09 (11.85-123.70), 21.97 (5.20-95.58), 13.97 (3.47-46.82), 9.56 (2.48-33.38) and 4.38 (1.87-11.00) at one to seven weeks after SARS-CoV-2 infection, respectively. In inactivated COVID-19 vaccine recipients, the age range was 18-87 years (median age: 47 years), and the medians(Q1,Q3)of IgG titers were 16.22 (15.84-33.42), 5.35 (2.96-13.23), 3.30 (2.18-6.18), 3.14 (1.16-5.70), 2.77 (1.50-4.52), 2.72 (1.76-4.36), 2.01 (1.27-3.51) and 1.94 (1.35-3.09) at one to eight months after SARS-CoV-2 infection, respectively. The results suggested that IgG antibodies increased gradually within two weeks after SARS-CoV-2 infection, then declined gradually at three to seven weeks in SARS-CoV-2 natural infection cases. In SARS-CoV-2 breakthrough cases, IgG antibodies increased rapidly within two weeks, then declined gradually at three to seven weeks after SARS-CoV-2 infection. Additionally, IgG antibodies decreased rapidly within three months, then decreased gradually and remained at a low level within three months after immunization.

Tourist Congestion Perception of Tourist Flow during the COVID-19 Pandemic

COVID-19 has had a large impact on tourism demands, preferences, and behaviors. Understanding tourist congestion perception during normal and abnormal events has become a key to formulate tourist flow control schemes and develop tourism demand management in the post-COVID period. This paper explores the correlation mechanism among tourist congestion perception, tourism information services, and tourists travel behaviors in normal and abnormal conditions. To acquire tourist travel behavior, congestion perception, and tourists' socioeconomic attributes, a stated preference survey was done. The changes in travel information demand during different COVID-19 pandemic levels with different congestion perceptions were analyzed, and the effects of influencing factors such as information obtained from different tourism stages and tourist density were qualitatively analyzed. A tourist congestion perception model was established. The analysis provides basic data for establishment of tourist flow control schemes in tourist attractions and reasonable tourism information dissemination in the post-COVID-19 period. © ASCE.

Investigating impacts of CoronaVac vaccination in males on in vitro fertilization: A propensity score matched cohort study

Study question: Does a history of SARS-CoV-2 vaccination (CoronaVac) in males influence male fertility, gamete and embryo development, and in vitro fertilization (IVF) outcomes? Summary answer: CoronaVac vaccination in males may not have an adverse effect on patient's performance or the gamete and embryonic development potential during ART treatments. What is known already: Vaccines against COVID-19 have been approved for emergency use in several countries and regions, while concerns about the potential negative effect of vaccines on fertility contributed to vaccine hesitancy. It is urgent to explore the effect of CoronaVac on human fertility to help to overcome vaccine hesitancy about possible fertility impairment. Study design, size, duration: A retrospective cohort study enrolled couples undergoing IVF cycles between June and August 2021 at Reproductive Medicine Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. According to the history of SARS-CoV-2 vaccination in males, the participants were divided into the vaccination group and the non-vaccination group. Participants/materials, setting, methods: A self-controlled study of semen analyses for males before and after CoronaVac vaccination was conducted. Baseline characteristics were matched using propensity score matching. Participants were categorized into the unexposed group (non-vaccination) and exposed group (vaccination), and the population was 271 for each. Semen parameters and IVF outcomes were the main outcomes. Main results and the role of chance: Generally, no statistically significant differences were exhibited between the matched cohorts regarding embryo developmental parameters, including fertilization rate, cleavage rate, high-quality embryo rate, blastocyst formation rate, and available blastocyst rate, as well as clinical outcomes, such as implantation rate, biochemical pregnancy rate, and clinical pregnancy rate. Moreover, males after vaccination seemed to have fluctuated semen parameters including increased semen volume, lower motility, and decreased normal forms of sperms, while the motile sperm counts were similar. In addition, all semen parameters were above the lower reference limits. Limitations, reasons for caution: It was a single-center retrospective cohort study with a small sample size, and the men enrolled were suffering from infertility, which limited the generalizability of the conclusions. In addition, the endpoint of the current is a confirmation of clinical pregnancy, a study with a longer period of follow-up was urgent. Wider implications of the findings: Our findings suggested that CoronaVac vaccinations in males may not have adverse effects on patient's performance or the gamete and embryonic development potential during ART treatments. Larger studies among a wider population with longer followup in the future are required to support and validate our observations.

Protection of the Right to Life and Health of Medical Staff in Public Health Emergency: Based on the Case of COVID-19 Epidemic

With the COVID-19 outbreak, many provinces and municipalities have announced the firstlevel response to public health emergencies. As the backbone of fighting the epidemic, medical staff are faced with many ethical dilemmas, such as the lack of medical protection materials, the high risk of virus infection, discrimination and so on, and their health and life rights and interests have been impacted. Starting with the concept of public health emergencies and the right to life and health, the theory and display basis of the right of life and health were discussed based on the practical guidelines of public health emergencies. Taking the COVID-19 epidemic as an example, this paper proposed measures for ensuring the right to life and health of medical staff in public health emergencies, so as to better cope with the epidemic of COVID-19 and protect the life and health of medical workers. © 2022, Editorial department of Chinese Medical Ethics. All rights reserved.

Social isolation promotes mammary cancer recurrence, increases IL6/JAK/STAT3 signaling and causes mitochondrial dysfunction in tamoxifen treated rats, and a traditional herbal mixture reverses all these changes

Social isolation is associated with increased risk and mortality from many diseases, such as breast cancer. Socially isolated breast cancer survivors have a 43% higher risk of recurrence and a 64% higher risk of breast cancer-specific mortality than socially integrated survivors. Since Covid-19 has dramatically increased the incidence of social isolation, it is important to determine if social isolation affects the response to endocrine therapy and/or recurrence after the therapy is completed. Since previous studies indicate that social isolation increases circulating inflammatory cytokines, we investigated if an anti-inflammatory herbal mixture Jaeumkanghwa-tang (JGT) prevents the adverse effects of social isolation on breast cancer mortality. Estrogen receptor positive mammary tumors were initiated with 7,12-dimethylbenz[a]anthracene. When a rat developed a palpable mammary tumor, it was either socially isolated (SI) by housing it singly or a rat was allowed to remain group-housed (GH). Tamoxifen (340ppm via diet) or tamoxifen + JGT (500ppm via drinking water) started when the first mammary tumor reached a size of 11 mm in diameter. Tamoxifen administration ended when a complete response to this therapy had lasted for 9 weeks (corresponds to 5 years in women). During tamoxifen therapy, social isolation non-significantly reduced the rate of complete responses to 21%, from 31% in GH group (p>0.05). After the therapy was completed, SI significantly increased local mammary tumor recurrence (p<0.001;45% GH vs 75% SI). RNAseq analysis was performed in the mammary glands. Gene set enrichment analysis (GSEA) of transcriptome showed that the increased recurrence risk in socially isolated rats was associated with an enrichment of IL6/JAK/STAT3 signaling: this result was confirmed in the tumors. In addition, oxidative phosphorylation (OXPHOS) pathway was suppressed: the suppressed genes included those involved in mitochondrial pyruvate transport and conversion of pyruvate to acetyl CoA as well as genes in the TCA cycle and mediating electron transport in mitochondrial complexes I-IV. Social isolation also increased the expression of inflammatory receptor for advanced glycation end-products (RAGE) (p≤0.05). Consumption of an anti-inflammatory JGT inhibited IL6/JAK/STAT3 signaling, upregulated OXPHOS signaling and prevented the increased risk of mammary cancer recurrence in socially isolated animals. The percentage of recurrences in the SI rats dropped from 75% without JGT to 22% with JGT (p<0.001). Breast cancer mortality among socially isolated survivors may be most effectively prevented by focusing on the period following endocrine therapy using tools that inhibit IL6/JAK/STAT3 inflammatory cytokine signaling and correct disrupted OXPHOS and mitochondrial dysfunction.

The Port Shuttle Hub System Model based on Rail-Sea Intermodal Transportation Taking Shenzhen Port as an Example

The major ports along the coast of China that undertake container transportation are all facing problems in collection and dispatching to a certain extent. In particular, due to the recent impact of the COVID-19 epidemic, truck drivers have difficulty moving across regions, and there was once a phenomenon of no containers being transported by vehicles. This paper sorted out the basic situation of container port collection and dispatching methods all over the world. Taking Shenzhen Port as an example, this paper focused on the analysis of the structural characteristics of container transportation and the impact on the rear urban traffic and atmospheric environment. Then it proposed a intermodal transportation network and established the 'Port Shuttle Hub System' model, which would closely link the port with the railway and inland port, and integrate the transportation organization mode, which greatly improves the efficiency of port containers' transportation. © 2021 IEEE.

Angle-dependent effects in DLS measurements of polydisperse particles

Dynamic light scattering (DLS) is widely used for analyzing biological polymers and colloids. Its application to nanoparticles in medicine is becoming increasingly important with the recent emergence of prominent lipid nanoparticle (LNP)-based products, such as the SARS-CoV-2 vaccines from Pfizer, Inc.-BioNTech (BNT162b2) and Moderna, Inc. (mRNA-1273). DLS plays an important role in the characterization and quality control of nanoparticle-based therapeutics and vaccines. However, most DLS instruments have a single detection angle theta, and the amplitude of the scattering vector, q, varies among them according to the relationship q = (4 pi n/lambda (0)) sin(theta/2), where lambda (0) is the laser wavelength. Results for identical, polydisperse samples among instruments of varying q yield different hydrodynamic diameters, because, as particles become larger they scatter less light at higher q, so that higher-q instruments will under-sample large particles in polydisperse populations, and report higher z-average diffusion coefficients, and hence smaller effective hydrodynamic diameters than lower-q instruments. As particle size reaches the Mie regime the scattering envelope manifests angular maxima and minima, and the monotonic decrease of average size versus q is lost. The discrepancy among instruments of different q is hence fundamental, and not merely technical. This work examines results for different q-value instruments, using mixtures of monodisperse latex sphere standards, for which experimental measurements agree well with computations, and also polydisperse solutions of physically-degraded LNPs, for which results follow expected trends. Mie effects on broad unimodal populations are also considered. There is no way to predict results between two instruments with different q for samples of unknown particle size distributions. Initial analysis of the polydispersity index among different instruments shows a technical difference due to method of autocorrelation analysis, in addition to the fundamental q-effect.

The spatial pattern and spatio-temporal evolution of COVID-19 in China

Objective To better control the spread of covID-19, it is important to understand the spatial pattern of covID-19 and its spatiotemporal evolution characteristics, and explore its distribution and diffusion laws. Methods In this study, based on the daily incidence data of covID-19 in china from January 22 to May 26, 2020, spatial autocorrelation was used to analyze the spatial pattern of covID-19, and center of gravity trajectory migration algorithm was used to explore spatial-temporal evolution process. Results In the study period, covID-19 had strong spatial dependence at the provincial scale. From January 22 to May 26, 2020, the global spatial correlation of covID-19 showed a trend of increasing from strong to weak. Moran’s I was negative in the range of (-0.04,-0.02) and had a small fluctuation range. The covID-19 epidemic in china showed a general pattern with Wuhan city in Hubei Province as the center, spreading to the surrounding cities and random distribution. The domestic epidemic were mainly high-low clusters, and high-high clusters were distributed in Hong Kong and Macao Special Administrative Regions, while Hubei Province had been in the high-low clusters. In the study period, the high-low cluster was only one province in Hubei Province, and the low-low clusters were mainly distributed in Heilongjiang Province and Tibet Autonomous Region. During the T,-T3 period, the epidemic spread rapidly from Wuhan City to the northwest. During the T4-T6 period, the epidemic gradually spread to the southwest. During the T7-T9 period, the epidemic spread to the northeast. Conclusions In the future epidemic prevention and control work, we should pay more attention to the study of epidemic spatial diffusion model, explore the factors affecting diffusion, so as to provide strong theoretical support for the formulation of precise epidemic prevention measures.

Female fertility under impact of COVID-19 pandemic: A narrative review

Coronavirus disease 2019 (COVID-19) is a serious respiratory disease mediated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The worldwide spread of COVID-19 has caused millions of confirmed cases and morbidity, and the crisis has greatly affected global economy and daily life and changed our attitudes towards life. The reproductive system, as a potential target, is at a high risk of SARS-CoV-2 infection, and females are more vulnerable to viral infection than males. Therefore, female fertility and associated reproductive health care in the COVID-19 era need more attention. This review summarizes the mechanism of SARS-CoV-2 infection in the female reproductive system and discusses the impact of the COVID-19 crisis on female fertility. Studies have proven that COVID-19 might affect female fertility and interfere with assisted reproductive technology procedures. The side effects of vaccines against the virus on ovarian reserve and pregnancy have not yet been well investigated yet. In the future, the female fertility after SARS-CoV-2 infection and vaccination needs more attention due to the uncertainty of COVID-19. Copyright © The Author(s), 2021. Published by Cambridge University Press.

GIS-based characteristics of Infectious disease transmission: A comparison of COVID-19 and SARS in Guangzhou, China

There are differences in the temporal and spatial characteristics of the spread of severe respiratory syndrome (SARS) and new coronavirus pneumonia (COVID-19). In order to explore the difference, this study selected Guangzhou as the research object. Based on the information of confirmed cases of new coronavirus pneumonia (COVID-19) given by the Guangzhou Municipal Health Commission, GIS software was used to analyze the differences in temporal and spatial characteristics of transmission. The study found that: Compared with SARS, COVID-19 spreads more widely and is more contagious. The spread of COVID-19 is characterized by a wide range and dispersion. Compared with SARS, the infection situation of medical staff in the prevention and control of the epidemic has been greatly improved. This study is helpful to grasp the characteristics of the time and space transmission of infectious diseases in metroetpolitan areas and provide effective early warning for emergency decision-making and prevention and control of the epidemic. © 2021 IEEE.

A cross-sectional survey on information access through hospital's official account on new media and its association with antenatal care knowledge and health behaviors of pregnant women under COVID-19 epidemic

Objective To explore the association between accessing antenatal care information through hospitals' official new media accounts and antenatal care knowledge and individual prevention behavior under COVID-19 epidemic, and to provide evidence for improving the emergency plan for maternity health care services in China under public health emergencies. Methods The online survey was conducted from Feb 5th to Mar 1st, 2020, at the peak of the COVID-19 epidemic in China. Approaches of accessing antenatal care information, COVID-19 related antenatal care knowledge and individual prevention behavior was collected via cross-sectional design. Results A total of 1 936 valid questionnaires were obtained from 21 provinces, autonomous regions and municipalities. Under the COVID-19 epidemic, 75.4% of the pregnant women reported they got institutional service and health education information from hospitals' official new media accounts such as WeChat and Weibo. Multivariate Logistic analysis showed that pregnant women who received information from official accounts of new media had higher scores of COVID-19 relevant antenatal care knowledge (aOR=1.36, 95%CI:1.08-1.71, P<0.01)and individual prevention behaviors(aOR=1.46, 95%CI:1.18-1.82, P<0.01) than those who obtained information from other sources. Conclusion The access to antenatal care knowledge via hospitals' official social media accounts was associated with better antenatal care knowledge and individual prevention behaviors among pregnant women. Under major public health emergency, it is suggested for health institutions to disseminate antenatal health care information via hospitals' official accounts in new media like Wechat and Weibo. Appropriate training should be developed to ensure the quality of health education and service provision in official new media accounts. © 2021, Editorial Department of Fudan University Journal of Medical Sciences. All right reserved.

Face-to-face classes hijacked by COVID-19: What and how HEI instructors want to learn for online teaching

Upon the forced interruption of face-to-face classes because of COVID-19, HEIs moved online to deliver courses in the spring semester of the 2019-2020 academic year. A survey of 108 instructors from HEIs in Wuhan, Hubei, China was carried out to Figure out the situation or perception of HEI instructors before, during and after the online transition. The research reveals a severe lack of online teaching experience among teaching staff prior to the transition but they got prepared mainly by self-directed learning or attending training programs. In the pandemic semester, about two thirds of respondents used five-streamed delivery while the rest employed asynchronous teaching and the most-frequently-encountered problems were internet connection failure, fake attendance and poor involvement of students. Almost all respondents agreed upon an investment in and speed up of the development of online teaching resources in the post-pandemic period and their primary concerns for training lied in how to engage students, how to design in-class activities and online course assessment. As for forms of training, smaller and more focused programs like small workshops or short training videos were more favored by the respondents. The research also reveals some interesting differences between different categories of respondents. © 2020 IEEE.

Blood molecular markers associated with COVID-19 immunopathology and multi-organ damage

COVID-19 is characterized by dysregulated immune responses, metabolic dysfunction and adverse effects on the function of multiple organs. To understand host responses to COVID-19 pathophysiology, we combined transcriptomics, proteomics, and metabolomics to identify molecular markers in peripheral blood and plasma samples of 66 COVID-19-infected patients experiencing a range of disease severities and 17 healthy controls. A large number of expressed genes, proteins, metabolites, and extracellular RNAs (exRNAs) exhibit strong associations with various clinical parameters. Multiple sets of tissue-specific proteins and exRNAs varied significantly in both mild and severe patients suggesting a potential impact on tissue function. Chronic activation of neutrophils, IFN-I signaling, and a high level of inflammatory cytokines were observed in patients with severe disease progression. In contrast, COVID-19-infected patients experiencing milder disease symptoms showed robust T-cell responses. Finally, we identified genes, proteins, and exRNAs as potential biomarkers that might assist in predicting the prognosis of SARS-CoV-2 infection. These data refine our understanding of the pathophysiology and clinical progress of COVID-19. SYNOPSIS image Proteomics, metabolomics and RNAseq data map immune responses in COVID-19 patients with different disease severity, revealing molecular makers associated with disease progression and alterations of tissue-specific proteins. A multi-omics profiling of the host response to SARS-CoV2 infection in 66 clinically diagnosed and laboratory confirmed COVID-19 patients and 17 uninfected controls. Significant correlations between multi-omics data and key clinical parameters. Alteration of tissue-specific proteins and exRNAs. Enhanced activation of immune responses is associated with COVID-19 pathogenesis. Biomarkers to predict COVID-19 clinical outcomes pending clinical validation as prospective marker.

A novel intervention recurrent autoencoder for real time forecasting and non-pharmaceutical intervention selection to curb the spread of Covid-19 in the world

As the Covid-19 pandemic soars around the world, there is urgent need to forecast the number of cases worldwide at its peak, the length of the pandemic before receding and implement public health interventions to significantly stop the spread of Covid-19. Widely used statistical and computer methods for modeling and forecasting the trajectory of Covid-19 are epidemiological models. Although these epidemiological models are useful for estimating the dynamics of transmission od epidemics, their prediction accuracies are quite low. To overcome this limitation, we formulated the real-time forecasting and evaluating multiple public health intervention problem into forecasting treatment response problem and developed recurrent neural network (RNN) for modeling the transmission dynamics of the epidemics and Counterfactual-RNN (CRNN) for evaluating and exploring public health intervention strategies to slow down the spread of Covid-19 worldwide. We applied the developed methods to the real data collected from January 22, 2020 to May 8, 2020 for real-time forecasting the confirmed cases of Covid-19 across the world.

Who gets the ventilator? Moral decision making regarding medical resource allocation in a pandemic

As the COVID-19 pandemic increases the number of critically ill patients flowing into hospitals, hospitals in many countries are facing a growing shortage of vital equipment and supplies, presenting ethical dilemmas to physicians who have to decide which COVID-19 patients to prioritize when resources are scarce. Using over 75,000 hypothetical decisions collected from over 5,000 people across 11 countries accounting for over 69% of all COVID-19 cases reported worldwide, we explore lay people’s preferences of how scarce medical resources should be allocated in the time of the COVID-19 pandemic. We first examine the global ethical preferences in medical resource allocation decisions as well as cross-country differences. We then document individual variations in these preferences. Our findings suggest that people have the strongest preferences for saving young (vs. old) patients and saving patients that are more likely to survive, indicating that lay people consider maximizing total benefits as the most important ethical rule when allocating scarce medical resources in the COVID-19 pandemic. Country-level differences in cultural dimensions (e.g., individualism-collectivism) and economic development (e.g., GDP per capita) contribute to cross-country differences in weights attached to various patient characteristics. Individual characteristics (e.g., gender, age, religiosity) and the severity of the local pandemic also have an impact on people’s ethical preferences. © 2020 the Association for Consumer Research. All rights reserved.

Analysis on the characteristics and contributing factors of ophthalmic online consultation during the COVID-19 epidemic

AIM: To analyze the demands, consultation patterns and contributing factors of the patients involved in the ophthalmic on-line consultation during the COVID-19 epidemic to provide reference for the optimization of the ophthalmic online health care system. METHODS: Prospective observational study. The patients using "expert online consultation" provided by the Zhongshan Ophthalmic Center from February 1 to March 15, 2020 were enrolled. The baseline characteristics were analyzed. For the patients with repeated consultation, we randomly selected the same amount of patients with single consultation as comparison. The baseline characteristics, consultation purposes, disease types, and number of combined eye diseases between the patients with single and repeated consultation were compared, and the contributing factors of patients'consultation pattern were analyzed with statistical test and regression model. RESULTS: The "expert online consultation" provided 9 831 consultations during the study, 3 919 of which were single consultation while 5 912 of which came from the repeated consultations of 1 967 patients. 1 967 patients with single consultation were randomly selected and compared with the repeated inquirers. The main consultation purposes in the both groups were "return visit" (59.7%, 64.9%). There was no significant difference in age and gender distribution between the patients with single online visit and repeated online visits(P=0.897, 0.482). Compared with the patients with single visit, the patients with repeated visit were less with the purpose of "new-onset discomfort", more with the purpose of "return visit" and "follow-up after surgery", more with ocular surface, fundus and uveal diseases, and more with two or more combined eye diseases. Regression analysis showed that the patients with ocular refractive issues tended to have a single consultation, while the patients inquired on previous eye disease and surgery, with fundus or uveal disease tended to have repeated consultations. The number of repeated visits for the patients with diagnosed ophthalmopathy and ophthalmic surgery was higher than that for the patients with new-onset discomfort;the number of repeated visits was lower for the patients with lens and anterior segment diseases, and was higher for the patients with ocular surface diseases. CONCLUSION: During the COVID-19 epidemic, the main purpose of on-line ophthalmic consultation was return visit for the diagnosed eye diseases. Type of eye disease, consultation purpose and number of combined ophthalmopathies all affected whether the patients repeated the consultation and the repeated times. The arrangement of ophthalmologists in different sub-specialties should be adjusted according to the patients' needs and their consultation patterns.