A moderately higher time-in-range threshold improves the prognosis of type-2 diabetes patients complicated with COVID-19 (preprint)

After fully lifting coronavirus disease 2019 (COVID-19) pandemic control measures in mainland China in 12/2022, the incidence of COVID-19 has increased markedly, making it difficult to meet the general time-in-range (TIR) requirement. We investigated a more clinically practical TIR threshold and examined its association with the prognosis of COVID-19 patients with type-2 diabetes. Sixty-three type-2 diabetes patients complicated with COVID-19 were evaluated. Patient information included epidemiological and laboratory characteristics, treatment options and outcomes. The percentages of time-above-range (TAR), time-below-range (TBR) and TIR were calculated from intermittently scanned continuous glucose monitoring. The composite end point included a >20-day length of stay, intensive care unit admission, mechanical ventilation use, or death. TIR with thresholds of 80 to 190 mg/dL was significantly associated with favorable outcomes. An increase of 1% in TIR is connected with a reduction of 3.70% in the risk of adverse outcomes. The Youden index was highest when the TIR was 54.73%, and the sensitivity and specificity were 58.30% and 77.80%, respectively. After accounting for confounding variables, our analysis revealed that threshold target ranges (TARs) ranging from 200 mg/dL to 230 mg/dL significantly augmented the likelihood of adverse outcomes.The TIR threshold of 80 to 190 mg/dL has a comparatively high predictive value of the prognosis of COVID-19. TIR >54.73% was associated with a decreased risk of adverse outcomes. These findings provide clinically critical insights into possible avenues to improve outcomes for COVID-19 patients with type-2 diabetes.

COVID-19 causing death in a rheumatoid arthritis patient who retested positive for SARS-CoV-2 RNA: A case report.

BACKGROUND: In the first half 2022, SARS-CoV-2 variant omicron rapidly spread in Shanghai. CASE PRESENTATION: A 74-year-old woman, diagnosed as having rheumatoid arthritis for almost 30 years and treated with prednisone and cyclophosphamide, went through nasopharyngeal swab RNA test for SARS-CoV-2 for routine screening and was positive. She was then sent to the designated hospital. After negative RNA test, the patient returned to the former hospital for the treatment of basic disease. Unfortunately, the RNA test of this patient became positive again. And in this period, the clinical manifestations and computed tomography scans were more progressive. Finally, the patient passed away. CONCLUSION: There is a long way to go for us to study expression characteristics of SARS-CoV-2.

Comparison of respiratory pathogens in children with community-acquired pneumonia before and during the COVID-19 Pandemic (preprint)

Background Multifaceted non-pharmaceutical interventions during the COVID-19 pandemic have not only reduced the transmission of SARS-CoV2, but have had an effect on the prevalence of other pathogens. This retrospective study aimed to compare and analyze the changes of respiratory pathogens in hospitalized children with community-acquired pneumonia.Methods From January 2019 to December 2020, children with community-acquired pneumonia were selected from the Department of Respiratory Medicine, Shanghai Children's Medical Center. On the first day of hospitalization, sputum, throat swabs, venous blood samples from them were collected for detection of pathogens.Results A total of 2596 children with community-acquired pneumonia were enrolled, including 1871 patients in 2019 and 725 in 2020. The detection rate in 2020 was lower than in 2019, whether single or multiple pathogens. Compared with 2019, the detection rate of virus, especially parainfluenza virus, influenza virus and respiratory syncytial virus, all decreased in 2020. On the contrary, the prevalence of human rhinovirus was much higher than that in 2019. In addition, the positivity rate for bacteria did not change much over the two years, which seemed to be less affected by COVID-19. And Mycoplasma pneumoniae which broke out in 2019 has been in low prevalence since March 2020 even following the reopening of school.Conclusions Strict public health interventions for COVID-19 in China have effectively suppressed the spread of not only SARS-CoV2 but parainfluenza virus, influenza virus and Mycoplasma pneumonia as well. However, it had a much more limited effect on bacteria and rhinovirus. Therefore, more epidemiological surveillance of respiratory pathogens will help improve early preventive measures.

Associations between anthropometric indicators and refraction in school-age children during the post-COVID-19 era

Purpose To explore the associations between anthropometric indicators and refraction in school-aged children in the post-COVID-19 era. Methods Data were collected from 25,644 children aged 7 to 12 years in 48 elementary schools in Tianjin. The comprehensive examination included height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), refraction, and calculation of BMI, with a follow-up visit after 6 months. Myopia was defined as spherical equivalent refraction (SER) ≤-0.50 diopter (D). Bivariate correlation coefficients and multiple linear regression models were used to explore the cross-sectional and longitudinal associations between anthropometric indicators (height, weight, BMI, SBP, and DBP) and refraction. Results The mean changes in height, weight, BMI, SBP, DBP, and SER of the participants were 4.03 ± 2.18 cm, 3.10 ± 2.39 kg, 0.45 ± 1.16 kg/m2, 2.26 ± 14.74 mmHg, 2.18 ± 11.79 mmHg and −0.17 ± 0.51 D, respectively. Overall, height, weight, BMI, SBP, and DBP were all correlated with SER (r = −0.324, r = −0.234, r = −0.121, r = −0.112, r = −0.066, both p < 0.001), and changes in height and weight were correlated with changes in SER (r = −0.034, −0.031, both p < 0.001). Furthermore, multiple linear regression analysis revealed that the association of BMI, SBP, and DBP with SER was significant in myopic children but not in non-myopic children. The association between changes in weight and changes in SER was only present in non-myopic children but not in myopic children. Conclusion Height and weight were negatively correlated with SER in both cross-sectional analysis and longitudinal changes, indicating that children's height, weight and growth rate may be used as a reference indicator for myopia risk prediction and myopia progression monitoring.

The network pharmacology of the mechanism of the drug pair on the treatment of new Coronavirus pneumonia offending lung health syndrome

Objective: To explore the main pathways and possible mechanisms of Lonicera japonica-forsythia in the treatment of COVID-19 using network pharmacology.

Latent profile analysis of security among patients with COVID-19 infection in mobile cabin hospitals and its relationship with psychological capital

Aim COVID-19 patients' security is related to their mental health. However, the classification of this group's sense of security is still unclear. The aim of our research is to clarify the subtypes of security of patients infected with COVID-19, explore the factors affecting profile membership, and examine the relationship between security and psychological capital for the purpose of providing a reference for improving patients' sense of security and mental health. Methods A total of 650 COVID-19 patients in a mobile cabin hospital were selected for a cross-sectional survey from April to May 2022. They completed online self-report questionnaires that included a demographic questionnaire, security scale, and psychological capital scale. Data analysis included latent profile analysis, variance analysis, the Chi-square test, multiple comparisons, multivariate logistical regression, and hierarchical regression analysis. Results Three latent profiles were identified—low security (Class 1), moderate security (Class 2), and high security (Class 3)—accounting for 12.00, 49.51, and 38.49% of the total surveyed patients, respectively. In terms of the score of security and its two dimensions, Class 3 was higher than Class 2, and Class 2 was higher than Class 1 (all P < 0.001). Patients with difficulty falling asleep, sleep quality as usual, and lower tenacity were more likely to be grouped into Class 1 rather than Class 3;Patients from families with a per capita monthly household income <3,000 and lower self-efficacy and hope were more likely to be grouped into Classes 1 and 2 than into Class 3. Psychological capital was an important predictor of security, which could independently explain 18.70% of the variation in the patients' security. Conclusions Security has different classification features among patients with COVID-19 infection in mobile cabin hospitals. The security of over half of the patients surveyed is at the lower or middle level, and psychological capital is an important predictor of the patients' security. Medical staff should actively pay attention to patients with low security and help them to improve their security level and psychological capital.

Localizing Scan Targets from Human Pose for Autonomous Lung Ultrasound Imaging (preprint)

Ultrasound is progressing toward becoming an affordable and versatile solution to medical imaging. With the advent of COVID-19 global pandemic, there is a need to fully automate ultrasound imaging as it requires trained operators in close proximity to patients for a long period of time, therefore increasing risk of infection. In this work, we investigate the important yet seldom-studied problem of scan target localization, under the setting of lung ultrasound imaging. We propose a purely vision-based, data driven method that incorporates learning-based computer vision techniques. We combine a human pose estimation model with a specially designed regression model to predict the lung ultrasound scan targets, and deploy multiview stereo vision to enhance the consistency of 3D target localization. While related works mostly focus on phantom experiments, we collect data from 30 human subjects for testing. Our method attains an accuracy level of 16.00(9.79) mm for probe positioning and 4.44(3.75) degree for probe orientation, with a success rate above 80% under an error threshold of 25mm for all scan targets. Moreover, our approach can serve as a general solution to other types of ultrasound modalities. The code for implementation has been released.

Contested Journalistic Professionalism in China: Journalists’ Discourses in a Time of Crisis

Legacy media worldwide face challenges from both digital platforms and new media rivalries. China offers alternative views and modes of journalistic practices in response to the worldwide "professionalism" crisis. The outbreak of the COVID-19 pandemic has provided legacy media with an opportunity to reassert journalistic professionalism at a critical moment. Taking the market-oriented media outlet Caixin as a case, this study explores how Chinese journalists articulate their professional roles, values and ideals in the coverage of COVID-19. Through discourse analysis, we find that Caixin has defended its authority and legitimacy as quality journalism by incorporating "self-reflexivity" and "transparency" in their professional practices in the digital age. In response to the global journalism crisis, while Chinese state media have adopted the Marxist view, positivity and "conditioned autonomy" to counter the Western "professionalism", market-oriented media represented by Caixin have turned inward to "reflexivity" and "transparency" as a compromising strategy in their professional conventions.

Psychological disorders and related factors among Chinese adolescent earthquake survivors during the COVID-19 pandemic

We studied the mental health of adolescent earthquake survivors during the COVID-19 pandemic by measuring their psychological disorders with the Zung Self-Rating Depression Scale (SDS) and their risk factors with the Zung Self-Rating Anxiety Scale (SAS). We conducted an exploratory factor analysis and logistic regression modeling and the results revealed that there were high levels of depression and anxiety among the 385 participants. Significant indicators of depression as measured by the SDS were family monthly income, years of education of the adolescents, and marital status of parents. The SAS measured family monthly income as a significant factor predicting anxiety. This study will provide references for future psychological support and early interventions for disadvantaged groups during the ongoing COVID-19 pandemic.

COVID-19 and big data technologies: Experience in China

The experience of COVID-19 has shown that big data combined with advanced algorithms have a huge potential in supporting the fight against infectious diseases and pandemics. In China, big data on human mobility derived from smart sensors, integrated with detailed epidemiological data from patient interviews, have played an important role in the efficient and effective control of the pandemic via nonpharmaceutical interventions. Two official big data applications, namely “Health Code” and “Instrument for Measuring Close Contacts,” have been promoted to detect infected people with the potential to infect and conduct risk assessments in a timely manner during the pandemic. We explored the relationship between big data technologies and applications in virus transmission, risk assessment, and recovery decision making. In the future, the process of social recovery is likely to require the support of big data technology. The experience of using big data in China is expected to bring new insights into policymaking to control the COVID-19 pandemic in other countries and prevent future pandemics.

Pathways from self-disclosure to medical coping strategy among adolescents with moderate and major depression during the COVID-19 pandemic: A mediation of self-efficacy

Background The prevalence of adolescent depression in China during the COVID-19 pandemic is increasing. Self-disclosing depressive emotions could help release stress. Self-disclosure, which is a prerequisite for self-efficacy, can directly contribute to people’s psychological health, and depression and the choice of coping strategy are determined by the level of self-efficacy perceived. Purpose We aimed to discuss the relationship between self-efficacy, self-disclosure, and medical coping strategy. Further, we explore the mediation effect of self-efficacy on the influence of self-disclosure on medical coping strategies in adolescents with depression. Methods A total of 585 patients aged 11–24 years with moderate and major depression were recruited. All the assessments were completed on the second day after admission, including the General Self-Efficacy Scale (GSE), Distress Disclosure Index (DDI), and Medical Coping Modes Questionnaire (MCMQ). Pearson correlation was performed to explore the relationships of these variables. The bootstrap analysis was used to conduct to assess the mediation effects. Results Both direct and indirect effects of self-disclosure on medical coping strategy were found. As predicted, self-efficacy partially mediated the relationship between self-disclosure and medical coping strategy (b = 0.0385, 95% CI: 0.0244–0.0538 for Confrontation;b = –0.0466, 95%CI: –0.0651 to –0.0296 for Resignation), respectively. The effect size for Confrontation and Resignation was 0.2659 and 0.2485, respectively. Conclusion Self-efficacy played a partial mediating role in the effect of self-disclosure on medical coping strategies for adolescent depression during the COVID-19 pandemic, and the use of a positive self-disclosure mechanism may be anticipated to promote improved self-efficacy and the use of active coping strategies.

Working Toward Becoming Doctoral Researchers: A Collective Autoethnography of International Students in Australia

It is well established that international education can profoundly influence a student, including identity and agency formation and the acquisition of knowledge and culture. This study applies the concept of self-formation to reconceptualize the international student experience. It captures the development, changes, and operation of identity and agency during self-formation. Utilizing collective autoethnography, the authentic experiences of three international students studying in Australia during the Covid-19 pandemic were collected. These stories illustrate their transformation from international students to student researchers. Through thematic analysis, three phases have been identified in this study, which are self-exploration, self-positioning, and self-determination and shedding light on the role of agency and hybrid identity. A further scholarly investigation is advocated to enrich the discussion of self-formation and add a nuanced investigation into the variability of individual experiences.

Safety and immunogenicity of a broad-spectrum mosaic vaccine as a booster dose against SARS-CoV-2 Omicron and other circulating variants (preprint)

BACKGROUNDThe rising breakthrough infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, especially Omicron and its sub-lineages, have raised an urgent need to develop broad-spectrum vaccines against coronavirus disease 2019 (COVID-19). We have developed a mosaic-type recombinant vaccine candidate, named NVSI-06-09, having immune potentials against a broad range of SARS-CoV-2 variants. METHODSAn ongoing randomized, double-blind, controlled phase 2 trial was conducted to evaluate the safety and immunogenicity of NVSI-06-09 as a booster dose in subjects aged 18 years and older from the United Arab Emirates (UAE), who had completed two or three doses of BBIBP-CorV vaccinations at least 6 months prior to the enrollment. The participants were randomly assigned with 1:1 to receive a booster dose of NVSI-06-09 or BBIBP-CorV. The primary outcomes were immunogenicity and safety against SARS-CoV-2 Omicron variant, and the exploratory outcome was cross-immunogenicity against other circulating strains. RESULTSA total of 516 participants received booster vaccination. Interim results showed a similar safety profile between NVSI-06-09 and BBIBP-CorV booster groups, with low incidence of adverse reactions of grade 1 or 2. For immunogenicity, by day 14 after the booster vaccination, the fold rises in neutralizing antibody geometric mean titers (GMTs) from baseline level elicited by NVSI-06-09 were remarkably higher than those by BBIBP-CorV against the prototype strain (19.67 vs 4.47-fold), Omicron BA.1.1 (42.35 vs 3.78-fold), BA.2 (25.09 vs 2.91-fold), BA.4 (22.42 vs 2.69-fold), and BA.5 variants (27.06 vs 4.73-fold). Similarly, the neutralizing GMTs boosted by NVSI-06-09 against Beta and Delta variants were also 6.60-fold and 7.17-fold higher than those boosted by BBIBP-CorV. CONCLUSIONSA booster dose of NVSI-06-09 was well-tolerated and elicited broad-spectrum neutralizing responses against SARS-CoV-2 prototype strain and immune-evasive variants, including Omicron and its sub-lineages. The immunogenicity of NVSI-06-09 as a booster vaccine was superior to that of BBIBP-CorV. (Funded by LIBP and BIBP of Sinopharm; ClinicalTrials.gov number, NCT05293548).

XCO2 and XCH4 Reconstruction Using GOSAT Satellite Data Based on EOF-Algorithm

The Greenhouse Gases Observing Satellite (GOSAT) can help to ascertain the global distribution of carbon dioxide (CO2) and methane (CH4), and how the sources and sinks of these gases vary by season, year, and location. However, the data provided by the GOSAT level 2 and 3 products have certain limitations due to their lack of spatial and temporal information;even with the application of the kriging geostatistical method on the level 2 products, the processing algorithms still need further upgrades. In this study, we apply an empirical orthogonal function (EOF)-based method on the GOSAT L3 products (137 images, from January 2010 to May 2021) to estimate the column average of carbon dioxide and methane (XCO2–XCH4) within the entire Earth. The reconstructed results are validated against the Total Carbon Column Observing Network (i.e., TCCON), with 31 in situ stations, and GOSAT L4B column-averaged data, using 107 layers. The results show an excellent agreement with the TCCON data and exhibit an R-squared coefficient of 0.95 regarding the CO2 measurements and 0.86 regarding the CH4 measurements. Therefore, this methodology can be incorporated into the processing steps used to map global greenhouse gases.

N-Acetylcysteine Treatment Accelerates Patient-Reported Outcomes Improvement in Patients With COVID-19 A Prospective Study (preprint)

Background: Since its outbreak in late December 2019, the coronavirus disease 2019 (COVID-19) has culminated in a global pandemic, and its causative virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has continued to mutate, with increasing rates of transmission and pathogenicity, having a serious worldwide impact. This study aims to assess the benefits of the health-related quality of life of using N-acetylcysteine(NAC).Methods: In this prospective observational research, 63 confirmed COVID-19 patients who were treated between the ends of January and March 2020 were divided into patients treated with NAC-treatment (32 cases) and non-NAC-treatment groups (31 cases). Patients were followed up at discharge and at 1, 3, and 6 months after discharge. The clinical treatment effects of the two groups were compared, and the St. George’s Respiratory Questionnaire (SGRQ) evaluated patient-reported outcomes.Results: There were strong correlations between SGRQ component scores (0.728, 0.749, 0.850; P < 0.001 for all items) as well as between each SGRQ component score and the total patient score (0.822, 0.958, 0.957; P < 0.001 for all items). In the univariate analysis, the change differences of one month after discharge compared with discharge between two groups patients were statistically significant in the impacts and total scores (753.000, P < 0.001; 644.000, P = 0.042); the change differences of three months after discharge compared with discharge were also significant in the activity, impacts, and total scores (660.500, P = 0.022; 800.000, P < 0.001; 707.000, P = 0.004). In the multivariate analysis, the factors that have statistically significant influence on the unit value of SGRQ total score difference (UVDSGRQ) is NAC treatment (β = 1.954, P < 0.001), disease severity (β = 3.179, P < 0.001), follow-up duration (β = -0.232, P = 0.001), as well as NAC treatment and follow-up duration interaction item (β = -0.436, P = 0.004).Conclusion: Our study shows as the follow-up time increases, the SGRQ total scores of patients treated with NAC decreases significantly faster than those who were treated without NAC. In the treatment of COVID-19 patients, increasing the use of NAC has clinical significance.

Alterations of Urinary Microbial Metabolites and Immune Indexes Linked With COVID-19 Infection and Prognosis

Coronavirus disease 2019 (COVID-19) has evolved into an established global pandemic. Metabolomic studies in COVID-19 patients is worth exploring for further available screening methods. In our study, we recruited a study cohort of 350 subjects comprising 248 COVID-19 patients (161 non-severe cases, 60 asymptomatic cases, and 27 severe cases) and 102 healthy controls (HCs), and herein present data with respect to their demographic features, urinary metabolome, immunological indices, and follow-up health status. We found that COVID-19 resulted in alterations of 39 urinary, mainly microbial, metabolites. Using random forest analysis, a simplified marker panel including three microbial metabolites (oxoglutaric acid, indoxyl, and phenylacetamide) was constructed (AUC=0.963, 95% CI, 0.930-0.983), which exhibited higher diagnostic performance than immune feature-based panels between COVID-19 and HC groups (P<0.0001). Meanwhile, we observed that urine metabolic markers enabled discriminating asymptomatic patients (ASY) from HCs (AUC = 0.981, 95% CI, 0.946-0.996), and predicting the incidence of high-risk sequalae in COVID-19 individuals (AUC=0.931, 95% CI, 0.877-0.966). Co-expression network analysis showed that 13 urinary microbial metabolites (e.g., oxoglutaric acid) were significantly correlated with alterations of CD4+, CD3+, and CD8+ T-cells, as well as IFN-γ, IL-2 and IL-4 levels, suggesting close interactions between microbial metabolites and host immune dysregulation in COVID-19. Taken together, our findings indicate that urinary metabolites may have promising potential for screening of COVID-19 in different application scenarios, and provide a new entry point to understand the microbial metabolites and related immune dysfunction in COVID-19.