Timing and Depth Selection for Sedated Gastroscopy After SARS-CoV-2 Infection—A Retrospective Cohort Study (preprint)

Background Sedated gastroscopy is a crucial procedure for patients with upper respiratory infections. SARS-CoV-2-infected patients are more susceptible to anesthesia-related complications, such as edema, pharyngeal mucosa congestion, laryngospasm, and pulmonary infections.Methods We retrospectively analyzed a total of 386 patients who underwent sedated gastroscopy at the Affiliated Hospital of Qingdao University during the SARS-CoV-2 infection period. The patients were divided into three groups based on SARS-CoV-2 status: Negative (N), Two-week post-SARS-CoV-2 infection (T), and Three-week post-SARS-CoV-2 infection (Th) groups. Based on the anesthesia method, patients were divided into mild/moderate sedation and deep sedation/general anesthesia groups. Additionally, patients were categorized into groups based on COVID-19 severity and vaccination status. We recorded the laryngeal mucosal conditions, the occurrence rates of adverse reactions such as coughing, laryngospasm, and transient oxygen desaturation during the examination, as well as the satisfaction of patients and endoscopists were recorded.Results The T group displayed a significantly higher occurrence rate of adverse reactions when compared to the N and Th group, with decreased satisfaction levels of patients and endoscopists. In the T group, the occurrence rate of adverse reactions was higher in mild to moderate sedation than in deep sedation/general anesthesia methods, while patient and endoscopist satisfaction was lower. In the Th group, there was no statistically significant difference in the examination success rate or patient satisfaction between the mild/moderate sedation and deep sedation/general anesthesia methods; however, endoscopist satisfaction was lower with mild/moderate sedation method than deep sedation/general anesthesia method. There was a significant difference in the gastroscopy success rates of patients with different COVID-19 classifications. A significant difference was observed in the gastroscopy success rates among patients with different vaccination statuses.Conclusions Sedated gastroscopy post-three weeks of SARS-CoV-2 infection is safe. Moreover, using a deep sedation/general anesthesia method for sedated gastroscopy in SARS-CoV-2-infected patients within three weeks is significantly safer.

The Impact of Post Embryo Transfer SARS-CoV-2 Infection on Pregnancy in In Vitro Fertilization: A Prospective Cohort Study (preprint)

ImportanceLimited knowledge exists on the effects of SARS-CoV-2 infection after embryo transfer, despite an increasing number of studies exploring the impact of previous SARS-CoV-2 infection on IVF outcomes. ObjectiveThis prospective cohort study aimed to assess the influence of SARS-CoV-2 infection at various time stages after embryo transfer on pregnancy outcomes in patients undergoing conventional in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI) treatment. DesignThe study was conducted at a single public IVF center in China. SettingThis was a population-based prospective cohort study. ParticipantsFemale patients aged 20 to 39 years, with a body mass index (BMI) between 18 and 30 kg/m2, undergoing IVF/ICSI treatment, were enrolled from September 2022 to December 2022, with follow-up until March 2023. ExposureThe pregnancy outcome of patients was compared between those SARS-CoV-2-infected after embryo transfer and those noninfected during the follow-up period. Main Outcomes and MeasuresThe pregnancy outcomes included biochemical pregnancy rate, implantation rate, clinical pregnancy rate, and early miscarriage rate. ResultsA total of 857 female patients undergoing IVF/ICSI treatment were included in the analysis. We observed the incidence of SARS-CoV-2 infection within 10 weeks after embryo transfer. The biochemical pregnancy rate and implantation rate were lower in the infected group than the uninfected group (58.1% vs 65.9%; 36.6% vs 44.0%, respectively), but no statistically significant. Although, the clinical pregnancy rate was significant lower in the infection group when compared with the uninfected group (49.1%vs 58.2%, p < 0.05), after adjustment for confounders, this increased risk was no longer significant between the two groups (adjusted OR, 0.736, 95% CI, 0.518-1.046). With continued follow-up, a slightly higher risk of early miscarriage in the infected group compared to the uninfected group (9.3% vs 8.8%), but it was not significant (adjusted OR, 0.907, 95% CI, 0.414-1.986). Conclusions and RelevanceThe studys findings suggested that SARS-CoV-2 infection within 10 weeks after embryo transfer may have not significantly affect pregnancy outcomes. This evidence allays concerns and provides valuable insights for assisted reproduction practices. Key pointsO_ST_ABSQuestionC_ST_ABSDid the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after embryo transfer affect pregnancy outcomes? FindingsIn this prospective cohort study involving 857 patients, we made a pioneering discovery that SARS-CoV-2 infection following embryo transfer did not exhibit adverse impact on the biochemical pregnancy rate, embryo implantation rate, clinical pregnancy rate, and early miscarriage rate. MeaningThe evidence from this study alleviates existing concerns and offers new insights into the actual risk of SARS-CoV-2 infection after embryo transfer in assisted reproduction.

Advances in cell death mechanisms involved in viral myocarditis.

Viral myocarditis is an acute inflammatory disease of the myocardium. Although many etiopathogenic factors exist, coxsackievirus B3 is a the leading cause of viral myocarditis. Abnormal cardiomyocyte death is the underlying problem for most cardiovascular diseases and fatalities. Various types of cell death occur and are regulated to varying degrees. In this review, we discuss the different cell death mechanisms in viral myocarditis and the potential interactions between them. We also explore the role and mechanism of cardiomyocyte death with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Exploring the mechanisms may help in the early identification and the development of effective treatments, thus improving the quality of life of patients with viral myocarditis. We believe that the inhibition of cardiomyocyte death has immense therapeutic potential in increasing the longevity and health of the heart.

Risk factors for concomitant infectious pancreatic necrosis in patients with severe acute pancreatitis: A systematic review and meta-analysis.

OBJECTIVE: Acute pancreatitis (AP) is a self-limiting disease. However, 20-30% of patients will develop into severe AP (SAP), and infectious pancreatic necrosis in the late course of SAP is the leading cause of death for such patients. This review aims to provide a comprehensive and systematic report of the currently published risk factors for complicated infectious pancreatic necrosis in patients with severe acute pancreatitis by meta-analysis of published retrospective case-control studies. METHODS: Five electronic database systems were selected to search for articles on risk factors of infectious pancreatic necrosis in patients with severe acute pancreatitis. According to the heterogeneity among studies, the standardized mean difference (SMD), odds ratio and 95% confidence interval (95%CI) were calculated by applying a random-effects model or fixed-effects model, respectively. RESULTS: As of 2nd Jun, 2021, a total of 1408 articles were searched, but only 21 articles were finally included in this meta-analysis. The results found that patients with severe acute pancreatitis complicated by infected pancreatic necrosis had higher APACHE II scores and higher levels of lipase (LPS), C-reactive protein (CRP) and procalcitonin (PCT) compared to patients with severe acute pancreatitis alone. The differences were statistically significant (APACHE II: SMD = 0.86, 95%CI: 0.55, 1.18; LPS: SMD = 1.52, 95%CI: 1.13, 1.92; CRP: SMD = 1.42, 95%CI: 1.05, 1.79; PCT: SMD = 1.82, 95%CI: 1.36, 2.28). CONCLUSIONS: Compared with patients with severe acute pancreatitis alone, high levels of LPS, CRP, PCT and high APACHE II score were risk factors for infectious pancreatic necrosis in patients with severe acute pancreatitis.

Latent Class Analysis of Healthcare Workers' Job Demands in Mobile Cabin Hospitals In China (preprint)

Owing to the outbreak of the Omicron variant of SARS-CoV-2 in Shanghai, China, partitioned dynamic closure and control management plans were implemented on March 28, 2022. This created huge emergency pressure on Shanghai’s medical and healthcare systems. However, the job needs and classification of frontline healthcare workers (HCWs) in mobile cabin hospitals are unknown. In this study, we investigated the job demands of 1223 frontline HCWs working in mobile cabin hospitals during the COVID-19 pandemic (May 25, 2022 to June 9, 2022). We performed latent class analysis to identify classification features of job demands. A binary multivariate logistic regression model was used to explore the influencing factors of latent class. The total mean job demand score was 132.26 (SD = 9.53), indicating a high level of job demand. A two-class model provided the best fit. The two classes were titled “middle-demand group” (17.66%) and “high-demand group” (82.34%). A regression analysis suggested that female HCWs, HCWs satisfied with the doctor/nurse–patient relationship, HCWs who believed that the risk of working in mobile cabin hospitals was high, and HCWs without physical discomfort during the pandemic were more likely to be in the “high-demand group”. Characteristics of the “high-demand group” subtype suggest that attention should be paid to the physical condition of frontline HCWs and the job demands of female HCWs. Managers should strengthen the training of HCWs in terms of their communication skills as well as their knowledge and technical skills to aid epidemic prevention and control.

NULISA: a novel proteomic liquid biopsy platform with attomolar sensitivity and high multiplexing (preprint)

The blood proteome holds great promise for precision medicine but poses daunting challenges due to the low abundance of the majority of plasma proteins and the vast dynamic range across the proteome. We report the development and validation of a novel proteomic analysis technology - NUcleic acid Linked Immuno-Sandwich Assay (NULISA) - that incorporates a dual capture and release mechanism to suppress the assay background to the minimum, thus drastically improving the signal-to-noise ratio. NULISA improves the sensitivity of the proximity ligation assay by over 10,000-fold to the attomolar level, which is enabled by antibody-conjugated DNA sequences that mediate the purification of immunocomplexes and contain target- and sample-specific barcodes for next-generation sequencing-based, highly multiplexed analysis. To demonstrate its performance and utility, we developed a 200-plex NULISA targeting 124 cytokines and chemokines and 80 other immune response-related proteins that demonstrated superior sensitivity for detecting low-abundance proteins and high concordance with other immunoassays. The ultra-high sensitivity enabled the detection of previously difficult-to-detect but biologically important, low-abundance biomarkers in patients with autoimmune diseases and COVID-19. Fully automated NULISA uniquely addresses longstanding challenges in the proteomic analysis of liquid biopsy samples and makes broad and in-depth proteomic analysis accessible to the general research community and future diagnostic applications.

Association of cytomegalovirus infection with hemorheology, endothelin level and prognosis of elderly patients with coronary heart disease

OBJECTIVE: To explore the association of cytomegalovirus(CMV) infection with hemorheology, endothelin level and prognosis of elderly patients with coronary heart disease. METHODS: A total of 86 elderly patients with coronary heart disease who had CMV infection and were treated in the Second Affiliated Hospital of Henan University of Science and Technology from Oct 2017 to Jun 2019 were assigned as the infection group, and 71 patients without CMV infection were chosen as the no infection group. The hemorheological indexes, endothelin level and incidence of adverse cardiovascular events were compared between the two groups, and the relationship between CMV-DNA load and hemorheological indexes, endothelin level was observed. RESULTS: The high shear viscosity, low shear viscosity, plasma viscosity, Hematocrit and endothelin level of the infection group were respectively(6.89+or-0.95)mPa.s,(11.12+or-1.20)mPa.s,(2.31+or-0.45) mPa.s, (53.54+or-4.97)% and(89.34+or-9.63)pg/ml, significantly higher than those of the no infection group(P<0.05). The endothelin level of the patients with CMV-DNA load no less than 1x10~3copies/ml was significantly higher than that of the patients with CMV-DNA load less than 1x10~3 copies/ml(P<0.05). The incidence of adverse cardiovascular events of the infection group was 12.79%, significantly higher than that of the no infection group(P<0.05). CONCLUSION: The CMV infection may raise the levels of hemorheological indexes and endothelin of the elderly patients with coronary heart disease and lead to the increase of incidence of adverse cardiovascular events.

Bivalent mRNA vaccine improves antibody-mediated neutralization of many SARS-CoV-2 Omicron lineage variants (preprint)

The early Omicron lineage variants evolved and gave rise to diverging lineages that fueled the COVID-19 pandemic in 2022. Bivalent mRNA vaccines, designed to broaden protection against circulating and future variants, were authorized by the U.S. Food and Drug Administration (FDA) in August 2022 and recommended by the U.S. Centers for Disease Control and Prevention (CDC) in September 2022. The impact of bivalent vaccination on eliciting neutralizing antibodies against homologous BA.4/BA.5 viruses as well as emerging heterologous viruses needs to be analyzed. In this study, we analyze the neutralizing activity of sera collected after a third dose of vaccination (2-6 weeks post monovalent booster) or a fourth dose of vaccination (2-7 weeks post bivalent booster) against 10 predominant/recent Omicron lineage viruses including BA.1, BA.2, BA.5, BA.2.75, BA.2.75.2, BN.1, BQ.1, BQ.1.1, XBB, and XBB.1. The bivalent booster vaccination enhanced neutralizing antibody titers against all Omicron lineage viruses tested, including a 10-fold increase in neutralization of BQ.1 and BQ.1.1 viruses that predominated in the U.S. during the last two months of 2022. Overall, the data indicate the bivalent vaccine booster strengthens protection against Omicron lineage variants that evolved from BA.5 and BA.2 progenitors.

Examining continuance intention of online learning during COVID-19 pandemic: Incorporating the theory of planned behavior into the expectation–confirmation model

COVID-19 pandemic has tremendously affected many industries in the world, including higher education. To cope with changes in the pandemic, online learning has become a prevalent means for university students to receive education. Based on the expectation-confirmation model (ECM) and the theory of planned behavior (TPB), this study aims to develop an integrated model, consisting of confirmation, perceived usefulness, satisfaction, perceived enjoyment, subjective norm, perceived behavioral control, and continuance intention instruments, to predict Chinese university students’ continuance intention toward online learning. Using convenience sampling, we enrolled full-time university students who have used online-learning platforms in November 2020. Data collected from 493 Chinese university students were analyzed by confirmatory factor analysis (CFA) and structural equation model (SEM) to test the model and hypotheses. All measurements of constructs used in this study are adapted by previous studies. The results show that perceived satisfaction, subjective norms, and perceived behavioral control were significantly associated with the continuance intention of online learning. Furthermore, the two components of the expectation–confirmation model (ECM), perceived usefulness and perceived enjoyment, have a significant impact on the satisfaction of online learning. Notably, although confirmation of expectations had no direct impact on satisfaction, it was positively associated with perceived usefulness and perceived enjoyment. Implications and limitations were discussed.

Ambient fine particulate matter exposures and oxidative protein damage in early pregnant women

The association between oxidative protein damage in early pregnant women and ambient fine particulate matter (PM2.5) is unknown. We estimated the effect of PM2.5 exposures within seven days before blood collection on serum 3-nitrotyrosine (3-NT) and advanced oxidation protein products (AOPP) in 100 women with normal early pregnancy (NEP) and 100 women with clinically recognized early pregnancy loss (CREPL). Temporally-adjusted land use regression model was applied for estimation of maternal daily PM2.5 exposure. Single-day lag effect of PM2.5 was analyzed using multivariable linear regression model. Net cumulative effect and distributed lag effect of PM2.5 within seven days were analyzed using distributed lag non-linear model. In all 200 subjects, the serum 3-NT were significantly increased with the single-day lag effects (4.72%–8.04% increased at lag 0–2), distributed lag effects (2.32%–3.49% increased at lag 0–2), and cumulative effect within seven days (16.91% increased). The single-day lag effects (7.41%–10.48% increased at lag 0–1), distributed lag effects (3.42%–5.52% increased at lag 0–2), and cumulative effect within seven days (24.51% increased) of PM2.5 significantly increased serum 3-NT in CREPL group but not in NEP group. The distributed lag effects (2.62%–4.54% increased at lag 0–2) and cumulative effect within seven days (20.25% increased) of PM2.5 significantly increased serum AOPP in early pregnant women before the coronavirus disease (COVID-19) pandemic but not after that. In conclusion, PM2.5 exposures were associated with oxidative stress to protein in pregnant women in the first trimester. Wearing masks may be potentially preventive in PM2.5 exposure and its related oxidative protein damage. Whether PM2.5–associated systemic 3-NT increase contributes to the pathogenic mechanisms of spontaneous abortion remains to be further investigated.

The histopathological changes of piglets intestinal tissues and the effection of pathogenicity-associated factors induced by porcine deltacoronavirus

For exploring the histopathological changes of intestinal tissues and the mechanism of porcine deltacoronavirus(PDCo V) replication and leading to inflammatory lesions of piglets intestine which induced by PDCo V infection, 10-day-old piglets were infected by PDCo V strain TJ1 which isolated from Tianjin through oral route in this study. The piglets were necropsied at 4 days post-infection. Through histopathological observation, the main lesions of jejunum, ileum, colon and cecum were investigated. The diffuse inflammatory cell infiltration was found in mesenchyme, lamina propria and submucosa of intestinal mucosa, and the mucosal villi atrophy occurred in response to local tissues. The m RNA expression level of PDCo V M gene, innate immune genes including IFN-a, IFN-beta, DDX58 and STAT2 as well as the inflammatory cytoines including TNF-a and IL-6 in intestinal tissues were examined. The results showed that PDCo V replication was achieved by inhibiting host cell innate immune response, and the occurrence of inflammatory lesions in jejunum, ileum and colon were promoted through the enhancement of TNF-a and IL-6 expression. This study can provide a theoretical basis for the pathogenic mechanism study of porcine deltacoronavirus.

An allocation model for emergency medical services based on integrated healthcare during an epidemic

Enhanced virus control and patient treatment outcomes during an epidemic requires flexible and efficient medical services. This research explores an epidemic medical service allocation model from an integrated healthcare perspective, aiming to enhance the overall regional emergency medical service capability based on collaborative medical treatment. The study is based on COVID-19 medical services and its main treatment stages, and resource allocation models are constructed for the allocation of multiple medical services. The model addresses the dispersed medical service resources and demands in a certain region, and realizes the division of labor and resource sharing among medical institutions from the perspectives of distance, cost, and fairness with the advantage of integrated healthcare. We design examples in the context of COVID-19 epidemic and verify the validity and applicability of the model under different phases. This paper provides reference to the research and practice of achieving collaborative medical treatment between multiple medical institutions.

Contamination assessment of Listeria monocytogenes in fresh pork in the post-epidemic era

[Background] The epidemic of novel coronavirus disease 2019 (COVID-19) at the end of 2019 brought challenges to food safety. 【Objective】To evaluate the contamination of Listeria monocytogenes in fresh pork sold in the post-epidemic era. [Methods] During the epidemic period from 2020 to 2021, fresh pork from different locations, different packaging methods and different seasons were selected to analyze the contamination rate and contamination level of Listeria monocytogenes, and the epidemiological characteristics of the isolated strains were analyzed. [Results] The contamination rate of Listeria monocytogenes in fresh pork was 15.28% (77/504), and the contamination rate in pork direct-sale stores and farmers' markets was higher than that in supermarkets. Among different packaging methods, the contamination rates of pre-packaging and simple packaging were higher than those of bulk samples, and there were significant differences in the contamination rates in different quarters, with the highest contamination rate in the third quarter, which was 27.78%. Quantitative results found that 40.26% exceeded 10 MPN/g (MPN: most probable number), and 3 samples had contamination levels over 100 MPN/g. The results of serotype analysis showed that 1/2a-3a (48.05%) and 1/2c-3c (44.16%) were the main serotypes. The results of drug resistance test showed that 19.50% of the isolates were multi-drug resistant, 2 (2.60%) were sensitive to all antibiotics, 68 (88.30%) were resistant to oxacillin, and 46 (59.70%) were resistant to oxacillin. Ampicillin-resistant, 45 strains (58.40%) were resistant to cefotaxime. 【Conclusion】In the post-epidemic era, there are different degrees of Listeria monocytogenes contamination in the marketed fresh pork in different locations, different packaging methods and different seasons. The contamination level of individual products is high, and the serum distribution and drug resistance characteristics are diverse. It is necessary to strengthen food safety supervision to reduce the occurrence of foodborne diseases.

Advances in cell death mechanisms involved in viral myocarditis

Viral myocarditis is an acute inflammatory disease of the myocardium. Although many etiopathogenic factors exist, coxsackievirus B3 is a the leading cause of viral myocarditis. Abnormal cardiomyocyte death is the underlying problem for most cardiovascular diseases and fatalities. Various types of cell death occur and are regulated to varying degrees. In this review, we discuss the different cell death mechanisms in viral myocarditis and the potential interactions between them. We also explore the role and mechanism of cardiomyocyte death with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Exploring the mechanisms may help in the early identification and the development of effective treatments, thus improving the quality of life of patients with viral myocarditis. We believe that the inhibition of cardiomyocyte death has immense therapeutic potential in increasing the longevity and health of the heart.

Forecasting of Automobile Sales Based on Support Vector Regression Optimized by the Grey Wolf Optimizer Algorithm

With the development of the Internet and big data, more and more consumer behavior data are used in different forecasting problems, which greatly improve the performance of prediction. As the main travel tool, the sales of automobiles will change with the variations of the market and the external environment. Accurate prediction of automobile sales can not only help the dealers adjust their marketing plans dynamically but can also help the economy and the transportation sector make policy decisions. The automobile is a product with high value and high involvement, and its purchase decision can be affected by its own attributes, economy, policy and other factors. Furthermore, the sample data have the characteristics of various sources, great complexity and large volatility. Therefore, this paper uses the Support Vector Regression (SVR) model, which has global optimization, a simple structure, and strong generalization abilities and is suitable for multi-dimensional, small sample data to predict the monthly sales of automobiles. In addition, the parameters are optimized by the Grey Wolf Optimizer (GWO) algorithm to improve the prediction accuracy. First, the grey correlation analysis method is used to analyze and determine the factors that affect automobile sales. Second, it is used to build the GWO-SVR automobile sales prediction model. Third, the experimental analysis is carried out by using the data from Suteng and Kaluola in the Chinese car segment, and the proposed model is compared with the other four commonly used methods. The results show that the GWO-SVR model has the best performance of mean absolute percentage error (MAPE) and root mean square error (RMSE). Finally, some management implications are put forward for reference.