How does emotional labor influence restaurant employees' service quality during COVID-19? The roles of work fatigue and supervisor–subordinate Guanxi

Purpose: This study aims to test the relationship between emotional labor and service quality of the frontline employees of Chinese restaurants during the coronavirus disease pandemic (COVID-19). This study further investigated the mediating role of work fatigue (WF) and the moderating role of supervisor–subordinate Guanxi (SSG). Design/methodology/approach: The authors used a time-lag approach to gather data from a sample of 365 frontline staff members working in Chinese restaurants. All hypotheses were tested using SPSS and AMOS. Findings: First, restaurant frontline employees' deep acting was associated with higher service quality, whereas surface acting leads to lower service quality. Second, WF mediated the relationship between emotional labor and service quality. Third, SSG moderated the impact of emotional labor on WF during COVID-19. Research limitations/implications: All variables measured in this study were self-reported by restaurant frontline employees, which may increase the risk of common-method bias. However, this study enriches the literature on emotional labor, WF and SSG during COVID-19. Practical implications: COVID-19 has severely affected the hotel, restaurant and catering sector and especially the psychological state and the work performance of frontline employees. Restaurant managers should implement some measures to improve employees' service quality during COVID-19. Originality/value: The present findings show that restaurant frontline employees adopted various emotional labor strategies when they were faced with higher than usual job demands and the risk of infection during COVID-19. © 2023, Emerald Publishing Limited.

How does natural resource dependence influence carbon emissions? The role of environmental regulation

Sustainable economic development and green recovery in the post-COVID-19 era in China requires consideration of natural resource dependence (NRD) and environmental regulation (ER) of CO2 emissions. Based on panel data covering 2008 and 2018 in China, this paper explores the impacts of NRD on carbon emissions and the moderating role of ER. In addition, the heterogeneity, asymmetry, and mediating mechanism are investigated in this study. Following are the main conclusions: (1) Decreasing the dependence on natural resources and strengthening ER can effectively cut down CO2 emissions, and the enhanced ER can reduce the contribution of NRD to CO2 emissions;(2) the positive influence of NRD on carbon emissions are consistent in various regions, while the influence of ER on CO2 emissions is negative in areas with high levels of NRD;(3) the reduced natural resources dependence can accelerate the carbon emissions reduction process indirectly by causing a reduction in China's total energy demand and coal consumption and accelerating the green technological innovation. The findings present several policy recommendations for achieving carbon emissions reduction.

[Establishment of early warning indicators of SARS-CoV-2 Omicron variant in Tianjin].

In this study, Delphi method was used to conduct a questionnaire survey on 12 experts to determine the indicators system and the corresponding weight for early warning features of SARS-CoV-2 Omicron in Tianjin.The positive indexes of experts in three rounds of consultations were both 100%. The experts' authority coefficient was 0.79. The Kendall's W coordination coefficients were 0.375, 0.356 and 0.385 respectively (all P<0.05). The indicators system for early warning features of 2019-nCoV Omicron variant had 5 first-level indicators, 10 second-level indicators and 52 third-level indicators. The weight of each indicator was also determined.

Reasons for not improving visual acuity of DME patients due to interruption of anti-VEGF therapy during the pandemic and OCT imaging analysis

*AIM: To identify the reasons for not improving visual acuity of patients with diabetic macular edema (DME) and its correlation with optical coherent tomography (OCT) imaging characteristics. They were treated with anti - vascular endothelial growth factor (VEGF) again after an interruption of treatment due to the COVID - 19 pandemic. * METHODS: Retrospective cases study. A total of 31 patients (40 eyes) with DME and treated with anti-VEGF drugs in the Department of Ophthalmology of the First Affiliated Hospital of Xi' an Jiaotong University between December 2019 and July 2020 were selected. All patients had an treatment history of interruption due to COVID-19. Based on the behavioral standard of best corrected visual acuity (BCVA) at 1mo after re - treatment, they were divided into improved visual acuity group (14 eyes) and non-improved visual acuity group (26 eyes). All patients received comprehensive ophthalmic examinations, including BCVA, intraocular pressure, OCT, fundus photography, and fundus fluorescein angiography (FFA). The central retinal thickness (CRT), hyper - reflective retinal dots (HRD), subretinal fluid (SRF), intraretinal fluid (IRF), disorganization of the inner retinal layers (DRIL) and ellipsoid zone disruption (EZD) were quantified by Image J. The correlation between BCVA and CRT, the number of HRD, the diameter of SRF and IRF, and the height of DRIL and EDZ width at 1mo after treatment were analyzed by Spearman correlation. * RESULTS: The proportion of HRD in OCT was significantly higher in the non - improved visual acuity group than that in the improved visual acuity group (chi2 = 5.43, P = 0.0072);There was a positive correlation between the difference of BCVA (LogMAR) and CRT change in DME patients after treatment (rs = 0.406, P = 0.009);There was a positive correlation between BCVA (LogMAR) and EZD width after treatment (rs = 0.358, P = 0.023). There was no correlation between BCVA (LogMAR) after treatment and the number of CRT (rs = - 0. 086, P = 0. 600) and HRD (rs = - 0. 115, P = 0. 482), the diameter and height of SRF (rs = 0.102, P = 0.530;rs = 0.100,P = 0.538) and IRF (rs = 0.134, P = 0. 410;rs = - 0. 014, P = 0. 932), and the width of DRIL (rs = 0.089, P = 0.587). * CONCLUSION(S): The probability of retinal HRD was significantly higher in patients with no visual improvement than that in patients with visual improvement after the re - treatment with anti - VEGF due to the treatment interruption during COVID- 19. EZD width was also closely correlated to the prognosis of visual acuity. As for these patients, HRD manifestations in OCT should be comprehensively considered, taking intravitreal injection of glucocorticoid as an auxiliary strategy if necessary. Copyright © 2022 International Journal of Ophthalmology (c/o Editorial Office). All rights reserved.

Design, Preparation and Immune Characterization of SARS-CoV-2 Multi-Epitope Chimeric Protein

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can cause respiratory symptoms such as fever, cough and dyspnea after infection, and Coronavirus Disease 2019 (COVID-19), severe acute respiratory syndrome, and even death can occur in severe cases.SARS-CoV-2 infection has no specific treatment drugs, mainly rely on vaccination to block its transmission.In various structural proteins of SARS-CoV-2, Spike protein (S) and Nucleocapsid protein (N) are the main antigenic proteins, which are also important candidate proteins for developing SARS-CoV-2 vaccine and antibody detection reagents.To express chimeric protein containing multiple epitopes of SARS-CoV-2 by prokaryotic expression system, and to verify the immunogenicity of the chimeric protein, antigenic epitopes of SARS-CoV-2 structural proteins were analyzed and screened by molecular biology software, the selected antigenic epitopes were connected in tandem, and expressed high efficiently in E.coli as a chimeric protein by genetic engineering technology.The soluble chimeric protein of high purity was obtained after purification and renaturation.Mice were immunized with the purified chimeric protein together with MF59 adjuvant, aluminum adjuvant or no adjuvant at different doses respectively.Humoral immunity and cellular immunity induced by the chimeric protein were evaluated by detecting the antibody titer of antiserum and the level of related cytokine.The expressed chimeric protein was in the form of inclusion body and exists in the sediment, soluble chimeric protein was obtained after renaturation.The specific antibodies with high titer were produced in the immunized mice, and strong cellular immunity was induced also.Higher concentration of chimeric protein had better elicited immune effect than the lower concentration of chimeric protein.The immune effect induced by the chimeric protein with MF59 adjuvant was no different from that induced with aluminum adjuvant.This study provides novel ideas for the design and renaturation of SARS-CoV-2 chimeric protein, and the chimeric protein is expected to be used for the development of SARS-CoV-2 recombinant protein vaccine and diagnosis reagent.

[Problems to be solved in the development from the perspective of future application scenarios of telesurgery].

Telemedicine, which integrates medicine, communication, engineering, information and other disciplines, is a hot emerging cross field in recent years. With the development of telecommunication technology and surgical robot, telesurgery is regarded as the "crown pearl" in telemedicine and has attracted more and more attention. As an extension of traditional surgery, telesurgery greatly extends the connotation and concept of surgery and embodies the great leap forward development of surgical technology. Despite the current limitations such as network delay, transparency of remote robot operation and team construction of surgeons, telesurgery has still formed a variety of innovative application scenarios and achieved rapid development in China in recent years. In view of the uneven distribution of medical resources in China and the epidemic of COVID-19 in the world, this paper puts forward the possible problems and solutions in the development of telesurgery, and looks forward to the feasibility of telesurgery technology in process of shifting the focus of medical and health care down to the community level, channeling resources accordingly.

The Right to Accessible COVID-19 Testing in the Post-Epidemic Period under the Urban-Rural Integration: Haishu District, Ningbo City, China

The reasonable distribution of COVID-19 testing facilities is a crucial public necessity to protect the civil right of health and the proper functioning of society in the post-epidemic period. However, most of the current COVID-19 testing facilities are in large hospitals in China, partially overlooking the COVID-19 testing needs of rural dwellers. This paper used shortest-path analysis and the improved potential model to measure the accessibility of current and potential COVID-19 testing facilities, superimposing this with the testing demands of residents, as calculated by the population demand index, so as to comprehensively evaluate the equity of the spatial allocation of the current and potential testing facilities, with a particular focus on Haishu District, Ningbo City, China. The results revealed that the overall accessibility of the current testing facilities in Haishu District was high, while the internal spatial differentiation was considerable. The comprehensive accessibility of testing facilities gradually declined from the downtown areas towards the rural areas. Moreover, roughly half of the rural population needing COVID-19 tests encountered hindrances due to poor access to testing agencies. However, after fully exploiting the potential testing facilities, the comprehensive accessibility of testing facilities was significantly improved, and the inequity in the accessibility to testing facilities was effectively alleviated, which significantly improved the equity of the allocation of testing facilities in Haishu District. The leveraging of current medical facilities to boost the number of testing facilities in rural areas could eliminate the disparity of resource distribution caused by urban and rural binary opposition, and could quickly identify external sources of COVID-19 in rural areas in the post-epidemic period. Moreover, efficient COVID-19 testing combined with the travel records of infection carriers can effectively identify unknown infection cases and obviate large-scale infection outbreaks.

[National external quality assessment for molecular detection of severe acute respiratory syndrome coronavirus 2 Delta variant].

Objective: To clarify the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant on the performance of existing molecular diagnostic assays, and investigate the detection ability of clinical laboratories across China. Methods: The first nationwide external quality assessment (EQA) for molecular detection of Delta variant was carried out based on the non-infectious phage virus-like particles samples, which were prepared by genetic engineering methods and distributed to 8 488 laboratories nationwide. The EQA panel was composed of three Delta variant samples (7.5×102, 1.5×103 and 6.0×103 copies/ml), one non-variant weak positive sample and one negative sample. The percentage of agreement (PA) of Delta variant samples with different concentration, the PA of Delta variant and non-variant samples with 7.5×102 copies/ml, the PA of assays used by more than 100 laboratories for Delta variant samples with different concentration and the PA of Delta variant and non-variant samples with 7.5×102 copies/ml were calculated and analyzed. Results: The data from 8 127 laboratories were available for evaluation. The testing capability of 98.77% (8 027/8 127) of the participating laboratories was found to be competent in reporting correct results for all samples. The overall percentage of agreement (OPA), negative percentage of agreement (NPA) and positive percentage of agreement (PPA) of the samples were 99.64% (40 490/40 635), 99.73% (8 105/8 127), 99.62% (32 385/32 508), respectively. With the decrease of the concentration of the samples, the PPA of Delta variant samples decreased. The PPAs were 99.41% and 99.51% for Delta variant and non-variant samples with 7.5×102 copies/ml, respectively, with no statistical difference (P=0.392). The OPA, NPA and PPA of the assays used by more than 100 laboratories were all greater than 98%, and no statistical difference of the PPAs was identified between Delta variant and non-variant samples with 7.5×102 copies/ml (P>0.05). Conclusions: Delta variant fails to impair the performance of current molecular diagnostic assays in China. The clinical laboratories have the same detection capabilities for Delta variant and non-variant samples. However, in certain laboratories, further improvement is required to ensure the accurate detection of weak positive samples.

[Analysis on cluster cases of COVID-19 in Tianjin].

Objective: To understand the characteristics of clusters of COVID-19 cases in Tianjin, and provide epidemiological evidence for the prevention and control of COVID-19. Methods: The data of all the COVID-19 cluster cases in Tianjin, reported by 22 February 2020, were collected to analyze the characteristics of different types of the clusters. Results: A total of 115 COVID-19 cases were reported in 33 clusters in Tianjin included 28 family clusters (71 cases), 1 work place cluster (10 cases), 3 transport vehicle clusters (8 cases) and 1 public place cluster (26 cases). Family clusters were caused by the cases from the working place or public place clusters. Numbers of secondary cases of family clusters was between 1 to 7, the median number was 2. The interval from onset to diagnosis for the first case was longer than those of other cases in the familial clusters (Z=-2.406, P=0.016). The median of incubation period of the public place clusters was 2 days. The intervals from onset to diagnosis were significant different among the family, working place and public place clusters (H=8.843, P=0.012), and also significant differences in onset time among the secondary cases (H=16.607, P=0.000). Conclusions: In the surveillance of COVID-19 epidemic, special attention should be paid to places where clustering are prone to occur, and the epidemiological investigation should be carried out timely to confirm the cluster. To prevent the transmission of COVID-19, the close contacts of the patients should be transferred to an assigned observation place on time for single room isolation. The awareness of COVID-19 prevention is low in some rural areas, reflected by many mass gathering activities and delayed medical care seeking after onset. It is necessary to strengthen the health education and take control measures in early period of epidemic.

[Epidemiological characteristics of confirmed COVID-19 cases in Tianjin].

Objective: To investigate the clinical and epidemiological characteristics of 135 confirmed cases of COVID-19 in Tianjin. Methods: The clinical and epidemiological data of 135 cases of COVID-19 in Tianjin were collected, and the data were analyzed with descriptive method. The factors influencing the severity of the illness were analyzed. Results: Among the 135 COVID-19 cases, 72 were males and 63 were females, the age of the cases was (48.62±16.83) years, and the case fatality rate was 2.22%. Local transmission caused 74.81% of the cases. A total of 33 clusters occurred, involving 85.92% of all COVID-19 cases. The median of the incubation period of COVID-19 was 6.50 days, the average generation interval was 5 days, and the household secondary transmission rate was 20.46%. Fever was the main symptom (78.63%), followed by cough (56.48%). Multivariate regression analysis indicated that age (OR=1.038, 95%CI: 1.010-1.167) and the number of chronic underlying diseases (OR=1.709, 95%CI: 1.052-2.777) were the risk factors of severe illness. Conclusions: Fever was the main symptom at the early phase of COVID-19 in Tianjin, and the local cluster cases accounted for high proportion in confirmed COVID-19 cases reported in Tianjin. Severe illness was prone to occur in people with old age and multi underlying diseases. Strict isolation of close contacts and intensive care of high-risk groups are the main measures to reduce the morbidity and case fatality of COVID-19.