COVID-19 and Cardiovascular Diseases: From Cellular Mechanisms to Clinical Manifestations.

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), quickly spread worldwide and led to over 581 million confirmed cases and over 6 million deaths as 1 August 2022. The binding of the viral surface spike protein to the human angiotensin-converting enzyme 2 (ACE2) receptor is the primary mechanism of SARS-CoV-2 infection. Not only highly expressed in the lung, ACE2 is also widely distributed in the heart, mainly in cardiomyocytes and pericytes. The strong association between COVID-19 and cardiovascular disease (CVD) has been demonstrated by increased clinical evidence. Preexisting CVD risk factors, including obesity, hypertension, and diabetes etc., increase susceptibility to COVID-19. In turn, COVID-19 exacerbates the progression of CVD, including myocardial damage, arrhythmia, acute myocarditis, heart failure, and thromboembolism. Moreover, cardiovascular risks post recovery and the vaccination-associated cardiovascular problems have become increasingly evident. To demonstrate the association between COVID-19 and CVD, this review detailly illustrated the impact of COVID-19 on different cells (cardiomyocytes, pericytes, endothelial cells, and fibroblasts) in myocardial tissue and provides an overview of the clinical manifestations of cardiovascular involvements in the pandemic. Finally, the issues related to myocardial injury post recovery, as well as vaccination-induced CVD, has also been emphasized.

Association between meteorological factors and COVID-19 transmission in low- and middle-income countries: A time-stratified case-crossover study.

BACKGROUND: Evidence is limited regarding the association between meteorological factors and COVID-19 transmission in low- and middle-income countries (LMICs). OBJECTIVE: To investigate the independent and interactive effects of temperature, relative humidity (RH), and ultraviolet (UV) radiation on the spread of COVID-19 in LMICs. METHODS: We collected daily data on COVID-19 confirmed cases, meteorological factors and non-pharmaceutical interventions (NPIs) in 2143 city- and district-level sites from 6 LMICs during 2020. We applied a time-stratified case-crossover design with distributed lag nonlinear model to evaluate the independent and interactive effects of meteorological factors on COVID-19 transmission after controlling NPIs. We generated an overall estimate through pooling site-specific relative risks (RR) using a multivariate meta-regression model. RESULTS: There was a positive, non-linear, association between temperature and COVID-19 confirmed cases in all study sites, while RH and UV showed negative non-linear associations. RR of the 90th percentile temperature (28.1 °C) was 1.14 [95% confidence interval (CI): 1.02, 1.28] compared with the 50th percentile temperature (24.4 °C). RR of the10th percentile UV was 1.41 (95% CI: 1.29, 1.54). High temperature and high RH were associated with increased risks in temperate climate but decreased risks in tropical climate, while UV exhibited a consistent, negative association across climate zones. Temperature, RH, and UV interacted to affect COVID-19 transmission. Temperature and RH also showed higher risks in low NPIs sites. CONCLUSION: Temperature, RH, and UV appeared to independently and interactively affect the transmission of COVID-19 in LMICs but such associations varied with climate zones. Our results suggest that more attention should be paid to meteorological variation when the transmission of COVID-19 is still rampant in LMICs.

McAN: a novel computational algorithm and platform for constructing and visualizing haplotype networks.

Haplotype networks are graphs used to represent evolutionary relationships between a set of taxa and are characterized by intuitiveness in analyzing genealogical relationships of closely related genomes. We here propose a novel algorithm termed McAN that considers mutation spectrum history (mutations in ancestry haplotype should be contained in descendant haplotype), node size (corresponding to sample count for a given node) and sampling time when constructing haplotype network. We show that McAN is two orders of magnitude faster than state-of-the-art algorithms without losing accuracy, making it suitable for analysis of a large number of sequences. Based on our algorithm, we developed an online web server and offline tool for haplotype network construction, community lineage determination, and interactive network visualization. We demonstrate that McAN is highly suitable for analyzing and visualizing massive genomic data and is helpful to enhance the understanding of genome evolution. Availability: Source code is written in C/C++ and available at https://github.com/Theory-Lun/McAN and https://ngdc.cncb.ac.cn/biocode/tools/BT007301 under the MIT license. Web server is available at https://ngdc.cncb.ac.cn/bit/hapnet/. SARS-CoV-2 dataset are available at https://ngdc.cncb.ac.cn/ncov/. Contact: songshh@big.ac.cn (Song S), zhaowm@big.ac.cn (Zhao W), baoym@big.ac.cn (Bao Y), zhangzhang@big.ac.cn (Zhang Z), ybxue@big.ac.cn (Xue Y).

Mining and quantitative evaluation of COVID-19 policy tools in China.

Policy quantitative analysis can effectively evaluate the government's response to COVID-19 emergency management effect, and provide reference for the government to formulate follow-up policies. The content mining method is used to explore the 301 COVID-19 policies issued by the Central government of China since the outbreak of the epidemic in a multi-dimensional manner and comprehensively analyze the characteristics of epidemic prevention policies. Then, based on policy evaluation theory and data fusion theory, a COVID-19 policy evaluation model based on PMC-AE is established to evaluate quantitatively eight representative COVID-19 policy texts. The results show that: Firstly, China's COVID-19 policies are mainly aimed at providing economic support to enterprises and individuals affected by the epidemic, issued by 49 departments, and include 32.7 percent supply-level and 28.5 percent demand-level, and 25.8 percent environment-level. In addition, strategy-level policies accounted for at least 13 percent. Secondly, according to the principle of openness, authority, relevance and normative principle, eight COVID-19 policies are evaluated by PMC-AE model. Four policies are level Ⅰ policies, three policies are level Ⅱ policies and one policy is level Ⅲ policies. The reason for its low score is mainly affected by four indexes: policy evaluation, incentive measures, policy emphasis and policy receptor. To sum up, China has taken both non-structural and structural measures to prevent and control the epidemic. The introduction of specific epidemic prevention and control policy has realized complex intervention in the whole process of epidemic prevention and control.

Transcription factor Dmrt1 triggers the SPRY1-NF-κB pathway to maintain testicular immune homeostasis and male fertility.

Bacterial or viral infections, such as Brucella, mumps virus, herpes simplex virus, and Zika virus, destroy immune homeostasis of the testes, leading to spermatogenesis disorder and infertility. Of note, recent research shows that SARS-CoV-2 can infect male gonads and destroy Sertoli and Leydig cells, leading to male reproductive dysfunction. Due to the many side effects associated with antibiotic therapy, finding alternative treatments for inflammatory injury remains critical. Here, we found that Dmrt1 plays an important role in regulating testicular immune homeostasis. Knockdown of Dmrt1 in male mice inhibited spermatogenesis with a broad inflammatory response in seminiferous tubules and led to the loss of spermatogenic epithelial cells. Chromatin immunoprecipitation sequencing (ChIP-seq) and RNA sequencing (RNA-seq) revealed that Dmrt1 positively regulated the expression of Spry1, an inhibitory protein of the receptor tyrosine kinase (RTK) signaling pathway. Furthermore, immunoprecipitation-mass spectrometry (IP-MS) and co-immunoprecipitation (Co-IP) analysis indicated that SPRY1 binds to nuclear factor kappa B1 (NF-κB1) to prevent nuclear translocation of p65, inhibit activation of NF-κB signaling, prevent excessive inflammatory reaction in the testis, and protect the integrity of the blood-testis barrier. In view of this newly identified Dmrt1- Spry1-NF-κB axis mechanism in the regulation of testicular immune homeostasis, our study opens new avenues for the prevention and treatment of male reproductive diseases in humans and livestock.

Structural design and performance study of corrugated fibreboard with a laminated structure

Corrugated box is an important transport packaging container in the global logistics. The research on its raw material, that is, corrugated fibreboard, has always been an important topic in the packaging field. However, the research objects nearly focus on the corrugated fibreboard of traditional corrugated medium. The innovative research on the structure of corrugated fibreboard is also still rare. Since the pandemic COVID-19 in 2020, the international corrugated packaging industry has faced new dilemma. The development of new corrugated boxes and fibreboard is the way to break the situation in innovation and transformation. This study aims to design a new fibreboard with laminated structure medium for obtaining a new type of corrugated fibreboard for packaging with better cushioning and anti-vibration performance than traditional corrugated fibreboard. The verification experiments show that the new fibreboard has better recovery and structural stability due to its unique three-layer structure. The static and dynamic cushioning performance and anti-vibration performance of the proposed fibreboard have been greatly improved compared with those of the traditional one. © 2023 John Wiley & Sons Ltd.

Immunotoxicity In Vitro Assays for Environmental Pollutants under Paradigm Shift in Toxicity Tests.

With the outbreak of COVID-19, increasingly more attention has been paid to the effects of environmental factors on the immune system of organisms, because environmental pollutants may act in synergy with viruses by affecting the immunity of organisms. The immune system is a developing defense system formed by all metazoans in the course of struggling with various internal and external factors, whose damage may lead to increased susceptibility to pathogens and diseases. Due to a greater vulnerability of the immune system, immunotoxicity has the potential to be the early event of other toxic effects, and should be incorporated into environmental risk assessment. However, compared with other toxicity endpoints, e.g., genotoxicity, endocrine toxicity, or developmental toxicity, there are many challenges for the immunotoxicity test of environmental pollutants; this is due to the lack of detailed mechanisms of action and reliable assay methods. In addition, with the strong appeal for animal-free experiments, there has been a significant shift in the toxicity test paradigm, from traditional animal experiments to high-throughput in vitro assays that rely on cell lines. Therefore, there is an urgent need to build high-though put immunotoxicity test methods to screen massive environmental pollutants. This paper reviews the common methods of immunotoxicity assays, including assays for direct immunotoxicity and skin sensitization. Direct immunotoxicity mainly refers to immunosuppression, for which the assays mostly use mixed immune cells or isolated single cells from animals with obvious problems, such as high cost, complex experimental operation, strong variability and so on. Meanwhile, there have been no stable and standard cell lines targeting immune functions developed for high-throughput tests. Compared with direct immunotoxicity, skin sensitizer screening has developed relatively mature in vitro assay methods based on an adverse outcome pathway (AOP), which points out the way forward for the paradigm shift in toxicity tests. According to the experience of skin sensitizer screening, this paper proposes that we also should seek appropriate nodes and establish more complete AOPs for immunosuppression and other immune-mediated diseases. Then, effective in vitro immunotoxicity assay methods can be developed targeting key events, simultaneously coordinating the studies of the chemical immunotoxicity mechanism, and further promoting the paradigm shift in the immunotoxicity test.

Association between the overall burden of comorbidity and Ct values among the older patients with Omicron infection: Mediated by inflammation.

Objectives: To investigate the associations between the overall burden of comorbidity, inflammatory indicators in plasma and Ct values among the elderly with COVID-19. Methods: We conducted a retrospective observational study. The results of each nucleic acid test of during hospitalization were obtained. Linear regression models assessed the associations between the overall burden of comorbidity, inflammatory indicators in plasma and Ct values among the elderly. A causal mediation analysis was performed to assess the mediation effects of inflammatory indicators on the association between the overall burden of comorbidity and Ct values. Results: A total of 767 COVID-19 patients aged ≥ 60 years were included between April 2022 and May 2022. Patients with a high burden of comorbidity had significantly lower Ct values of the ORF gene than subjects with a low burden of comorbidity (median, 24.81 VS 26.58, P < 0.05). Linear regression models showed that a high burden of comorbidity was significantly associated with higher inflammatory responses, including white blood cell count, neutrophil count and C-reactive protein. Also, white blood cell count, neutrophil count, C-reactive protein and the overall burden of comorbidity assessed by age-adjusted Charlson comorbidity index were independent risk factors for the Ct values. A mediation analysis detected the mediation effect of white blood cells on the association between the burden of comorbidity and Ct values, with the indirect effect estimates of 0.381 (95% CI: 0.166, 0.632, P < 0.001). Similarly, the indirect effect of C-reactive protein was -0.307 (95% CI: -0.645, -0.064, P = 0.034). White blood cells and C-reactive protein significantly mediated the relationship between the burden of comorbidity and Ct values by 29.56% and 18.13% of the total effect size, respectively. Conclusions: Inflammation mediated the association between the overall burden of comorbidity and Ct values among elderly with COVID-19, which suggests that combined immunomodulatory therapies could reduce the Ct values for such patients with a high burden of comorbidity.

Comparative Analysis of Clinical and CT Findings in Patients with SARS-CoV-2 Original Strain, Delta and Omicron Variants.

OBJECTIVES: To compare the clinical characteristics and chest CT findings of patients infected with Omicron and Delta variants and the original strain of COVID-19. METHODS: A total of 503 patients infected with the original strain (245 cases), Delta variant (90 cases), and Omicron variant (168 cases) were retrospectively analyzed. The differences in clinical severity and chest CT findings were analyzed. We also compared the infection severity of patients with different vaccination statuses and quantified pneumonia by a deep-learning approach. RESULTS: The rate of severe disease decreased significantly from the original strain to the Delta variant and Omicron variant (27% vs. 10% vs. 4.8%, p < 0.001). In the Omicron group, 44% (73/168) of CT scans were categorized as abnormal compared with 81% (73/90) in the Delta group and 96% (235/245, p < 0.05) in the original group. Trends of a gradual decrease in total CT score, lesion volume, and lesion CT value of AI evaluation were observed across the groups (p < 0.001 for all). Omicron patients who received the booster vaccine had less clinical severity (p = 0.015) and lower lung involvement rate than those without the booster vaccine (36% vs. 57%, p = 0.009). CONCLUSIONS: Compared with the original strain and Delta variant, the Omicron variant had less clinical severity and less lung injury on CT scans.

[Evolution and Characteristics of Full-process Vehicular VOCs Emissions in Tianjin from 2000 to 2020].

Vehicle emissions are an important source of anthropogenic volatile organic compound (VOCs) emissions in urban areas and are commonly quantified using vehicle emission inventories. However, most previous studies on vehicle emission inventories have incomplete emission factors and emission processes or insufficient consideration of meteorological parameters. Based on the localized full-process emission factors attained from tested data and previous studies, a method to develop a monthly vehicular VOC emission inventory of full process for the long-term was established, which covered exhaust and evaporative emissions (including running loss, diurnal breathing loss, hot soak loss, and refueling emission). Then, the method was used to develop a full-process vehicular VOC emission inventory in Tianjin from 2000 to 2020. The results showed that the total vehicular VOC emissions in Tianjin rose slowly and then gradually decreased. In 2020, the total emissions were 21400 tons. The light-duty passenger vehicles were the dominant contributors and covered 75.00% of the total emissions. Unlike the continuous decline in exhaust emissions, evaporative emissions showed an inverted U-shaped trend with an increasing contribution to total emissions yearly, accounting for 31.69% in 2020. Monthly emissions were affected by both vehicle activity and emission factors. VOC emissions were high in autumn and winter and low in spring and summer. During the COVID-19 epidemic in 2020, vehicle activity was limited by closure and control, making VOC emissions significantly lower than those during the same period in previous years. The method and data in this study can provide technical reference and a decision-making basis for air pollution prevention and control.

Neutralizing antibodies and T-cell responses to inactivated SARS-CoV-2 vaccine in COVID-19 convalescents one and a half years after infection.

Vaccines have been considered the most promising solution for ending the coronavirus disease 2019 (COVID-19) pandemic. Information regarding neutralizing antibodies (NAbs) and T-cell immune response in inactivated SARS-CoV-2 vaccine-immunized COVID-19 convalescent patients were either only available for a short time after illness recovered or not available at all (T-cell immunity). We evaluated SARS-CoV-2 NAbs and cellular immune responses to the SARS-CoV-2 inactivated vaccine in convalescent patients who recovered from infection for about one and a half years. We found that compared to before vaccination, SARS-CoV-2 NAbs and specific T-cell responses were significantly boosted by the inactivated vaccine in convalescent patients, which confirmed the pre-existing adaptive immunity in SARS-CoV-2 infected people. We observed that NAbs and IFN-γ-secreting T-cell response elicited by a single vaccine dose in subjects with prior COVID-19 infection were higher than after two doses of vaccine in SARS-CoV-2 naïve subjects. Both humoral and cellular immune responses elicited by one and two doses of inactivated vaccine were comparable in COVID-19-recovered persons. In conclusion, inactivated COVID-19 vaccine induced robust NAbs and T-cell responses to SARS-CoV-2 in COVID-19 convalescent patients and immune responses after one dose were equal to that after receiving two doses, which highlighted that robust humoral and cellular immune response can be reactivated by the inactivated vaccine in SARS-CoV-2 convalescent patients.

Optimization of storage conditions for lipid nanoparticle-formulated self-replicating RNA vaccines.

The recent clinical success of multiple mRNA-based SARS-CoV-2 vaccines has proven the potential of RNA formulated in lipid nanoparticles (LNPs) in humans, and products based on base-modified RNA, sequence-optimized RNA, and self-replicating RNAs formulated in LNPs are all in various stages of clinical development. However, much remains to be learned about critical parameters governing the manufacturing and use of LNP-RNA formulations. One important issue that has received limited attention in the literature to date is the identification of optimal storage conditions for LNP-RNA that preserve long-term activity of the formulations. Here, we analyzed the physical structure, in vivo expression characteristics, and functional activity of alphavirus-derived self-replicating RNA (repRNA)-loaded LNPs encoding HIV vaccine antigens following storage in varying temperatures, buffers, and in the presence or absence of cryoprotectants. We found that for lipid nanoparticles with compositions similar to clinically-used LNPs, storage in RNAse-free PBS containing 10% (w/v) sucrose at -20 °C was able to maintain vaccine stability and in vivo potency at a level equivalent to freshly prepared vaccines following 30 days of storage. LNPs loaded with repRNA could also be lyophilized with retention of bioactivity.

Exploring the roles of intestinal flora in enhanced recovery after surgery.

Striving to optimize surgical outcomes, the Enhanced Recovery After Surgery (ERAS) pathway mitigates patients' stress through the implementation of evidence-based practices during the pre-, intra-, and postoperative periods. Intestinal flora is a sophisticated ecosystem integrating with the host and the external environment, which serves as a mediator in diverse interventions of ERAS to regulate human metabolism and inflammation. This review linked gut microbes and their metabolites with ERAS interventions, offering novel high-quality investigative proponents for ERAS. ERAS could alter the composition and function of intestinal flora in patients by alleviating various perioperative stress responses. Modifying gut flora through multiple modalities, such as diet and nutrition, to accelerate recovery might be a complementary approach when exploring novel ERAS initiatives. Meanwhile, the pandemic of COVID-19 and the availability of promising qualitative evidence created both challenges and opportunities for the establishment of ERAS mode.

Analysis of Systemic Risk Scenarios and Stabilization Effect of Monetary Policy under the COVID-19 Shock and Pharmaceutical Economic Recession

The Global Financial Crisis (GFC) will cause turbulence in the pharmaceutical market and the stagnation of market liquidity, leading to a deep recession in the pharmaceutical economy. After the COVID-19 outbreak, the pharmaceutical economic recession and the rising pharmaceutical financial crisis caused by the closure and control of the COVID-19 outbreak in China were important reasons for the accumulation of systemic financial risks in China. To realize the pharmaceutical economy and financial stability, this paper studies the weakening mechanism of the stabilization effect in systemic risk scenarios and analyzes how the evolution of systemic risk under the COVID-19 shock affects the stabilization effect of monetary policy. Under the COVID-19 shock, in the stage of falling China Financial Stress Index (CFSI), the systemic risk is relatively low, and the impact of traditional policy on macroeconomic stability is more significant;in the rising stage of CFSI, the systemic risk is relatively high, and the impact of traditional policy on macroeconomic stability is limited. This paper develops a Time-Varying Modified CRITIC weighting method and constructs a Time-Varying CFSI. This paper identifies systemic risk scenarios under the COVID-19 shock based on the Markov-Switching Mean Heteroskedastic Vector Auto-Regressive (MSMH-VAR) model and evaluates the stabilizing effects of monetary policy in different economic and financial regional systems (normal times and systemic risk scenarios). The results show that in normal times, loose monetary policy increases price levels, and tight monetary policy reduces price levels with a time lag. In systemic risk scenarios under the COVID-19 shock, the easing effect of policy on output growth is relatively small, and tighter policy increases output growth and prices in the short run and increases volatility in output growth and price levels in the long run. That is, under the COVID-19 shock in systemic risk scenarios, it is difficult to achieve stable growth and stable prices with monetary policy, and the stabilization effect is weakened. This paper focuses on the relationship between systemic risks, monetary policy, and output stability under the COVID-19 shock, analyzes the weakening of stabilization effects after the crisis, and expands the theoretical path of monetary policy stabilization and enriches the research scope of the new framework.

Relationship between Tai Chi and clinical outcomes in elderly patients with COVID-19: a protocol for systematic review and dose-response meta-analysis.

INTRODUCTION: COVID-19 has posed a serious threat to people worldwide, especially the older adults, since its discovery. Tai Chi as a traditional Chinese exercisethat belongs to traditional Chinese medicine has proven its effectiveness against COVID-19. However, no high-quality evidence is found on the dose-response relationships between Tai Chi and clinical outcomes in patients with COVID-19. This study will evaluate and determine the clinical evidence of Tai Chi as a treatment in elderly patients with COVID-19. METHODS AND ANALYSIS: The following electronic bibliographical databases including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, VIP Database and Wanfang Database will be screened from their inception date to 30 June 2022. All eligible randomised controlled trials or controlled clinical trials related to Tai Chi for elderly patients with COVID-19 will be included. The primary outcomes are forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio (FEV1%). The secondary outcomes are the time of main symptoms disappearance, length of hospital stay, serum levels of interleukin (IL)-6, IL-1b and tumour necrosis factor-α, and adverse event rate. Two independent reviewers will select the studies, extract the data, and analyse them on EndNote V.X9.0 and Stata V.12.1. The robust error meta-regression model will be used to establish the dose-response relationships between Tai Chi and clinical outcomes. The heterogeneity and variability will be analysed by I2 and τ2 statistics. Risk of bias, subgroup analysis and sensitivity analysis will also be performed. The quality of evidence will be assessed by the Grading of Recommendations Assessment, Development and Evaluation, and the risk of bias will be evaluated by using the Physiotherapy Evidence Database Scale. ETHICS AND DISSEMINATION: This study will review published data; thus, obtaining ethical approval and consent is unnecessary. The results will be disseminated through peer-reviewed publications. PROSPERO REGISTRATION NUMBER: CRD42022327694.

Association Between Role Overload and Sleep Quality Among Chinese First-Line Nurses During the COVID-19 Outbreak: The Moderating Effect of Mindfulness.

BACKGROUND: Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have experienced a high incidence of insomnia because of exposure to life-threatening occupational risks. Good sleep is essential for nurses to maintain their ability to care for patients with infectious diseases. PURPOSE: The aim of this study was to assess the influence of role overload on sleep quality and the moderating role of mindfulness. METHODS: A cross-sectional survey design was used in this study, which was conducted between March 20 and April 5, 2020. The survey was completed by 357 nurses who had relocated from Fujian Province to the epicenter of the outbreak in China to treat patients with COVID-19. Role overload, sleep quality, and mindfulness in these nurses were evaluated using the Role Overload Scale, Pittsburgh Sleep Quality Index, and Five-Facet Mindfulness Questionnaire, respectively. RESULTS: Hierarchical regression and other statistical methods were used to analyze the data. Role overload was shown to be positively related to poor sleep quality, and mindfulness was found to be effective in alleviating sleep disorders associated with role overload. CONCLUSIONS: The high risk of sleep disturbance among frontline nurses may be alleviated by reducing their perceived role overload. The identification of mindfulness as a moderating mechanism in the relationship between role overload and sleep quality provides new insights to improve sleep quality in nurses.

Housing safety and health academic and public opinion mining from 1945 to 2021: PRISMA, cluster analysis, and natural language processing approaches.

Housing safety and health problems threaten owners' and occupiers' safety and health. Nevertheless, there is no systematic review on this topic to the best of our knowledge. This study compared the academic and public opinions on housing safety and health and reviewed 982 research articles and 3,173 author works on housing safety and health published in the Web of Science Core Collection. PRISMA was used to filter the data, and natural language processing (NLP) was used to analyze emotions of the abstracts. Only 16 housing safety and health articles existed worldwide before 1998 but increased afterward. U.S. scholars published most research articles (30.76%). All top 10 most productive countries were developed countries, except China, which ranked second (16.01%). Only 25.9% of institutions have inter-institutional cooperation, and collaborators from the same institution produce most work. This study found that most abstracts were positive (n = 521), but abstracts with negative emotions attracted more citations. Despite many industries moving toward AI, housing safety and health research are exceptions as per articles published and Tweets. On the other hand, this study reviewed 8,257 Tweets to compare the focus of the public to academia. There were substantially more housing/residential safety (n = 8198) Tweets than housing health Tweets (n = 59), which is the opposite of academic research. Most Tweets about housing/residential safety were from the United Kingdom or Canada, while housing health hazards were from India. The main concern about housing safety per Twitter includes finance, people, and threats to housing safety. By contrast, people mainly concerned about costs of housing health issues, COVID, and air quality. In addition, most housing safety Tweets were neutral but positive dominated residential safety and health Tweets.

Quality of healthcare and admission rates for acute cardiac events during COVID-19 pandemic: a retrospective cohort study on ST-segment-elevation myocardial infarction in China.

OBJECTIVE: To evaluate changes in admission rates for and quality of healthcare of ST-segment-elevation myocardial infarction (STEMI) during the period of the COVID-19 outbreak and postoutbreak. METHODS: We conducted a retrospective study among patients with STEMI in the outbreak time and the postoutbreak time. DESIGN: To examine the changes in the admission rates and in quality of healthcare, by comparison between periods of the postoutbreak and the outbreak, and between the postoutbreak and the corresponding periods. SETTING: Data for this analysis were included from patients discharge diagnosed with STEMI from all the hospitals of Suzhou in each month of the year until the end of July 2020. PARTICIPANTS: 1965 STEMI admissions. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the number of moecondary outcomnthly STEMI admissions, and the secondary outcomes were the quality metrics of STEMI healthcare. RESULTS: There were a 53% and 38% fall in daily admissions at the phase of outbreak and postoutbreak, compared with the 2019 corresponding. There remained a gap in actual number of postoutbreak admissions at 306 and the predicted number at 497, an estimated 26 deaths due to STEMI would have been caused by not seeking healthcare. Postoutbreak period of 2020 compared with corresponding period of 2019, the percentage of cases transferred by ambulance decreased from 9.3% to 4.2% (p=0.013), the door-to-balloon median time increased from 17.5 to 34.0 min (p=0.001) and the rate of percutaneous coronary intervention (PCI) therapy declined from 71.3% to 60.1% (p=0.002). CONCLUSIONS: The impact of public health restrictions may lead to unexpected out-of-hospital deaths and compromised quality of healthcare for acute cardiac events. Delay or absence in patients should be continuously considered avoiding the secondary disaster of the pandemic. System delay should be modifiable for reversing the worst clinical outcomes from the COVID-19 outbreak, by coordination measures with focus on the balance between timely PCI procedure and minimising contamination of cardiac catheterisation rooms.