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COVID-19 is a severe acute respiratory syndrome caused by a novel coronavirus, SARS-CoV- 2.COVID-19 is now a pandemic, and is not yet fully under control.As the surface spike protein (S) mediates the recognition between the virus and cell membrane and the process of cell entry, it plays an important role in the course of disease transmission.The study on the S protein not only elucidates the structure and function of virus-related proteins and explains their cellular entry mechanism, but also provides valuable information for the prevention, diagnosis and treatment of COVII)-19.Concentrated on the S protein of SARS-CoV-2, this review covers four aspects: (1 ) The structure of the S protein and its binding with angiotensin converting enzyme II (ACE2) , the specific receptor of SARS-CoV-2, is introduced in detail.Compared with SARS-CoV, the receptor binding domain (RBD) of the SARS-CoV- 2 S protein has a higher affinity with ACE2, while the affinity of the entire S protein is on the contrary.(2) Currently, the cell entry mechanism of SARS-CoV-2 meditated by the S protein is proposed to include endosomal and non-endosomal pathways.With the recognition and binding between the S protein and ACE2 or after cell entry, transmembrane protease serine 2(TMPRSS2) , lysosomal cathepsin or the furin enzyme can cleave S protein at S1/S2 cleavage site, facilitating the fusion between the virus and target membrane.(3) For the progress in SARS-CoV-2 S protein antibodies, a collection of significant antibodies are introduced and compared in the fields of the target, source and type.(4) Mechanisms of therapeutic treatments for SARS-CoV-2 varied.Though the antibody and medicine treatments related to the SARS-CoV-2 S protein are of high specificity and great efficacy, the mechanism, safety, applicability and stability of some agents are still unclear and need further assessment.Therefore, to curb the pandemic, researchers in all fields need more cooperation in the development of SARS-CoV-2 antibodies and medicines to face the great challenge.Copyright © Palaeogeography (Chinese Edition).All right reserved.
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This purpose of this study is to help students developing problem-solving skills by using Problem-based Learning (PBL) as a teaching model, combining with the Objective Structured Clinical Examination (OSCE) as a training tool to evaluate students' clinical competencies. Sixty-five college junior students from a therapeutic nutrition course were participated. The topics of PBL included diabetes, kidney disease, cancer, and cardiovascular disease. For each disease, pre- and post-test quiz and after class exam were assessed to evaluate the students' learning effectiveness. Due to the impact of the COVID-19 epidemic, OSCE was performed online. The focus group interview and learning effectiveness questionnaire were conducted by the end of this course for all participants. Moreover, 37 students who attended the dietitian internship filled in the learning effectiveness questionnaire again after the internship. The results indicated that after the PBL, the post quiz score for each disease was increased, and through the online OSCE training, students' abilities to master nutrition education and counseling had been upgraded. Students indicated that both PBL and OSCE training could contributed to the learning effectiveness. The better academic performance students were, the more willing they are to work in nutrition-related fields in the future. For those who finished the dietitian internship agreed that they could understand the work content better in general regional and regional hospitals than in teaching ones. In conclusion, PBL teaching model combined with OSCE training could effectively improve students' learning motivation, learning effectiveness and practical application in a therapeutic nutrition course.Copyright © 2022 Nutrition Society in Taipei. All rights reserved.
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Rainbow trout (Oncorhynchus mykiss) are currently consumed as live fish, primarily for catering or consumers, as an alternative to salmon in sashimi or dishes. However, Covid-19 has hampered store and restaurant operations. Therefore, developing suitable processing conditions to extend its shelf life, such as online distribution specifications while enhancing the filets' commercial value, would raise its production value. In this study, we investigated the fish filets salted in a 5% salt solution for 2 days and then smoked at 65 degrees C for 4 h under different storage conditions. As result, the higher rate of salt penetration and water loss in the resolved rigor mortis group was associated with tenderization of the meat compared to the rigor mortis group. Thermal-shrinkage and thermal-induced tissue destruction of the smoked fish filets during processing which affects the appearance, flavor, chewiness and overall acceptability. Nevertheless, according to the results of a consumer-type evaluation, the product characteristics of the fish filets from the resolution of rigor mortis group were consistent with those of the rigor mortis group, except for a weaker aroma. Thus, these results explain the relationship between frozen stored fish and the quality of processed products. The economic concept of regulating and distributing scheduling production between raw materials and finished products in the food industry conveys promising findings that will contribute to developing sustainable food processing systems.
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Background/Aims Adult-onset Still's disease is a systemic inflammatory disease of unknown aetiology. Post-COVID-19 vaccine adult-onset Still's disease has been reported and was associated with only mild myocarditis. Here we report the first case of adult-onset Still's disease after mRNA COVID-19 vaccination presenting with severe myocarditis with acute heart failure and cardiogenic shock. Methods We described the case history of the patient. Results A 72-year-old Chinese woman developed gradual onset of fever, shortness of breath, sore throat, generalised arthralgia, malaise and poor appetite 15 days after receiving the first dose of BNT162b2 mRNA COVID-19 vaccine. Physical examination revealed fever, bilateral ankle oedema and elevated jugular venous pressure. Significant investigation results are shown in Table 1. Extensive viral panel tests (including enterovirus, influenza and cytomegalovirus) were all negative. Echocardiography showed severely reduced left ventricular ejection fraction of 20%. The acute heart failure was complicated by cardiogenic shock requiring intensive care unit admission. Myocarditis was later diagnosed. Although the heart condition subsequently improved, there were persistent fever and arthralgia, as well as the development of generalised maculopapular skin rash. In view of that, series of investigations were performed, which revealed persistent neutrophilic leucocytosis, hyper-ferritinaemia and liver function derangement, while autoimmune panel was grossly unremarkable and septic/viral workup was negative (Table 1). Contrast PET-CT scan showed no features of malignancy. Adult-onset Still's disease was diagnosed, and the patient was treated with oral prednisolone 40mg daily. The patient's condition responded to the treatment;the fever subsided and the leucocyte count and inflammatory markers were normalised, and she was subsequently discharged. Three months after discharge, the patient was clinically well with prednisolone tapered down to 5mg daily. Reassessment echocardiogram showed full recovery with LVEF 60%. Conclusion Severe myocarditis with acute heart failure and cardiogenic shock is a possible initial presentation of adult-onset Still's disease after mRNA COVID-19 vaccination. After exclusion of more common aetiologies, it is important to consider adult-onset Still's disease as one of the differential diagnoses in the presence of compatible features following COVID-19 vaccination, such that appropriate and timely workup and treatment can be offered. (Table Presented).
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Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel and highly pathogenic coronavirus and is the causative agent of COVID-19, an ongoing pandemic that has posed a serious threat to public health and global economy. Thus, there is a pressing need for therapeutic interventions that target essential viral proteins and regulate virus spread and replication. To invade the host cell, the receptor-binding domain (RBD) of SARS-CoV-2 Spike protein binds to the host cell's ACE2 receptor, followed by cleavage events that allow the Spike protein to fuse with the host cell membrane. Thus, the essential role of Spike protein in ACE2 receptor binding and viral fusion makes it a prime target for therapeutic interventions. Method(s): We performed molecular docking and molecular dynamics (MD) simulation-based virtual screening against SARS-CoV-2 RBD/ACE2 interface using a commercial library of 93,835 drug-like compounds. Compounds with promising docking poses and scores were selected for further MD simulation refinement, from which ten lead compounds were identified. Antiviral potencies of ten lead compounds were evaluated against lentiviral vectors pseudotyped with SARS-CoV-2 Spike to down select to a single lead compound, SAI4. ELISA-based assays were employed to determine the binding affinities of SAI4 to recombinant SARS-CoV-2 RBD. Antiviral potential of SAI4 was validated against genuine SARS-CoV-2 in a BSL3 setting. Result(s): We identified SAI4 as a candidate small molecule, which inhibited SARS-CoV-2 pseudovirus entry with IC50 value of ~18 muM. We determined that SAI4 binds RDB with a Kd of ~20 muM. Using cells engineered to express ACE2 and cells that express physiological levels of ACE2, we found that SAI4 inhibited SARS-CoV-2 pseudovirus entry at both engineered and physiological ACE2 levels. We validated the antiviral potential of SAI4 against genuine SARS-CoV-2 and HCoV-NL63. Lastly, we demonstrated antiviral potential of SAI4 against four SARS-CoV-2 variants of concern (alpha, beta, gamma, and delta). Conclusion(s): Using virtual screening, we identified SAI4 as the promising hit compound which displayed inhibitory activities against SARS-CoV-2 entry and its four variants of concern. Thus, our study will pave the way for further development of small molecules for therapeutic targeting of SARS-CoV-2 entry to combat the COVID-19 pandemic.
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Objective: Pneumonia is an infectious inflammation of the alveoli,distal airway,and interstitium caused by bacterial,viral,and other pathogens. Maxing Shigantang,originated from Treatise On Cold Damage Diseases,is a classic prescription for treating pneumonia,with significant clinical efficacy. However,its treatment mechanism is still elusive. Method(s): In that paper,the transcriptome-based multi-scale network pharmacology was used to reveal the overall pharmacological mechanism of Maxing Shigantang in treating pneumonia from six scales of tissue,cell,pathological process,biological process,signaling pathway, and target. Result(s):At the tissue level,Maxing Shigantang mainly acted on the focal tissue of pneumonia-lung and the main inflammatory immune tissues-blood and spleen. Analysis of cell,pathological process and biological process suggested that Maxing Shigantang could treat pneumonia by reversing inflammatory and immune functions and improving cardiopulmonary and vascular injury caused by pneumonia. Analysis of signaling pathway and target showed that Maxing Shigantang regulated inflammatory immune response pathways such as "coronavirus disease-COVID-19" and "Toll-like receptor signaling pathway",and related targets such as "MAPKAPK3" and "NRG1". Conclusion(s):This paper,from molecular to tissue levels,indicated Maxing Shigantang treated pneumonia mainly by regulating inflammatory immune response and improving cardiopulmonary and vascular injury.Copyright © 2023, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.
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The COVID-19 pandemic has changed the mobility, accessibility, and behaviors of visitors dramatically. Under the impact of COVID-19, the social carrying capacity and emotion dynamics in parks and recreation areas are expected to change due to the uncertainty of health risks associated with visitors' behaviors. This study con-ducted an on-site visitor survey at Leiqiong Global Geological Park, a national park located in urban-proximate areas in Haikou, China. This study aims to examine factors impacting visitors' perceived crowding and emotions under varying levels of visitor use in urban national parks in the context of COVID-19. Study results suggest that visitors have the highest level of motivation for scenery and culture viewing and are generally satisfied with the environmental quality and design and COVID-19 prevention strategies and implementation efforts within the park. Moreover, this study suggests that the level of crowding and COVID-19 prevention strategies and imple-mentation can affect visitors' emotions in urban natioanl parks significantly. These findings highlight the importance of enforcing the social carrying capacity limits and COVID-19 prevention strategies for urban parks and protected areas to mitigate physical and mental health risks during the COVID-19 pandemic. Management implication: This study is one of the pilot studies that examines the social carrying capacity and emotion dynamics in urban national parks under the impact of the COVID-19 pandemic. Study results identify the thresholds of social carrying capacity and visitors' positive emotions based on the indicator of People Per View (PPV). Moreover, COVID-19 prevention strategies (e.g., mask-wearing and social distancing) can reduce visitors' perceived crowding and enhance positive emotions. These findings suggest that urban national parks should monitor visitor use levels based on the social carrying capacity framework to reduce visitors' perceived crowding and maintain positive emotions in the post-COVID-19 era.
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Background: Hong Kong started its territory-wide COVID-19 vaccination program in February 2021. A territory-wide VAS (Vaccine Allergy Safety) Clinic was set up to assess individuals deemed at "higher risk" of COVID-19 vaccine-associated allergies. A novel "Hub-and- Spoke" model was piloted to tackle the overwhelming demand of VAS services by allowing non-allergists to conduct allergy assessment. This study aims to evaluate the outcomes and effectiveness of the VAS Hub-and- Spoke Model for pre-vaccination allergy assessment. Method(s): Medical records of patients attending the VAS Hub and Spoke Clinics between March and August 2021 were reviewed (n = 2725). We studied the overall and comparative results between the Hub (allergist-led) and Spoke (non-allergist- led) Clinics. The Hub and the HKWC Spoke Clinic were selected for subgroup analysis as they saw the largest number of patients (n = 1411). Result(s): A total of 2725 patients were assessed under the VAS Hub-and- Spoke Model. Overall, 2324 patients (85.3%) were recommended to proceed with vaccination (Figure 1). There were no significant demographic differences noted. Allergists recommended significantly more patients for vaccination than non-allergists (OR = 21.58 [95% CI = 10.16-45.82], p < 0.001). Subgroup analysis revealed that 881/1055 (83.5%) of patients received their first dose of COVID-19 vaccination safely following assessment. Among those recommended vaccination, more patients assessed by allergists received their first dose of COVID-19 vaccination (OR = 4.18 [95% CI = 2.81-6.21], p < 0.001) (Table 1). Conclusion(s): The Hub-and- Spoke model has proven to be successful for the vaccination campaign. This study has illustrated the crucial role of allergists in countering vaccine hesitancy. Results from the study showed considerable differences in outcomes between allergist-led and non-allergist clinics. Precise reasons for these differences warrant further examination. We are hopeful the Hub-and Spoke model can be similarly adapted for other allergist-integrative services in the future.
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Background: The real-world management and clinical characteristics of chronic spontaneous urticaria (CSU) in Hong Kong, and its implications for COVID-19 vaccination are unknown. We investigated the patient characteristics, effectiveness of an immunologist-led Urticaria Clinic, and the impact of CSU on COVID-19 vaccine uptake in Hong Kong. Method(s): Longitudinal clinical data of 257 CSU patients attending our immunologist-led Urticaria Clinic were analysed. Result(s): Most patients had experienced wheals (98.8%) and 65.4% had angioedema. 1.2% of CSU patients had angioedema without wheals. Two-thirds (66.5%) received inappropriate treatment prior to immunologist review. A significant proportion of patients had concomitant autoimmunity (14.8%) and history of suspected drug allergy (9.7%) respectively. Weekly Urticaria Activity Score (UAS7) was significantly lower after immunologist review (12.0 vs 0.00, p < 0.001). The change in UAS7 was significantly greater among patients with baseline UAS7 >=16 (-24.0 vs -2.00, p < 0.001);and, among those with uncontrolled disease despite second-line treatment, with access to omalizumab and/or ciclosporin (-26.0 vs -3.50, p < 0.001). Majority of patients received at least one (68.5%) and two doses (65.0%) of COVID-19 vaccine respectively. History of suspected drug allergy was associated with lower COVID-19 vaccine uptake (odds ratio: 0.47, p = 0.010). Conclusion(s): CSU patients in Hong Kong have unique clinical characteristics and a considerable proportion had received inappropriate treatment before immunologist review. An immunologist-led Urticaria Clinic was effective in CSU management. COVID-19 vaccination rates were lower than the general population in Hong Kong, and a history of suspected drug allergy was associated with lower COVID-19 vaccine uptake.
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Objective： Pneumonia is an infectious inflammation of the alveoli，distal airway，and interstitium caused by bacterial，viral，and other pathogens. Maxing Shigantang，originated from Treatise On Cold Damage Diseases，is a classic prescription for treating pneumonia，with significant clinical efficacy. However，its treatment mechanism is still elusive. Method： In that paper，the transcriptome-based multi-scale network pharmacology was used to reveal the overall pharmacological mechanism of Maxing Shigantang in treating pneumonia from six scales of tissue，cell，pathological process，biological process，signaling pathway， and target. Result：At the tissue level，Maxing Shigantang mainly acted on the focal tissue of pneumonia-lung and the main inflammatory immune tissues-blood and spleen. Analysis of cell，pathological process and biological process suggested that Maxing Shigantang could treat pneumonia by reversing inflammatory and immune functions and improving cardiopulmonary and vascular injury caused by pneumonia. Analysis of signaling pathway and target showed that Maxing Shigantang regulated inflammatory immune response pathways such as "coronavirus disease-COVID-19" and "Toll-like receptor signaling pathway"，and related targets such as "MAPKAPK3" and "NRG1". Conclusion：This paper，from molecular to tissue levels，indicated Maxing Shigantang treated pneumonia mainly by regulating inflammatory immune response and improving cardiopulmonary and vascular injury. © 2023, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.
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This paper examines how the ‘national team', a direct government investment policy, influences the price efficiency of listed companies in the Shanghai Stock Index (SSE). We find that stocks directly invested in by the national team show greater price efficiency than stocks without direct bailout. We also analyse the impact of the COVID-19 pandemic on this price efficiency differentiation. The data period is divided into two sub-periods, and the results show that the price efficiency of stocks decreased after COVID-19. The reduction in price efficiency is more notable for stocks with direct government investment;the difference observed under national team investment in price efficiency is clearly reduced. Increased pessimistic investor expectations due to the pandemic could explain these changes. Our study provides novel evidence for the policy evaluation of national team intervention and a more detailed explanation about the decrease in financial market efficiency in the post-COVID-19 era. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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The coronavirus disease 2019 (COVID-19) pandemic is a serious threat to human life, health and social development. In response to this public health event, various COVID-19 vaccines have been rapidly developed around the world. To date, 41 vaccines have been approved for emergency use, and the use of vaccines has significantly reduced the morbidity and mortality of COVID-19. However, with the continuous mutants, especially the emergence of the Omicron variant, challenges to vaccine-induced immune protection are appearing, there is still a long way to go for the continued development of COVID-19 vaccines. This article briefly reviews the research progress of COVID-19 vaccine and its effect on mutant virus strains.Copyright © 2022 Authors. All rights reserved.
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For epidemic prevention and control, molecular diagnostic techniques such as field-effect transistor (FET) biosensors is developed for rapid screening of infectious agents, including Mycobacterium tuberculosis, SARS-CoV-2, rhinovirus, and others. They obtain results within a few minutes but exhibit diminished sensitivity (<75%) in unprocessed biological samples due to insufficient recognition of low-abundance analytes. Here, an electro-enhanced strategy is developed for the precise detection of trace-level infectious agents by liquid-gate graphene field-effect transistors (LG-GFETs). The applied gate bias preconcentrates analytes electrostatically at the sensing interface, contributing to a 10-fold signal enhancement and a limit of detection down to 5 × 10−16 g mL−1 MPT64 protein in serum. Of 402 participants, sensitivity in tuberculosis, COVID-19 and human rhinovirus assays reached 97.3% (181 of 186), and specificity is 98.6% (213 of 216) with a response time of <60 s. This study solves a long-standing dilemma that response speed and result accuracy of molecular diagnostics undergo trade-offs in unprocessed biological samples, holding unique promise in high-quality and population-wide screening of infectious diseases. © 2023 Wiley-VCH GmbH.
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The COVID-19 epidemic continues to have a negative impact on the economy and public health. There is a correlation between certain limits (meteorological factors and air pollution statistics) and verified fatal instances of Corona Virus Disease 2019 (COVID-19), according to several researchers. It has not yet been determined how these elements affect COVID-19. Using air pollution data and meteorological data from 15 cities in India from 2020 to 2022, Convergent Cross Mapping (CCM) is utilized to set up the causal link with new confirmed and fatal cases of COVID-19 in this study. Our experimental results show that the causal order of the factors influencing the diagnosis of COVID-19 is: humidity, PM25, temperature, CO, NO2, O3, PM10. In contrast to other parameters, temperature, PM25, and humidity are more causally associated with COVID-19, while data on air pollution are less causally related to the number of new COVID-19 cases. The causal order of the factors affecting the new death toll is as follows: temperature, PM25, humidity, O3, CO, PM10, NO2. The causality of temperature with new COVID-19 fatalities in India was higher than the causation of humidity with new COVID-19 deaths, and O3 also showed higher causality with it. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
Subject(s)
COVID-19 Vaccines , COVID-19 , Heart Failure , Myocarditis , Still's Disease, Adult-Onset , Adult , Humans , COVID-19/complications , COVID-19 Vaccines/adverse effects , Heart Failure/complications , Myocarditis/complications , Shock, Cardiogenic/complications , Still's Disease, Adult-Onset/etiology , VaccinationABSTRACT
Background: Global evidence on the transmission of asymptomatic SARS-CoV-2 infection needs to be synthesized. Methods: A search of 4 electronic databases (PubMed, EMBASE, Cochrane Library, and Web of Science databases) as of January 24, 2021 was performed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Studies which reported the transmission rate among close contacts with asymptomatic SARS-CoV-2 cases were included, and transmission activities occurred were considered. The transmission rates were pooled by zero-inflated beta distribution. The risk ratios (RRs) were calculated using random-effects models. Results: Of 4923 records retrieved and reviewed, 15 studies including 3917 close contacts with asymptomatic indexes were eligible. The pooled transmission rates were 1.79 per 100 person-days (or 1.79%, 95% confidence interval [CI] 0.41%–3.16%) by asymptomatic index, which is significantly lower than by presymptomatic (5.02%, 95% CI 2.37%–7.66%;p<0.001), and by symptomatic (5.27%, 95% CI 2.40%–8.15%;p<0.001). Subgroup analyses showed that the household transmission rate of asymptomatic index was (4.22%, 95% CI 0.91%–7.52%), four times significantly higher than non-household transmission (1.03%, 95% CI 0.73%–1.33%;p=0.03), and the asymptomatic transmission rate in China (1.82%, 95% CI 0.11%–3.53%) was lower than in other countries (2.22%, 95% CI 0.67%–3.77%;p=0.01). Conclusions: People with asymptomatic SARS-CoV-2 infection are at risk of transmitting the virus to their close contacts, particularly in household settings. The transmission potential of asymptomatic infection is lower than symptomatic and presymptomatic infections. This meta-analysis provides evidence for predicting the epidemic trend and promulgating vaccination and other control measures. Registered with PROSPERO International Prospective Register of Systematic Reviews, CRD42021269446;https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=269446. © 2022 The Author(s)
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Purpose: This study aims to investigate how the COVID-19 pandemic has impacted and changed Airbnb market in the Greater Melbourne area in terms of its temporal and spatial patterns and identify possible shifts in underlying trends in travel activities. Design/methodology/approach: A panel data set of Airbnb listings in Melbourne is analysed to compare temporal patterns, spatial distribution and lengths of stay of Airbnb users before and after the COVID outbreak. Findings: This study found that the COVID disruption did not fundamentally change the temporal cycle of the Airbnb market. Month-to-month fluctuations peaked at different levels from pre-pandemic times mainly because of lockdowns and other restrictive measures. The impact of COVID-19 disruptions on neighbourhood-level Airbnb revenues is associated with distance to CBD rather than number of COVID cases. Inner city suburbs suffered major loss during the pandemic, whereas outer suburbs gained popularity due to increased domestic travel and long stays. Long stays (28 days or more, as defined by Airbnb) were the fastest growing segment during the pandemic, which indicates the Airbnb market was adapting to increasing demand for purposes like remote working or lifestyle change. After easing of COVID-related restrictions, demand for short-term accommodation quickly recovered, but supply has not shown signs of strong recovery. Spatial distribution of post-pandemic supply recovery shows a similar spatial variation. Neighbourhoods in the inner city have not shown signs of significant recovery, whereas those in the middle and outer rings are either slowly recovering or approaching their pre-COVID levels. Practical implications: The COVID-19 pandemic has significantly impacted short-term rental markets and in particular the Airbnb sector during the phase of its rapid development. This paper helps inform in- and post-pandemic housing policy, market opportunity and investment decision. Originality/value: To the best of the authors' knowledge, this is one of the first attempts to empirically examine both temporal and spatial patterns of the COVID-19 impact on Airbnb market in one of the most severely impacted major cities. It is one of the first attempts to identify shifts in underlying trends in travel based on Airbnb data. © 2022, Emerald Publishing Limited.
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Objective To assess imported risk of COVID-19 in Hainan province from January 10 to March 7 in 2020, and to assess the effect of "The Normalization Prevention and Control" (measures during the Spring Festival Travel Rush (SFTR) in Hainan in 2021. Methods The daily reported imported cases in Hainan province, the daily reported cases in other 30 province of China, and the Baidu Migration Index were collected to calculated into the Imported Risk Index (IRI) to quantitatively assess the imported risk of Hainan province. Based on the analysis of the relationship between the imported risk index and imported cases, an imported case prediction model was constructed to fit the number of imported cases in "emergency containment" stage in Hainan. And number of imported cases during the Spring Festival Travel rush in 2021 was predicted by this model to compared with the actual number, which was to evaluate the "Normalization Prevention and Control" measures in this model was also used to assess the effect of "Normalization Prevention and Control" measures during the SFTR in 2021. Results Totally 112 imported cases were reported in Hainan. The average IRI was 0.98. Haikou, Sanya and Danzhou have the highest imported risk. Except Haikou, the imported risk index of all cities and counties reached the maximum value around January 24th. The generalized additive model based on the lag 4 days and lag 5 days was best fitted with the actual imported cases number (R2adjust1=83.50%, R2adjust2=82.00%, MRE=17.61%). If "Emergency Containment" strategy was still adopted, there were 10 COVID-19 cases imported into Hainan during the SFTR in 2021. Under the "Normalization Prevention and Control" strategy, virtually no imported cases were found in Hainan. Conclusions Tourism cities such as Haikou and Sanya have high imported risks. Hubei and Guangdong provinces are the main imported provinces. The Generalized Additive Model based on the Imported Risk Index can better fit with the imported cases number of COVID-19 in Hainan Province in "emergency containment". Compared with the "Emergency Containment" strategy, the "Normalization Prevention and Control" strategy adopted during the SFTR in 2021 reduced imported cases in Hainan by about 10. © 2022. China Tropical Medicine. All rights reserved.
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Tourists' visual attention has a central function in constructing their visual experiences and affects their perceptual and cognitive processes. Visual attention might be affected by environmental factors;however, the effects of environmental factors on visual attention are still vague in the literature. Moreover, visual attention might influence tourists' stress intensity. This study explores how tourists' visual attention patterns vary under environmental factors and quantifies the effects of visual attention on stress intensity by a mixed- methodology involving observations, eye-tracking experiments, and post-experiment surveys. Findings suggest that crowding is an important environmental factor affecting tourists' visual attention patterns. Moreover, natural sounds enhance tourists' visual attention to natural landscapes and mitigate tourists' stress simultaneously. Mask-wearing can reduce tourists' visual attention to human crowds but cannot reduce stress intensity directly. Our findings extend the attention restoration theory by a multi-sensory perspective and the transactional theory of stress through eye-tracking analytics.