Research on urban country parks based on emergency medical facilities for public health emergencies-a case study of Guangzhou, China.

As COVID-19 has swept across the world, the escalating number of confirmed and suspected cases overwhelmed the admission capacity of the designated hospitals. Faced with such a grim situation, governments made a quick decision to build emergency medical facilities to address the outbreak. However, the emergency medical facilities faced a huge risk of epidemic spread and improper site could lead to serious secondary transmission. Using the disaster prevention and risk avoidance function of urban green space can solve the problem of selecting the location of emergency medical facilities to a certain extent, with country parks having a high degree of compatibility with the latter. Based on the location requirements of emergency medical facilities, using Analytic Hierarchy Process and Delphi method, through analyzing the type of country parks, effective risk avoidance area, spatial fragmentation, distance from water sources, wind direction, and distance from the city, quantification of 8 impact factors such as hydrogeology and traffic duration was conducted to comprehensively compare 30 country parks in Guangzhou. The results showed that the overall quality of country parks approximated a normal distribution, with Lianma Forest Country Park having the highest comprehensive score and the most balanced distribution of scores for various impact factors. Considering safety, expandability, rehabilitation, convenience, pollution prevention, and fecal isolation, it is a preferred destination for emergency medical facility construction.

Response of PM2.5 pollution to meteorological and anthropogenic emissions changes during COVID-19 lockdown in Hunan Province based on WRF-Chem model.

In December 2019, the New Crown Pneumonia (the COVID-19) outbroke around the globe, and China imposed a nationwide lockdown starting as early as January 23, 2020. This decision has significantly impacted China's air quality, especially the sharp decrease in PM2.5 (aerodynamic equivalent diameter of particulate matter less than or equal to 2.5 µm) pollution. Hunan Province is located in the central and eastern part of China, with a "horseshoe basin" topography. The reduction rate of PM2.5 concentrations in Hunan province during the COVID-19 (24.8%) was significantly higher than the national average (20.3%). Through the analysis of the changing character and pollution sources of haze pollution events in Hunan Province, more scientific countermeasures can be provided for the government. We use the Weather Research and Forecasting with Chemistry (WRF-Chem, V4.0) model to predict and simulate the PM2.5 concentrations under seven scenarios before the lockdown (2020.1.1-2020.1.22) and during the lockdown (2020.1.23-2020.2.14). Then, the PM2.5 concentrations under different conditions is compared to differentiate the contribution of meteorological conditions and local human activities to PM2.5 pollution. The results indicate the most important cause of PM2.5 pollution reduction is anthropogenic emissions from the residential sector, followed by the industrial sector, while the influence of meteorological factors contribute only 0.5% to PM2.5. The explanation is that emission reductions from the residential sector contribute the most to the reduction of seven primary contaminants. Finally, we trace the source and transport path of the air mass in Hunan Province through the Concentration Weight Trajectory Analysis (CWT). We found that the external input of PM2.5 in Hunan Province is mainly from the air mass transported from the northeast, accounting for 28.6%-30.0%. To improve future air quality, there is an urgent need to burn clean energy, improve the industrial structure, rationalize energy use, and strengthen cross-regional air pollution synergy control.

Quantitative annotations of T-Cell repertoire specificity.

The specificity of a T-cell receptor (TCR) repertoire determines personalized immune capacity. Existing methods have modeled the qualitative aspects of TCR specificity, while the quantitative aspects remained unaddressed. We developed a package, TCRanno, to quantify the specificity of TCR repertoires. We created deep-learning-based, epitope-aware vector embeddings to infer individual TCR specificity. Then we aggregated clonotype frequencies of TCRs to obtain a quantitative profile of repertoire specificity at epitope, antigen and organism levels. Applying TCRanno to 4195 TCR repertoires revealed quantitative changes in repertoire specificity upon infections, autoimmunity and cancers. Specifically, TCRanno found cytomegalovirus-specific TCRs in seronegative healthy individuals, supporting the possibility of abortive infections. TCRanno discovered age-accumulated fraction of severe acute respiratory syndrome coronavirus 2 specific TCRs in pre-pandemic samples, which may explain the aggressive symptoms and age-related severity of coronavirus disease 2019. TCRanno also identified the encounter of Hepatitis B antigens as a potential trigger of systemic lupus erythematosus. TCRanno annotations showed capability in distinguishing TCR repertoires of healthy and cancers including melanoma, lung and breast cancers. TCRanno also demonstrated usefulness to single-cell TCRseq+gene expression data analyses by isolating T-cells with the specificity of interest.

Causes of the unexpected slowness in reducing winter PM2.5 for 2014-2018 in Henan Province.

Toughest-ever clean air actions in China have been implemented nationwide to improve air quality. However, it was unexpected that from 2014 to 2018, the observed wintertime PM2.5 (particulate matter with an aerodynamic diameter of less than 2.5 µm) concentrations showed an insignificant decrease in Henan Province (HNP), a region in the west of the North China Plain. Emission controls seem to have failed to improve winter air quality in HNP, which has caused great confusion in formulating the next air improvement strategy. We employed a deweathering technique to decouple the impact of meteorological conditions. The results showed that the deweathered PM2.5 trend was -3.3%/yr in winter from 2014 to 2018, which had a larger decrease than the observed concentrations (-0.9%/yr), demonstrating that emission reduction was effective at improving air quality. However, compared with the other two megacity clusters, Beijing-Tianjin-Hebei (BTH) (-8.4%/yr) and Yangtze River Delta (YRD) (-7.4%/yr), the deweathered decreasing trend of PM2.5 for HNP remained slow. The underlying mechanism driving the changes in PM2.5 and its chemical components was further explored, using the Weather Research and Forecasting model coupled with Chemistry (WRF-Chem). Model simulations indicated that nitrate dominated the increase of PM2.5 components in HNP and the proportions of nitrate to total PM2.5 increased from 22.4% in January 2015 to 39.7% in January 2019. There are two primary reasons for this phenomenon. One is the limited control of nitrogen oxide emissions, which facilitates the conversion of nitric acid to particulate nitrate by ammonia. The other is unfavourable meteorological conditions, particularly increasing humidity, further enhancing nitrate formation through multiphase reactions. This study highly emphasizes the importance of reducing nitrogen oxide emissions owing to their impact on the formation of particulate nitrate in China, especially in the HNP region.

Digital twin for healthy indoor environment: A vision for the post-pandemic era

Indoor environment has significant impacts on human health as people spend 90% of their time indoors. The COVID-19 pandemic and the increased public health awareness have further elevated the urgency for cultivating and maintaining a healthy indoor environment. The advancement in emerging digital twin technologies including building information modeling (BIM), Internet of Things (IoT), data analytics, and smart control have led to new opportunities for building design and operation. Despite the numerous studies on developing methods for creating digital twins and enabling new functionalities and services in smart building management, very few have focused on the health of indoor environment. There is a critical need for understanding and envisaging how digital twin paradigms can be geared towards healthy indoor environment. Therefore, this study reviews the techniques for developing digital twins and discusses how the techniques can be customized to contribute to public health. Specifically, the current applications of BIM, IoT sensing, data analytics, and smart building control technologies for building digital twins are reviewed, and the knowledge gaps and limitations are discussed to guide future research for improving environmental and occupant health. Moreover, this paper elaborates a vision for future research on integrated digital twins for a healthy indoor environment with special considerations of the above four emerging techniques and issues. This review contributes to the body of knowledge by advocating for the consideration of health in digital twin modeling and smart building services and presenting the research roadmap for digital twin-enabled healthy indoor environment.

Country Parks as Sites of Emergency Medical Facility: A Case of COVID-19 in Hangzhou, China.

City parks are suitable sites for the construction of emergency medical facilities. A comparison of various types of city parks revealed that country parks fit closely with site selection conditions for emergency medical facilities. Based on the latter site selection requirements, eight impact factors such as park type, effective avoidance area, spatial fragmentation degree, water source protection area, wind direction, distance from city center, impermeability, and transport duration were quantified, and then 29 country parks in the Hangzhou Urban Area were compared using Principal Component Analysis (PCA). The calculation results showed that Linglong Country Park has the highest score, taking into account the characteristics of safety, scalability, rehabilitation, convenience, pollution prevention, and isolation. Linglong can be given priority selection as a target location for emergency medical facilities. In addition, Silver Lake Country Park, Dongqiao Country Park, Taihuyuan Country Park, and Tuankou Country Park have higher scores and can be used as alternative targets for emergency plans. The scoring results prove that the evaluation method has a high degree of rigor, a significant degree of discrimination, and a high degree of consistency between the validity and weight assignment of each impact factor. In view of the different geographical conditions in each region, the weight assignment of each impact factor can be adjusted according to local conditions and can help make effective use of existing conditions and avoid disadvantages.

Follow-up survey of general practitioners in Zhejiang Province post-completion of position transition training in 2017-2020.

BACKGROUND: Position transition training for general practitioners in Zhejiang Province started in 2017 and has since been held once a year. By the beginning of 2022, four training sessions were completed. The purpose of this survey was to establish the current situation of trainees after their graduation and provide reference for the evaluation of the training effect. METHODS: Of the 738 trainees who completed the training, 253 were contacted and followed up. A self-designed questionnaire was used to conduct the survey through online filling in. The content included questions to elucidate the following information: whereabouts after the training, registration as a general practitioner, undertaken general practice teaching and scientific research work, current occupational environment, improvement of post competence after receiving position transition training, willingness to complete survey, willingness to participate in future training programs, etc. RESULTS: A number of 253 valid questionnaires were collected with a recovery rate of 100%. Notably, 93.68% of the participants successfully completed their training and obtained the Training Certificate of General Practitioners. Further, 83.4% were registered as general practitioners, 82.94% of which added on the basis of the original registered scope of practice. Currently, most of them work in primary health care institutions, primarily occupied with medical treatment, chronic disease management, COVID-19 prevention and control, health education, and prevention and health care. Of them, 27.01% were currently undertaking teaching work, and only 3.32% of them were conducting scientific research work related to general practice. The overall satisfaction of the trainees in the three theoretical training bases was above 90%, with no statistically significant difference among them (P > 0.05). Importantly, 84.11% of the followed-up personnel hoped to continue to participate in similar training in the future to improve their general practitioner core competences. CONCLUSION: The position transition training in Zhejiang Province has achieved good results, but the details of training and the implementation of policies in individual regions need to be improved. Most of the graduates were willing to continue their education, especially in general practitioners with special interests.

Anti-PF4 antibodies associated with disease severity in COVID-19.

Severe COVID-19 is characterized by a prothrombotic state associated with thrombocytopenia, with microvascular thrombosis being almost invariably present in the lung and other organs at postmortem examination. We evaluated the presence of antibodies to platelet factor 4 (PF4)-polyanion complexes using a clinically validated immunoassay in 100 hospitalized patients with COVID-19 with moderate or severe disease (World Health Organization score, 4 to 10), 25 patients with acute COVID-19 visiting the emergency department, and 65 convalescent individuals. Anti-PF4 antibodies were detected in 95 of 100 hospitalized patients with COVID-19 (95.0%) irrespective of prior heparin treatment, with a mean optical density value of 0.871 ± 0.405 SD (range, 0.177 to 2.706). In contrast, patients hospitalized for severe acute respiratory disease unrelated to COVID-19 had markedly lower levels of the antibodies. In a high proportion of patients with COVID-19, levels of all three immunoglobulin (Ig) isotypes tested (IgG, IgM, and IgA) were simultaneously elevated. Antibody levels were higher in male than in female patients and higher in African Americans and Hispanics than in White patients. Anti-PF4 antibody levels were correlated with the maximum disease severity score and with significant reductions in circulating platelet counts during hospitalization. In individuals convalescent from COVID-19, the antibody levels returned to near-normal values. Sera from patients with COVID-19 induced higher levels of platelet activation than did sera from healthy blood donors, but the results were not correlated with the levels of anti-PF4 antibodies. These results demonstrate that the vast majority of patients with severe COVID-19 develop anti-PF4 antibodies, which may play a role in the clinical complications of COVID-19.

Both simulation and sequencing data reveal coinfections with multiple SARS-CoV-2 variants in the COVID-19 pandemic.

SARS-CoV-2 is a single-stranded RNA betacoronavirus with a high mutation rate. The rapidly emerging SARS-CoV-2 variants could increase transmissibility and diminish vaccine protection. However, whether coinfection with multiple SARS-CoV-2 variants exists remains controversial. This study collected 12,986 and 4,113 SARS-CoV-2 genomes from the GISAID database on May 11, 2020 (GISAID20May11), and Apr 1, 2021 (GISAID21Apr1), respectively. With single-nucleotide variant (SNV) and network clique analyses, we constructed single-nucleotide polymorphism (SNP) coexistence networks and discovered maximal SNP cliques of sizes 16 and 34 in the GISAID20May11 and GISAID21Apr1 datasets, respectively. Simulating the transmission routes and SNV accumulations, we discovered a linear relationship between the size of the maximal clique and the number of coinfected variants. We deduced that the COVID-19 cases in GISAID20May11 and GISAID21Apr1 were coinfections with 3.20 and 3.42 variants on average, respectively. Additionally, we performed Nanopore sequencing on 42 COVID-19 patients and discovered recurrent heterozygous SNPs in twenty of the patients, including loci 8,782 and 28,144, which were crucial for SARS-CoV-2 lineage divergence. In conclusion, our findings reported SARS-CoV-2 variants coinfection in COVID-19 patients and demonstrated the increasing number of coinfected variants.

Characterization of RNA G-quadruplexes in porcine epidemic diarrhea virus genome and the antiviral activity of G-quadruplex ligands.

Porcine epidemic diarrhea virus (PEDV), an enteropathogenic coronavirus, has catastrophic impacts on the global pig industry. However, there are still no anti-PEDV drugs with accurate targets. G-quadruplexes (G4s) are non-canonical secondary structures formed within guanine-rich regions of DNA or RNA, and have attracted great attention as potential targets for antiviral strategy. In this study, we reported two putative G4-forming sequences (PQS) in S and Nsp5 genes of PEDV genome based on bioinformatic analysis, and identified that S-PQS and Nsp5-PQS were enabled to fold into G4 structure by using circular dichroism spectroscopy and fluorescence turn-on assay. Furthermore, we verified that both S-PQS and Nsp5-PQS PQS could form G4 structure in live cells by immunofluorescence microscopy. In addition, G4-specific compounds, such as TMPyP4 and PDS, could significantly inhibit transcription, translation and proliferation of PEDV in vitro. Importantly, these compounds exert antiviral activity at the post-entry step of PEDV infection cycle, by inhibiting viral genome replication and protein expression. Lastly, we demonstrated that TMPyP4 can inhibit reporter gene expression by targeting G4 structure in Nsp5. Taken together, these findings not only reinforce the presence of viral G-quadruplex sequences in PEDV genome but also provide new insights into developing novel antiviral drugs targeting PEDV RNA G-quadruplexes.

Impact of Seasonal Coronavirus Antibodies on SARS-CoV-2 Vaccine Responses in Solid Organ Transplant Recipients.

Antibody responses to SARS-CoV-2 vaccination are reduced in solid organ transplant recipients (SOTRs). We report that increased levels of pre-existing antibodies to seasonal coronaviruses are associated with decreased antibody response to SARS-CoV-2 vaccination in SOTRs, supporting that antigenic imprinting modulates vaccine responses in this immunosuppressed population.

Identification of niclosamide as a novel antiviral agent against porcine epidemic diarrhea virus infection by targeting viral internalization.

Porcine epidemic diarrhea virus (PEDV), an enteropathogenic coronavirus, has catastrophic impacts on the global pig industry. However, there remain no effective drugs against PEDV infection. In this study, we utilized a recombinant PEDV expressing renilla luciferase (PEDV-Rluc) to screen potential anti-PEDV agents from an FDA-approved drug library in Vero cells. Four compounds were identified that significantly decreased luciferase activity of PEDV-Rluc. Among them, niclosamide was further characterized because it exhibited the most potent antiviral activity with the highest selectivity index. It can efficiently inhibit viral RNA synthesis, protein expression and viral progeny production of classical and variant PEDV strains in a dose-dependent manner. Time of addition assay showed that niclosamide exhibited potent anti-PEDV activity when added simultaneously with or after virus infection. Furthermore, niclosamide significantly inhibited the entry stage of PEDV infection by affecting viral internalization rather than viral attachment to cells. In addition, a combination with other small molecule inhibitors of endosomal acidification enhanced the anti-PEDV effect of niclosamide in vitro. Taken together, these findings suggested that niclosamide is a novel antiviral agent that might provide a basis for the development of novel drug therapies against PEDV and other related pathogenic coronavirus infections.

Chinese parents' willingness to vaccinate their children against COVID-19: A systematic review and meta-analysis.

Introduction: To evaluate Chinese parents' willingness to vaccinate their children against COVID-19, identify its predictors, and provide a reference for raising the COVID-19 vaccination rate for children. Method: PubMed, Cochrane Library, Embase, and the databases in Chinese, including CNKI, WanFang, VIP, CBM, were searched from December 2019 to June 2022, and citation tracking was used to identify relevant studies. To calculate the rate with 95% confidence intervals (CI), a random-effects model was used. To explore sources of heterogeneity, sensitivity analysis and subgroup analysis were conducted. This analysis was registered on PROSPERO (CRD42022346866) and reported in compliance with the PRISMA guidelines. Result: Overall, 80 studies were screened, and 13 studies with 47994 parents were included after removing duplicates and excluding 19 studies that did not meet the selection criteria by title, abstract and full-text screening. The pooled willingness rate of Chinese parents to vaccinate their children against COVID-19 was 70.0% (95% CI: 62.0~78.0%). Level of education, perceived susceptibility of children infected with COVID-19, and parental attitudes toward vaccination (such as perceived efficacy and safety of the COVID-19 vaccines, parental willingness to vaccinate themselves, parental vaccination hesitancy, and the history of children's vaccination against influenza) were the main predictors of parents' intention to vaccinate their children. Discussion: Chinese parents' willingness to vaccinate their children against COVID-19 is moderate, and factors including parental education level, perceived susceptibility of children infected with COVID-19, and parental attitudes toward vaccination affect this decision. Fully identifying these factors and their mechanism will be essential to further raise the willingness rate. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022346866.

The Probiotic Attributes and Anti-pseudorabies Virus Evaluation of Lactobacillus Isolates.

The emergence of pseudorabies virus (PRV) variants brings serious harm to the swine industry, and its effective treatments are limited at present. As one of the probiotics, the Lactobacillus species have beneficial characteristics of regulating the balance of intestinal flora, inhibiting the growth of pathogenic bacteria and viruses' proliferation, and improving self-immunity. In this study, Lactobacillus plantarum HN-11 and Lactobacillus casei HN-12 were selected and identified through morphology observation, Gram stain microscopy, 16S rRNA sequencing analysis, and specific amplification of the recA gene and pheS gene. All tested isolates exhibited rapid adaptation to the different conditions, excellent acid, and bile tolerance, and sensitivity to Salmonella, Staphylococcus aureus, and Escherichia coli. The antibiotic susceptibility assay displayed the isolates sensitive to most antibiotics and resistant to Lincomycin and Norfloxacin. Moreover, the supernatants of HN-11 and HN-12 inhibited PRV proliferation in ST cells. The results of animal experiments showed that supplementing the challenged mice with the supernatants of Lactobacillus isolates in advance delayed the course of the disease. PRV was detected in the heart, liver, spleen, lung, kidney, and brain tissues of dead mice in the test groups, and its copies in the lungs were significantly decreased compared with the control mice (P < 0.05). These findings proved the advantages of L. plantarum and L. casei as potential probiotic cultures, which could provide a basis for its application in microecological preparations and functional formulations.

Research and development of intelligent question answering robot system: a case study of its application in response to COVID-19 epidemic in Jinan city

During the epidemic of coronavirus disease 2019(COVID-19), the local Centers for Disease Control were bombarded with large amounts of questions from the public and the human hotline system was unable to meet the demands. As a result, Jinan Centers for Disease Coatrd developed an "intelligent question answering robot system" to cope with this situation. This paper introduces the design of the robot system and construction and classification of the knowledge base, and evaluates its application effects. The robot system can greatly reduce pressure on the human hotline, actively record and analyze users' demands, and improve the quality and efficiency of Centers for Disease Coatrd consultation service. It is a valuable and growable operating mode of consultation service, which can provide reference for the information service in future public health events.

Nationwide assessment of energy costs and policies to limit airborne infection risks in U.S. schools

Practices such as improved ventilation and air filtration are being considered by schools to reduce the transmission of Severe Acute Respiratory Syndrome Coronavirus 2 that causes the pandemic of coronavirus disease 2019 (COVID-19). Improved ventilation may significantly increase the energy cost of heating, ventilation, and air conditioning (HVAC), exacerbating financial challenges schools face amidst the worst pandemic in decades. This study evaluated HVAC energy costs for reducing COVID-19 airborne infection risks in 111,485 public and private schools in the U.S. to support decision-making. The average annual HVAC energy cost to maintain the infection risk below 1% for the schools in the U.S. is estimated at $20.1 per square meter or $308.4 per capita with improved ventilation and air filtration, where the private schools have higher costs than the public schools on average. The cost could be reduced by adopting partial online learning. It is also found that additional cost to control infection risk with increased ventilation and air filtration is significantly lower for PK-5 schools than that for middle and high schools in all states, indicating the possibility of remaining in-person instruction for PK-5 schools with necessary governmental assistance. Analyses of school HVAC energy cost to reduce airborne infection risk under different intervention scenarios provide important operational guidelines, financial implications, and policy insights for schools, community stakeholders, and policymakers to keep schools safe during the ongoing pandemic and improve preparedness for epidemics projected in the future.

Construction and Investigation of Competing Endogenous RNA Networks and Candidate Genes Involved in SARS-CoV-2 Infection.

INTRODUCTION: The current COVID-19 pandemic caused by a novel coronavirus SARS-CoV-2 is a quickly developing global health crisis, yet the mechanisms of pathogenesis in COVID-19 are not fully understood. METHODS: The RNA sequencing data of SARS-CoV-2-infected cells was obtained from the Gene Expression Omnibus (GEO). The differentially expressed mRNAs (DEmRNAs), long non-coding RNAs (DElncRNAs), and microRNAs (DEmiRNAs) were identified by edgeR, and the SARS-CoV-2-associated competing endogenous RNA (ceRNA) network was constructed based on the prediction of bioinformatic databases. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted with the SARS-CoV-2-related DEmRNAs, and the protein-protein interaction network was also built basing on STRING database. The ROC analysis was performed for assessing the diagnostic efficiency of hub genes. RESULTS: The results indicated that SARS-CoV-2-related DEmRNAs were associated with the interferon signaling pathway and other antiviral processes, such as IFNL3, IFNL1 and CH25H. Our analysis suggested that lncRNA NEAT1 might regulate the host immune response through two miRNAs, hsa-miR-374-5p and hsa-miR-155-5p, which control the expression of SOCS1, IL6, IL1B, CSF1R, CD274, TLR6, and TNF. Additionally, IFI6, HRASLS2, IGFBP4 and PTN may be potential targets based on an analysis comparing the transcriptional responses of SARS-CoV-2 infection with that of other respiratory viruses. DISCUSSION: The unique ceRNA network identified potential non-coding RNAs and their possible targets as well as a new perspective to understand the molecular mechanisms of the host immune response to SARS-CoV-2. This study may also aid in the development of innovative diagnostic and therapeutic strategies.

Airborne infection risks of SARS-CoV-2 in U.S. schools and impacts of different intervention strategies.

The potential airborne transmission of SARS-CoV-2 has triggered concerns as schools continue to reopen and resume in-person instruction during the current COVID-19 pandemic. It is critical to understand the risks of airborne SARS-CoV-2 transmission under different epidemiological scenarios and operation strategies for schools to make informed decisions to mitigate infection risk. Through scenario-based analysis, this study estimates the airborne infection risk of SARS-CoV-2 in 111,485 U.S. public and private schools and evaluates the impacts of different intervention strategies, including increased ventilation, air filtration, and hybrid learning. Schools in more than 90% of counties exhibit infection risk of higher than 1%, indicating the significance of implementing intervention strategies. Among the considered strategies, air filtration is found to be most effective: the school average infection risk when applying MERV 13 is over 30% less than the risk levels correlating with the use of increased ventilation and hybrid learning strategies, respectively. For most schools, it is necessary to adopt combined intervention strategies to ensure the infection risk below 1%. The results provide insights into airborne infection risk in schools under various scenarios and may guide schools and policymakers in developing effective operations strategies to maintain environmental health.