Crowd intervention strategies considering indoor respiratory exposure risks

In order to explore impacts of crowd intervention strategies on indoor respiratory exposure risks during major pandemics, a variety of crowd motion scenarios were established in general indoor conditions based on improved pedestrian dynamics model and respiratory infection probability model. Then, multi-agent simulation technology was utilized to simulate impacts of strategies, including protection optimization, pedestrian flow optimization and route optimization, on the exposure risks. The results show that indoor respiratory exposure risks are mainly determined by total pedestrian flow, individuals' stay length, movement route planning and duration of stay in contaminated areas. The carryover effect will be formed due to pedestrians' obedience behavior of social distancing, which will further increase exposure time to contaminated areas. The lower pathogen permeability of masks, and the greater space ventilation are, the lower infection probability the crowd will face. © 2022 China Safety Science Journal. All rights reserved.

Three Cases of Non-compliance: Challenges of Trust and Governmental Response Strategies

This study examines three noncompliant cases occurred in Wuhan, China during the outbreak of the COVID-19 in 2020, including the Li Wenliang (sic) case, the Chen Qiushi (sic) case, and the Huang Dengying (sic) case. These cases, albeit with different natures, broke out during the early stage of Wuhan (TM) s epidemic and posted threat and challenges to the Chinese authorities to different degrees. Based on open source information, this study focuses on the issues of trust and examines trust at three different levels (interpersonal trust, public trust, and political trust) among interactions by three groups of actors, including individuals involved in each case, the general public (e.g., how the public perceived and evaluated each case), and the authorities (e.g., how governments at the local and central levels perceived and handled each case). Two research questions are addressed: 1) How did trust at different levels play out in each case? 2) How did Chinese authorities respond to and handle threat and public trust challenges? Policy implications are drawn.

Linear DNA Amplicons as a Novel Antiviral and Cancer Vaccine Strategy

Background DNA-based vaccines represent a simple, safe and promising strategy for harnessing the immune system to fight infectious diseases as well as various forms of cancer and thus are considered an important tool in the cancer immunotherapy toolbox. Nonetheless, the manufacture of plasmid DNA vaccines has several drawbacks, including long lead times and the need to remove impurities from bacterial cultures. Here we report the development of polymerase chain reaction (PCR)-produced amplicon expression vectors as DNA vaccines and their in vivo application to elicit antigen-specific immune responses in animal cancer models.1 Methods Plasmid DNA and amplicon expression was assessed both in vitro, by Hela cells transfection, and in vivo, by evaluating luciferase expression in mice through optical imaging. Immunogenicity induced by DNA amplicons was assessed by vaccinating mice, cats and ferrets against SARS-CoV-2 Spike protein. Similarly, amplicons encoding a tumor-associated antigen (Telomerase Reverse Transcriptase, TERT) and neoantigens were tested to evaluate the antitumoral effect of DNA amplicons in murine cancer models in combination with immunecheckpoint inhibitors (ICIs). Results Amplicons encoding Spike Receptor Binding Domain (RBD) were strongly immunogenic in all models and were able to confer antiviral effects. DNA vaccines encoding tumorassociated- antigens, such as telomerase reverse transcriptase or neoantigens expressed by murine tumor cell lines were able to elicit antigen-specific immune responses and proved to significantly impact tumor growth when administered in combination with ICIs. Conclusions These results strongly support the further exploration of the use of PCR-based amplicons as an innovative immunotherapeutic approach to viral diseases and cancer treatment.

Characterization of SARS-CoV-2-Specific Humoral and Cellular Immune Responses Induced by Inactivated COVID-19 Vaccines in a Real-World Setting

While the immunogenicity of inactivated vaccines against coronavirus disease 2019 (COVID-19) has been characterized in several well-conducted clinical trials, real-world evidence concerning immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raised by such vaccines is currently missing. Here, we comprehensively characterized various parameters of SARS-CoV-2-specific cellular and humoral immune responses induced by inactivated COVID-19 vaccines in 126 individuals under real-world conditions. After two doses of vaccination, S-receptor binding domain IgG (S-RBD IgG) and neutralizing antibody (NAb) were detected in 87.06% (74/85) and 78.82% (67/85) of individuals, respectively. Female participants developed higher concentrations of S-RBD IgG and NAb compared to male vaccinees. Interestingly, a longer dosing interval between the first and second vaccination resulted in a better long-term SARS-CoV-2 S-RBD IgG response. The frequencies of CD4+ T cells that produce effector cytokines (IFN-gamma, IL-2, and TNF-alpha) in response to stimulation with peptide pools corresponding to the SARS-CoV-2 spike (S), nucleocapsid (N) or membrane (M) protein were significantly higher in individuals received two doses of vaccine than those received one dose of vaccine and unvaccinated individuals. S, N, or M-specific CD4+ and CD8+ T cell responses were detectable in 95.83% (69/72) and 54.16% (39/72) of double-vaccinated individuals, respectively. The longitudinal analysis demonstrated that CD4+ T cell responses recognizing S, N, and M waned quickly after a single vaccine dose, but were boosted and became more sustained following a second dose. Overall, we provide a comprehensive characterization of immune responses induced by inactivated COVID-19 vaccines in real-world settings, suggesting that both humoral and cellular SARS-CoV-2 specific immunity are elicited in the majority of individuals after two doses of inactivated COVID-19 vaccines.

College students and COVID-19: Mental health and purpose formation

Background: The COVID-19 pandemic is a disaster event associated with negative social, mental health, financial, and academic outcomes for college students. However, there is limited evidence to guide efforts to help support college students during the crisis. This study used a disaster conceptual model to evaluate the relationship between COVID-19 stressors and mental health and purpose in college students in the United States. Methods: Cross-sectional data were collected from 251 undergraduates through an online survey between April and May 2020. Results: Students were exposed to multiple COVID-19 stressors (M = 8.14, SD = 3.02). Overall, 53.0 percent reported moderate to severe levels of depression, 40.7 percent reported moderate to severe levels of anxiety, and 39.4 percent endorsed having a clear sense of purpose in life. A disaster conceptual model fit the data well (c2 [30] = 31.93, p = .37, CFI = 0.995, RMSEA = 0.02, SRMR = 0.04). COVID-19 stressors were directly associated with depression and anxiety, and inversely associated with purpose. Perceived stress was an intervening variable in this relationship. Conclusion: Findings highlight the relationship between COVID-19 disaster stressors and mental health and purpose outcomes and provide evidence which may help guide recovery efforts. © 2022 Weston Medical Publishing. All rights reserved.

[Characteristics of liver function changes in 111 elderly patients with COVID-19 pneumonia].

Objective: To retrospectively analyze the characteristics and influencing factors of liver function changes in 111 elderly patients with COVID-19 pneumonia. Methods: 111 elderly patients with COVID-19 admitted to the Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 5 to March 3, 2020 were enrolled. According to the severity of disease and liver function condition, they were divided into severe group (n=40), normal group (n=71), abnormal liver function group (n=86) and normal liver function group (n=25). The indexes related to liver function changes [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT)] and related influencing factors were analyzed. Results: Among 111 cases, 86 (77.5%) had abnormal liver function of varying degrees, and 28 (25.2%) had liver injury. The abnormal rates of TBil, AST, ALP and GGT were significantly higher in the severe group than normal group (P<0.05). There were no significant differences in age, ribavirin, glucocorticoid and the application of lopinavir-ritonavir tablets between the abnormal liver function and the normal group (P>0.05). The proportion of male was significantly higher in the abnormal liver function than normal liver function group (P<0.05). Conclusion: Elderly COVID-19 patients have a higher proportion of abnormal liver function, and patients in the severe group are more likely to have higher level of TB, AST, ALP and GGT. The abnormal liver function may be related to the direct viral infection of the liver and the inflammatory immune response of the body after infection in elderly patients.

An integrated optimization method for tactical-level planning in liner shipping with heterogeneous ship fleet and environmental considerations

The maritime transportation flows and container demand have been increasing over time, although the COVID-19 pandemic may slow down this trend for some time. One of the common strategies adopted by shipping lines to efficiently serve the existing customers is the deployment of large ships. The current practice in the liner shipping industry is to deploy a combination of ships of different types with different carrying capacities (i.e., heterogeneous fleet), especially at the routes with a significant demand. However, heterogeneous fleets of ships have been investigated by a very few studies addressing the tactical liner shipping decisions (i.e., determination of service frequency, ship fleet deployment, optimization of ship sailing speed, and design of ship schedules). Moreover, limited research efforts have been carried out to simultaneously capture all the major tactical liner shipping decisions using a single solution methodology. Therefore, this study proposes an integrated optimization model that addresses all the major tactical liner shipping decisions and allows the deployment of a heterogeneous ship fleet at each route, considering emissions generated throughout liner shipping operations. The model's objective maximizes the total turnaround profit generated from liner shipping operations. A decomposition-based heuristic algorithm is presented in this study to solve the model proposed and efficiently tackle large-size problem instances. Numerical experiments, carried out for a number of real-world liner shipping routes, demonstrate the effectiveness of the proposed methodology. A set of managerial insights, obtained from the proposed methodology, are also provided. © 2021 Elsevier Ltd

Cytokine storm warning and treatment progress on COVID-19

At present, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading around the world, and the number of deaths is rapidly rising. More and more studies show that the progression of critically ill patients is closely related to the occurrence of cytokine storm. This review summarizes the concepts and mechanisms of coronavirus disease-2019 (COVID-19)-related cytokine storm, early warning, clinical manifestations, laboratory test indicators, as well as drugs and therapies with clinical application evidence or potential application prospects, in order to reduce COVID-19 patients to turning into critically ill ones and the mortality rate, and to provide evidence for early diagnosis and treatment of cytokine storm. © 2020, Chinese Journal of New Drugs Co. Ltd. All right reserved.

Guidance for central pharmacy management of clinical drug research institutions based on grade I response to major public health emergencies

Since the outbreak of pneumonia caused by severe acute vespiratory syndrome coronavirus 2. December 2019, the situation of epidemic prevention and control has become more serious. In order to strengthen the prevention and control of the epidemic and effectively prevent the spread, provinces and cities across the country have successively initiated grade I responses to major public health events. A large number of clinical trials have been obliged to suspend follow-up and group joining. Drug management is an important part of drug clinical trials. In order to actively respond to national requirements, clinical trial institutions around the country have launched a series of emergency management measures to respond to the administration of follow-up drug delivery in an epidemic situation and ensure safety of relevant researchers and participants. We hereby discuss the formulation of a central pharmacy management system for clinical trial institutions, with a view to safeguard the rights and interests of participants and ensure carrying out clinical trials safely, orderly and successfully.

Investigation and analysis of the impact of severe acute respiratory syndrome coronavirus 2 outbreak on the development of GCP

Objective: In order to understand the current status of the work of clinical-trial-related units, strengthen communication between units, analyze relevant impact factors, and predict development trends of good clinical practice (GCP) field in the future based on the severe epidemic situation. Methods: Combined with key work in the GCP field, a questionnaire was compiled to widely understand the value of clinical trial staffs in response to outbreaks, the status of clinical trials, and their outlook for development. Statistical analysis performed after feedback was collected. Results: A total of 357 valid questionnaires were recovered. 53.45% of clinical trial institutions released response rules within 3 days, and only 5.17% of clinical trial institutions have not released relevant response measures so far. E-mail acceptance methods of research institutions accounted for 52.02%, suspended reviews of ethics committees accounted for 50.62%, and online conference reviews accounted for 22.36%. The main methods of follow-up of the subjects: telephone follow-up 35.16%, delayed follow-up 21.8%, off-site follow-up 16.03%. Off-site subjects who cannot come to the hospital and need to send medicine accounted for 50.62% and delayed drug administration for 28.88%. Different sponsors, contract research organization (CRO), site management organization (SMO) companies have taken proactive measures, such as formulating detailed drug delivery processes based on project characteristics, and remote monitoring by clinical research associate (CRA). 86.27% of employees still have great confidence in the future development of the GCP field. Conclusion: The epidemic has affected the current work of the GCP industry to varying degrees, but most units have adopted active and effective measures to maximize the health and safety of participants in clinical trials, and they still have strong confidence in the work status and development of units in GCP field after the epidemic.

Key points of CRC management in hospital by drug clinical trial institutions under the first level response to major public health emergencies

At the beginning of 2020, due to the serious infection caused by severe acute respiratory syndrome coronavious 2 (SARS-CoV-2), and the prevention and control situation was grim, most provinces, cities and regions in the country have successively announced the launch of first level response to major public health emergencies. Under such cirumstance, how to standardize and efficiently manage the clinical research coordinator (CRC) under the first level response to major health emergencies is an urgent problem to be solved by the drug clinical trial institutions. In this paper, based on the general situation of drug clinical trial institutions'management of CRC in hospital, compared with the difference of management of CRC in hospital under first-level response, the key points of management were proposed, in order to provide a reference for the smooth an orderly drug clinical trials in special period.