Early Stage Risk Identification and Governance of Major Emerging Infectious Diseases: A Double-Case Study Based on the Chinese Context.

Purpose: Based on the Chinese context, this study uses severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) outbreaks as examples to identify the risk factors that lead to the major emerging infectious diseases outbreak, and put forward risk governance strategies to improve China's biosecurity risk prevention and control capabilities. Material and Methods: This study combines grounded theory and WSR methodology, and utilizes the NVivo 12.0 qualitative analysis software to identify the risk factors that led to the major emerging infectious diseases outbreak. The research data was sourced from 168 publicly available official documents, which are highly authoritative and reliable. Results: This study identified 10 categories of Wuli risk factors, 6 categories of logical Shili risk factors, and 8 categories of human Renli risk factors that contributed to the outbreak of major emerging infectious diseases. These risk factors were distributed across the early stages of the outbreak, and have different mechanisms of action at the macro and micro levels. Conclusion: This study identified the risk factors that lead to the outbreak of major emerging infectious disease, and discovered the mechanism of the outbreak at the macro and micro levels. At the macro level, Wuli risk factors are the forefront antecedents that lead to the outbreak of the crisis, Renli factors are the intermediate regulatory factors, and Shili risk factors are the back-end posterior factors. At the micro level, there are risk coupling, risk superposition, and risk resonance interactions among various risk factors, leading to the outbreak of the crisis. Based on these interactive relationships, this study proposes risk governance strategies that are helpful for policymakers in dealing with similar crises in the future.

Anti-SARS-CoV-2 IgM Secondary Response Was Suppressed by Preexisting Immunity in Vaccinees: A Prospective, Longitudinal Cohort Study over 456 Days.

To obtain more insight into IgM in anti-SARS-CoV-2 immunity a prospective cohort study was carried out in 32 volunteers to longitudinally profile the kinetics of the anti-SARS-CoV-2 IgM response induced by administration of a three-dose inactivated SARS-CoV-2 vaccine regimen at 19 serial time points over 456 days. The first and second doses were considered primary immunization, while the third dose was considered secondary immunization. IgM antibodies showed a low secondary response that was different from the other three antibodies (neutralizing, total, and IgG antibodies). There were 31.25% (10/32) (95% CI, 14.30-48.20%) of participants who never achieved a positive IgM antibody conversion over 456 days after vaccination. The seropositivity rate of IgM antibodies was 68.75% (22/32) (95% CI, 51.80-85.70%) after primary immunization. Unexpectedly, after secondary immunization the seropositivity response rate was only 9.38% (3/32) (95% CI, 1.30-20.10%), which was much lower than that after primary immunization (p = 0.000). Spearman's correlation analysis indicated a poor correlation of IgM antibodies with the other three antibodies. IgM response in vaccinees was completely different from the response patterns of neutralizing, total, and IgG antibodies following both the primary immunization and the secondary immunization and was suppressed by pre-existing immunity induced by primary immunization.

The evolution of research on depression during COVID-19: A visual analysis using Co-Occurrence and VOSviewer.

Background: The COVID-19 pandemic has led to public health problems, including depression. There has been a significant increase in research on depression during the COVID-19 pandemic. However, little attention has been paid to the overall trend in this field based on bibliometric analyses. Methods: Co-Occurrence (COOC) and VOSviewer bibliometric methods were utilized to analyze depression in COVID-19 literature in the core collection of the Web of Science (WOS). The overall characteristics of depression during COVID-19 were summarized by analyzing the number of published studies, keywords, institutions, and countries. Results: A total of 9,694 English original research articles and reviews on depression during COVID-19 were included in this study. The United States, China, and the United Kingdom were the countries with the largest number of publications and had close cooperation with each other. Research institutions in each country were dominated by universities, with the University of Toronto being the most productive institution in the world. The most frequently published author was Ligang Zhang. Visualization analysis showed that influencing factors, adverse effects, and coping strategies were hotspots for research. Conclusion: The results shed light on the burgeoning research on depression during COVID-19, particularly the relationship between depression and public health. In addition, future research on depression during COVID-19 should focus more on special groups and those at potential risk of depression in the general population, use more quantitative and qualitative studies combined with more attention to scale updates, and conduct longitudinal follow-ups of the outcomes of interventions. In conclusion, this study contributes to a more comprehensive view of the development of depression during COVID-19 and suggests a theoretical basis for future research on public health.

Risk Transmission Mechanism of Domestic Cluster Epidemic Caused by Overseas Imported Cases: Multiple Case Studies Based on Grounded Theory.

The continued severity of the global epidemic situation has led to a rising risk of imported cases in China, and domestic cluster epidemic events caused by imported cases have occurred from time to time, repeatedly causing nation-wide disruption. To deeply explain this phenomenon, this study adopted the grounded theory method, using the 5·21 Guangzhou COVID-19 outbreak and 7·20 Nanjing COVID-19 outbreak as examples to study the risk transmission mechanism of domestic cluster epidemic caused by overseas imported cases. The study found that the risk factors for the phenomenon mainly include the following seven aspects: external protection, operations and supervision, international and domestic environment, contaminated objects, virus characteristics, management efficacy, and individual factors. These risk factors together constitute the "detonator", "risk source", "risk carrier," and "risk amplifier" in the risk transmission process. In addition, this study also found that the transmission mechanism of domestic clusters caused by imported cases is a process of secondary risk amplification. The increase in risk carriers leads to a surge in secondary risks compared with the first, which leads to the outbreak of domestic clusters. Finally, based on the characteristics of the transmission mechanism and risk transmission components, this study provides some suggestions on risk mitigation for public departments to optimize China's epidemic prevention policies.

The Yin-Yang roles of protease-activated receptors in inflammatory signalling and diseases.

Inflammatory diseases have become increasingly prevalent throughout the world. Coronavirus disease 2019 (COVID-19), which has recently become pandemic, also exhibits hyperinflammation and cytokine release syndrome. To address inflammation-related diseases, numerous molecular targets have been explored in preclinical studies and clinical trials. Among them, the protease-activated receptors (PARs) that belong to G protein-coupled receptors are one of the most popular classes of drug targets, participating in inflammatory signalling and diseases. PARs activation can trigger downstream intracellular signalling to modulate a variety of inflammatory responses in multiple systems, including nervous, respiratory, digestive, circulatory, urinary and immune systems. Importantly, there are the Yin-Yang effects, comprising anti- and pro-inflammatory roles, of PARs activation in different types of inflammations, and these are context-dependent. Alternatively, it was recently revealed that PARs not only modulate inflammatory-related tumour progression, but also participate in inflammatory cytokine release related to COVID-19 via direct interaction with severe acute respiratory syndrome coronavirus 2 protein, suggesting that PARs also participate in other diseases via inflammatory responses. In this review, we renew and discuss the findings of PARs as molecular targets for treating inflammatory diseases, highlighting the novel roles of PARs and facilitating a better understanding of their designated values in the specific inflammatory environment.