Discussion on feasibility of electronic informed consent in drug clinical trials.

With the development of science and technology, electronic information technology has penetrated into many aspects of society now. Electronic informed consent is an effective way to adapt to development clinical trial. China is still at an early stage in this field. Affected by the outbreak of COVID-19 in 2020, the demand for electronic informed consent in clinical trial has become more urgent. Based on my own work experience, the author wants to analyze the problems in the traditional informed consent process and the current situations of electronic informed consent in China and explores the feasibility of electronic informed consent in clinical trials.Copyright © 2021 Drug Evaluation Research. All rights reserved.

Coupling Random Forest, Allometric Scaling, and Cellular Automata to Predict the Evolution of LULC under Various Shared Socioeconomic Pathways

Accurately estimating land-use demand is essential for urban models to predict the evolution of urban spatial morphology. Due to the uncertainties inherent in socioeconomic development, the accurate forecasting of urban land-use demand remains a daunting challenge. The present study proposes a modeling framework to determine the scaling relationship between the population and urban area and simulates the spatiotemporal dynamics of land use and land cover (LULC). An allometric scaling (AS) law and a Markov (MK) chain are used to predict variations in LULC. Random forest (RF) and cellular automata (CA) serve to calibrate the transition rules of change in LULC and realize its micro-spatial allocation (MKCA(RF-AS)). Furthermore, this research uses several shared socioeconomic pathways (SSPs) as scenario storylines. The MKCA(RF-AS) model is used to predict changes in LULC under various SSP scenarios in Jinjiang City, China, from 2020 to 2065. The results show that the figure of merit (FoM) and the urban FoM of the MKCA(RF-AS) model improve by 3.72% and 4.06%, respectively, compared with the MKCA(ANN) model during the 2005-2010 simulation period. For a 6.28% discrepancy between the predicted urban land-use demand and the actual urban land-use demand over the period 2005-2010, the urban FoM degrades by 21.42%. The growth of the permanent urban population and urban area in Jinjiang City follows an allometric scaling law with an exponent of 0.933 for the period 2005-2020, and the relative residual and R-2 are 0.0076 and 0.9994, respectively. From 2020 to 2065, the urban land demand estimated by the Markov model is 19.4% greater than the urban area predicted under scenario SSP5. At the township scale, the different SSP scenarios produce significantly different spatial distributions of urban expansion rates. By coupling random forest and allometric scaling, the MKCA(RF-AS) model substantially improves the simulation of urban land use.

Practical exploration of online teaching of animal product processing

Online teaching has become an important part of higher education due to the continuous effects of the global COVID-19. In this paper, the online teaching of Animal Product Processing was designed and implemented from three aspects of optimization of online teaching content, organization of teaching process and implementation of online assessment. According to the analysis of the questionnaire survey and the final evaluation results, the online teaching of Animal Product Processing is well received by the students and has achieved good teaching results, providing a useful reference for colleges and universities to carry out in-depth online teaching of Animal Product Processing.

Progress of the Panama Meeting of the Convention on International Trade in Endangered Species of Wild Fauna and Flora

Background: The 19th meeting of the Conference of the Parties (CoP 19) to the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) took place in Panama from the 14th to the 25th of November 2022. The meeting was attended by 2,500 delegates representing more than 160 Parties and observers to the Convention. The COVID-19 pandemic impacted all CITES Parties and significantly disrupted the implementation of CITES. The CoP shared the actions and the experiences of the Parties, the Secretariat, the Committee members and observers in the face of the COVID-19 pandemic. Progress: Delegates reviewed 52 proposed amendments to the Appendices and discussed 91 agenda items. There was the highest proportion of proposals for new Appendix II species but the lowest number of revising annotation proposals the CoP 19 has considered in nearly 25 years. The CoP updated the regulation of international trade in over 600 species of animals and plants. In the adopted proposals, international trade in 50 species of freshwater turtles, 158 species of glass frogs, 100 species of sharks and rays, 150 species of trees and dozens of species of roseroots will be regulated as the newly revised lists are enforced. The CoP adopted the financing and the cost of the programme of work for the triennium 2023‒2025, with an overall budget being 6.1% higher compared to the triennium 2020‒2022. The Conference further refined compliance and enforcement requirements for elephants, big cats, totoaba and other wildlife species threatened with extinction. With the implementations of engagement of indigenous peoples and local communities, livelihoods-related issues have been relatively slow and hampered. Parties vigorously debated proposed amendments to the Rules of Procedure and criteria for the amendments of CITES Appendices, but no substantive amendments were adopted. A pilot version of the World Wildlife Trade Report and the Assessment Report on the Sustainable Use of Wild Species: Policy-Maker Summary were discussed and heard. CITES has added several new topics in the CoP to address new challenges, such as the role of CITES in reducing the risk of future zoonotic diseases associated with the international wildlife trade. The CoP 19 recommends interdisciplinary research to analyze the role of CITES in the conservation and sustainable use of forests. The Parties resolved to work on building gender equality into the international trade in wildlife, recognizing that women are often guardians of wildlife and biodiversity but, just as often, are not recognized or benefit from this trade. Prospects: Regardless of the challenges posed by the COVID-19 pandemic, China's CITES authorities made thorough preparations for the CoP, conducting research two years in advance and drafting a proposal a report which was submitted to the CoP 19, organized pre-session and in-session consultations with scientific authorities, collected information from all parties, and actively led the discussions in working groups, presenting a positive view of China in prioritizing ecological civilization and fulfilling its responsibilities as a major country. CITES will celebrate its 50th anniversary in 2023. The record 365 decisions in CoP 19 demonstrate that CITES Parties continue to take action to address the unprecedented pressures on species due to overexploitation and illegal trade. © 2023, Chinese Academy of Sciences. All rights reserved.

Progress of the Panama Meeting of the Convention on International Trade in Endangered Species of Wild Fauna and Flora

Background: The 19th meeting of the Conference of the Parties (CoP 19) to the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) took place in Panama from the 14th to the 25th of November 2022. The meeting was attended by 2,500 delegates representing more than 160 Parties and observers to the Convention. The COVID-19 pandemic impacted all CITES Parties and significantly disrupted the implementation of CITES. The CoP shared the actions and the experiences of the Parties, the Secretariat, the Committee members and observers in the face of the COVID-19 pandemic. Progress: Delegates reviewed 52 proposed amendments to the Appendices and discussed 91 agenda items. There was the highest proportion of proposals for new Appendix II species but the lowest number of revising annotation proposals the CoP 19 has considered in nearly 25 years. The CoP updated the regulation of international trade in over 600 species of animals and plants. In the adopted proposals, international trade in 50 species of freshwater turtles, 158 species of glass frogs, 100 species of sharks and rays, 150 species of trees and dozens of species of roseroots will be regulated as the newly revised lists are enforced. The CoP adopted the financing and the cost of the programme of work for the triennium 2023‒2025, with an overall budget being 6.1% higher compared to the triennium 2020‒2022. The Conference further refined compliance and enforcement requirements for elephants, big cats, totoaba and other wildlife species threatened with extinction. With the implementations of engagement of indigenous peoples and local communities, livelihoods-related issues have been relatively slow and hampered. Parties vigorously debated proposed amendments to the Rules of Procedure and criteria for the amendments of CITES Appendices, but no substantive amendments were adopted. A pilot version of the World Wildlife Trade Report and the Assessment Report on the Sustainable Use of Wild Species: Policy-Maker Summary were discussed and heard. CITES has added several new topics in the CoP to address new challenges, such as the role of CITES in reducing the risk of future zoonotic diseases associated with the international wildlife trade. The CoP 19 recommends interdisciplinary research to analyze the role of CITES in the conservation and sustainable use of forests. The Parties resolved to work on building gender equality into the international trade in wildlife, recognizing that women are often guardians of wildlife and biodiversity but, just as often, are not recognized or benefit from this trade. Prospects: Regardless of the challenges posed by the COVID-19 pandemic, China's CITES authorities made thorough preparations for the CoP, conducting research two years in advance and drafting a proposal a report which was submitted to the CoP 19, organized pre-session and in-session consultations with scientific authorities, collected information from all parties, and actively led the discussions in working groups, presenting a positive view of China in prioritizing ecological civilization and fulfilling its responsibilities as a major country. CITES will celebrate its 50th anniversary in 2023. The record 365 decisions in CoP 19 demonstrate that CITES Parties continue to take action to address the unprecedented pressures on species due to overexploitation and illegal trade. © 2023, Chinese Academy of Sciences. All rights reserved.

Real-World Safety and Effectiveness of Remdesivir and Corticosteroids in Hospitalized Patients with COVID-19

Real-world effectiveness studies of remdesivir in hospitalized patients with COVID-19 conducted to date have produced conflicting findings which may be due, in part, to treatment heterogeneity within standard of care comparison groups. Our objective was to evaluate the comparative effectiveness and safety of remdesivir in a cohort of patients all treated with corticosteroids. We conducted a retrospective cohort study in the National Veterans Affairs Healthcare System. We included hospitalized patients (>18 years old) with positive COVID-19 PCR tests and COVID-19 diagnosis codes, and corticosteroid treatment within 2 days of admission, from 1 May 2020 to 30 November 2021. Time-to-event outcomes included time to inpatient mortality (primary), discharge, mortality after discharge, readmission, and acute kidney injury and bacterial infection after treatment initiation. Propensity score (PS)-adjusted, PS-matched, and inverse probability of treatment weighted (IPTW) Cox proportional hazards regression models controlled for study timeframe, supplemental oxygen, vaccination status, and other important confounders. We observed significantly lower inpatient mortality, 90-day post-discharge mortality, 30-day post-discharge readmission, and significantly longer hospital stays in the remdesivir group (n = 14,509) compared with the non-remdesivir group (n = 4365). Higher rates of bacterial infections were observed in the remdesivir group. Acute kidney injury was lower in subgroup analyses restricting the study population to index dates in 2021, on supplemental oxygen, and fully vaccinated, and higher in those without baseline supplemental oxygen. When comparing the effectiveness and safety of remdesivir plus corticosteroids to a homogenous comparison group, all also treated with corticosteroids, mortality and readmission were significantly lower in the remdesivir group. Longer length of stay corresponds with duration of remdesivir treatment and may impact the risk of developing infections during the hospitalization, which requires further study.

Preliminary prediction of the basic reproduction number of the novel coronavirus 2019-nCoV.

Objectives To estimate the basic reproduction number of the novel coronavirus (2019-nCoV) and to provide support to epidemic preparedness and response. Methods Based on the susceptible-exposed-infected-removed (SEIR) compartment model and the assumption that the infection cases with symptoms occurred before January 26, 2020 were resulted from free propagation without intervention, we estimated the basic reproduction number of 2019-nCoV according to the reported confirmed cases and suspected cases, as well as theoretical estimated number of infected cases by other research teams, together with some epidemiological determinants learned from the severe acute respiratory syndrome. Results The basic reproduction number fall between 2.8 to 3.3 by using the real-time reports on the number of 2019-nCoV infected cases from People's Daily in China, and fall between 3.2 and 3.9 on the basis of the predicted number of infected cases from international colleagues. Conclusions The early transmission capability of 2019-nCoV is close to or slightly higher than SARS. It is a controllable disease with moderate-high transmissibility. Timely and effective control measures are capable to quickly reduce further transmission. Copyright © 2020 West China University of Medical Science. All rights reserved.

WIP - iCtrl - A Remote Login Software Application

As a result of the COVID-19 pandemic, the need for remote computer connection has drastically increased. This need is also anticipated to increase in the future as many institutes allow working remotely. This paper reports on a development of a software called “iCtrl”, which started in late 2020. iCtrl is a desktop remote-control application that allows remote connection to an institute's computer facilities. iCtrl application supports Virtual Network Computing (VNC) connection on both Windows and macOS operating systems. It offers a user-friendly interface to eliminate complicated setup processes. iCtrl has been used for over two years and received positive ratings from undergraduate students in a first-year programming language course and a third-year computer network course. Feedback provided by students suggested a few potential improvements such as cross-platform support and Secure Shell (SSH) connections. This motivated us to design a web-based version for iCtrl in summer 2021 that supported cross-OS platform access, SSH and VNC connection, while providing an industry-leading file management interface design with reference to Google Drive and Microsoft OneDrive. This allowed not only to transfer responsibilities of platform support to the browser developers but also to design a more intuitive interface for the students to upload, retrieve and manage files using the SSH File Transfer Protocol (SFTP). The latest survey noted an 86.2% approval of our application over the traditional methods, and the download count of the application is now 10 times of the old version after we applied engineering practices. © American Society for Engineering Education, 2022.

Discussion on feasibility of electronic informed consent in drug clinical trials

With the development of science and technology, electronic information technology has penetrated into many aspects of society now. Electronic informed consent is an effective way to adapt to development clinical trial. China is still at an early stage in this field. Affected by the outbreak of COVID-19 in 2020, the demand for electronic informed consent in clinical trial has become more urgent. Based on my own work experience, the author wants to analyze the problems in the traditional informed consent process and the current situations of electronic informed consent in China and explores the feasibility of electronic informed consent in clinical trials. © 2021 Drug Evaluation Research. All rights reserved.

Source-tracing investigation and analysis of a case of nucleic acid detection of 2019 Novel Corona Virus positive environmental samples in a medical institution

Objective This study is conducted against a case of positive nucleic acid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of environmental samples in a medical institution in Chengdu. Epidemiological investigation methods and laboratory tests are used to investigate the source and analyze the cause of the case, to explore the nucleic acid monitoring mode and the disposal scheme of abnormal conditions of SARS-CoV-2 in the medical institution environment. Methods Chengdu and Shuangliu district CDC jointly investigate A Medical Institution (A refers to a specific anonymous medical institute). Epidemiological surveys were conducted though related influencing factors of the medical institution. SARS-CoV-2 nucleic acid detection kits were used for detection. Sequencing was carried out on a second-generation sequencing platform. Results From Jan.18th 2021 to Jan.20th 2021, a total of 62 smear samples of environment and articles were collected, among which 30 samples were positive for SARS-CoV-2 nucleic acid. 30 positive samples were divided into Gongwei building (9) and Zhonghe building (21) according to the sampling location. The samples' Ct values of ORF1ab gene in Gongwei building were lower than that in Zhonghe building, and the difference was statistically significant (t=2.452, P=0.036). According to the nature of the specimens, they were divided into external environment smear samples (24 samples) and cleaning tool smear samples (6 samples). The N gene Ct values of external environment smear samples were lower than that of cleaning tools, and the difference was statistically significant (Z=-2.204, P=0.028). Through gene sequencing analysis, the sequence of SARS-CoV-2 nucleic acid positive environmental samples detected this time is highly homologous with SARS-CoV-2 vaccine (> 99.9%). Conclusions The positive environmental samples of SARS-CoV-2 nucleic acid in the medical institution are caused by the damage and leakage of COVID-19 vaccine ampoules in the process of vaccination, which led to the contamination of the vaccination room of public health building, and then transmit to the hospital environment of fever clinic and complex building through cleaning tools by cleaning workers. With the progress of COVID-19 vaccine vaccination, there is a high probability of environmental pollution of vaccine liquid in the vaccination area of medical institutions. Therefore, it is necessary in combination with the current normalization monitoring requirements of domestic COVID-19 epidemic situation to refine the specific implementation plan, conduct vaccination in a scientific and orderly manner, and reduce the social impact. © 2022, Publication Centre of Anhui Medical University. All rights reserved.

Utilization of Remdesivir for COVID-19 in the National Veterans Affairs Healthcare System

Background. As remdesivir (GS-5734) has become a leading treatment for COVID-19, we sought to assess remdesivir utilization patterns, including utilization of concomitant and supportive therapies, and heterogeneity in treatment approaches. Methods. Our retrospective cohort study included hospitalized Veterans with positive COVID-19 PCR tests treated with remdesivir, from 03/2020 through 4/2021. Using exposure mapping of barcode medication administration records and medication dispensings, we assessed other medications received by each patient on each day of remdesivir treatment. Heterogeneity was defined as patterns of treatment (drug & duration) not shared by any other patient. Results. Our study included 13,665 patients with COVID-19 receiving remdesivir. The median time to remdesivir initiation from either positive test or hospital admission was 1 day (interquartile range [IQR] 0-4 and 0-1, respectively). The median duration of remdesivir treatment was 5 days (IQR 4-5 days). Median length of hospital stay was 7 days (IQR 4-13). Inpatient mortality was 13.9% and an additional 6.2% of patients died within 90 days of discharge. The most common concomitant and supportive therapies were anticoagulants/antiplatelets (94.8%;enoxaparin 72.6%, heparin 18.4%, apixaban 10.8%, clopidogrel 6.3%), corticosteroids (90.8%;dexamethasone 87.3%, prednisone 2.9%, methylprednisolone 5.5%), statins (55.8%;atorvastatin 38.2%, simvastatin 7.1%, rosuvastatin 6.0%), antibiotics (41.9%;azithromycin 25.6%, ceftriaxone 13.2%, doxycycline 6.0%, vancomycin 4.9%), angiotensin receptor blockers (11.9%) and angiotensin-converting enzyme inhibitors (20.4%), melatonin (29.7%), and aspirin (35.6%). Concomitant utilization of Janus kinase inhibitors (0.5%), interleukin-6 inhibitors (2.4%), and hydroxychloroquine (0.5%) was low. Heterogeneity in concomitant and supportive therapies during remdesivir treatment was 84.6% (68.3% when assessed as drug class/category). Conclusion. Among hospitalized patients with COVID-19 in the national VA Healthcare system receiving remdesivir, remdesivir was initiated early in the admission and substantial heterogeneity was observed in concomitant and supportive therapies during remdesivir treatment.

Trends in Remdesivir Treatment over the Course of the COVID-19 Pandemic

Background. Remdesivir is approved for use in the United States for treatment of COVID-19 requiring hospitalization. Real-world data on trends in remdesivir use may elucidate its benefits and place in therapy. Methods. Hospitalized Veterans with a positive SARS-CoV-2 polymerase chain reaction (PCR) test that were treated with remdesivir at a Veterans Affairs Medical Center from May 2020 to April 2021 were included. Monthly trends in remdesivir treatment, as well as patient characteristics and clinical outcomes among patients treated with remdesivir, were assessed with joinpoint regression to calculate average monthly percent change and corresponding 95% confidence intervals (CI). Results. A total of 30,333 Veterans were hospitalized with a positive PCR test over the study period, and 13,639 were treated with remdesivir (45%). Throughout the study period, the proportion of Veterans treated with remdesivir increased significantly (4.5% per month, 95% CI 0.5%-8.6%) and median time to remdesivir initiation decreased significantly (12% per month, 95% CI -15.8% to -8.0%). Though demographic characteristics of Veterans treated with remdesivir remained stable, including age, race, and obesity, improvement in clinical outcomes were observed, including median length of hospital stay which decreased by 6.5% per month (95% CI -9.1% to -3.8%), intensive care admissions which decreased by 4.6% per month (95% CI -6.3% to -2.8%) and inpatient mortality which decreased by 6.3% per month (95% CI -9.4% to -3.1%). By April 2021, most patients initiated remdesivir on the day of admission, and the inpatient mortality rate decreased to 7.9% from 19.2% in May 2020. Conclusion. Over the course of the COVID-19 pandemic, utilization of remdesivir increased while initiation of remdesivir occurred earlier in the hospital admission, with concurrent reductions in length of hospital stay, intensive care admissions, and inpatient mortality.

Trends in Remdesivir Treatment Over the Course of the COVID-19 Pandemic

Background Remdesivir is approved for use in the United States for treatment of COVID-19 requiring hospitalization. Real-world data on trends in remdesivir use may elucidate its benefits and place in therapy. Methods Hospitalized Veterans with a positive SARS-CoV-2 polymerase chain reaction (PCR) test that were treated with remdesivir at a Veterans Affairs Medical Center from May 2020 to April 2021 were included. Monthly trends in remdesivir treatment, as well as patient characteristics and clinical outcomes among patients treated with remdesivir, were assessed with joinpoint regression to calculate average monthly percent change and corresponding 95% confidence intervals (CI). Results A total of 30,333 Veterans were hospitalized with a positive PCR test over the study period, and 13,639 were treated with remdesivir (45%). Throughout the study period, the proportion of Veterans treated with remdesivir increased significantly (4.5% per month, 95% CI 0.5%-8.6%) and median time to remdesivir initiation decreased significantly (12% per month, 95% CI -15.8% to -8.0%). Though demographic characteristics of Veterans treated with remdesivir remained stable, including age, race, and obesity, improvement in clinical outcomes were observed, including median length of hospital stay which decreased by 6.5% per month (95% CI -9.1% to -3.8%), intensive care admissions which decreased by 4.6% per month (95% CI -6.3% to -2.8%) and inpatient mortality which decreased by 6.3% per month (95% CI -9.4% to -3.1%). By April 2021, most patients initiated remdesivir on the day of admission, and the inpatient mortality rate decreased to 7.9% from 19.2% in May 2020. Conclusion Over the course of the COVID-19 pandemic, utilization of remdesivir increased while initiation of remdesivir occurred earlier in the hospital admission, with concurrent reductions in length of hospital stay, intensive care admissions, and inpatient mortality. Disclosures Aisling Caffrey, PhD, Merck (Research Grant or Support)Pfizer (Research Grant or Support)Shionogi, Inc (Research Grant or Support)

[Analysis on the imported Coronavirus Disease 2019 related cluster epidemic in rural areas of Chengdu].

An epidemiological investigation was carried out on a local cluster of outbreak caused by imported cases of Coronavirus Disease 2019 (COVID-19) in rural areas of Chengdu in December 2020, to find out the source of infection and the chain of transmission. According to Prevention and Control Protocol for COVID-19 (Version 7), field epidemiological investigation was adopted, combined with big data technology, video image investigation, gene sequencing and other methods to carry out investigation into COVID-19 cases and infections source tracing, analyze the epidemiological association, and map the chain of transmission. From December 7 to 17, 2020, 13 local COVID-19 confirmed cases and 1 asymptomatic case were diagnosed in Chengdu, of which 12 cases (85.71%) had a history of residence and activity in the village courtyard of Taiping (TP), Pidu (P) District, Chengdu. From November 8, 2020 to November 28, 2020, a group of inbound people form Nepal were transferred to the designated entry personnel quarantine hotel of P District which was adjacent to the TP village. During quarantine, there were 5 cases who tested positive for COVID-19. Through gene sequencing alignment, genes of local cases and Nepalese imported cases from the same period are homologous, all belong to the lineage of L2.2.3 (B.1.36 according to Pangolin lineage typing method). According to the results of field epidemiological investigation and gene sequencing analysis, the index case was most likely infected by contact with household waste of quarantine site. Under the situation of normalization prevention and control of COVID-19, sentinel monitoring of fever clinics in primary medical institutions is the key to early detection of the epidemic. The multi-department joint epidemiological investigation and the application of gene technology are the core links of the investigation and traceability of modern infectious diseases. The allocation of public health resources in rural areas needs to be strengthened. We need to improve the capacity for early surveillance and early warning of the epidemic in rural areas.

Dynamic spillovers across oil, gold and stock markets in the presence of major public health emergencies

Extreme events have a systemic impact on global financial markets, leading to significant cross-market spillovers in the oil, gold, and stock markets and raising widespread concerns about market linkages and risk contagion. In this paper, with a focus on both return and volatility, a frontier spillover network analysis is used to examine the strength and scale characteristics of spillovers in the oil, gold and stock markets under major public health emergency shocks. In addition, the paper adopts a marginal spillover and network analysis to evaluate linkage relationships, risk sources and transmission paths in the oil, gold, and stock markets during such events. The results show that the return and volatility spillover effects generated across the oil, gold, and stock markets are significant, with return spillovers being more stable and volatility spillovers being highly sensitive to emergencies. Meanwhile, the COVID-19 pandemic has displayed the strongest return and volatility spillovers. The high intensity of the shocks during the COVID-19 period has changed the usual characteristics of the market, with the gold market becoming the risk receiver and the oil market becoming risk sources. © 2021 Elsevier Inc.