An alkaline phosphatase-induced immunosensor for SARS-CoV-2 N protein and cardiac troponin I based on the in situ fluorogenic self-assembly between N-heterocyclic boronic acids and alizarin red S.

Alkaline phosphatase (ALP)-induced in situ fluorescent immunosensor is less investigated and reported. Herein, a high-performance ALP-labeled in situ fluorescent immunoassay platform was constructed. The developed platform was based on a fluorogenic self-assembly reaction between pyridineboronic acid (PyB(OH)2) and alizarin red S (ARS). We first used density functional theory (DFT) to theoretically calculate the changes of Gibbs free energy of the used chemicals before and after the combination and simulated the electrostatic potential on its' surfaces. The free ARS and PyB(OH)2 exist alone, neither emits no fluorescence. However, the ARS/PyB(OH)2 complex emits strong fluorescence, which could be effectively quenched by PPi based on the stronger affinity between PPi and PyB(OH)2 than that of ARS and PyB(OH)2. PyB(OH)2 coordinated with ARS again in the presence of ALP due to the ALP-catalyzed hydrolysis of PPi, and correspondingly, the fluorescence was restored. We chose cTnI and SARS-CoV-2 N protein as the model antigen to construct ALP-induced immunosensor, which exhibited a wide dynamic range of 0-175 ng/mL for cTnI and SARS-CoV-2 N protein with a low limit of detection (LOD) of 0.03 ng/mL and 0.17 ng/mL, respectively. Moreover, the proposed immunosensor was used to evaluate cTnI and SARS-CoV-2 N protein level in serum with satisfactory results. Consequently, the method laid the foundation for developing novel fluorescence-based ALP-labeled ELISA technologies in the early diagnosis of diseases.

Non-pharmacological interventions of travel restrictions and cancelation of public events had a major reductive mortality affect during pre-vaccination coronavirus disease 2019 period.

Background: The coronavirus disease 2019 (COVID-19) is a severe acute respiratory disease that poses a continuous threat to global public health. Many non-pharmacological interventions (NPIs) have been implemented to control the COVID-19 pandemic since the beginning. The aim of this study was to assess the impact of various NPIs on COVID-19 mortality during pre-vaccination and vaccination periods. Methods: The COVID-19 data used in this study comes from Our World in Data, we used the Oxford Strict Index (OSI) and its five combination interventions as independent variables. The COVID-19 mortality date (MRT) was defined as a date when daily rate of 0.02 COVID-19 deaths per 100,000 population in a country was reached, and the COVID-19 vaccination date (VRT) was defined as people vaccinated reaching 70%. Linear regression and random forest models were used to estimate the impact of various NPI implementation interventions during pre-vaccination and vaccination periods. The performance of models was assessed among others with Shapley Additive Explanations (SHAP) explaining the prediction capability of the model. Results: During the pre-vaccination period, the various NPIs had strong protective effect. When the COVID-19 MRT was reached, for every unit increase in OSI, the cumulative mortality as of June 30, 2020 decreased by 0.71 deaths per 100,000 people. Restrictions in travel (SHAP 1.68) and cancelation of public events and gatherings (1.37) had major reducing effect on COVID-19 mortality, while staying at home (0.26) and school and workplace closure (0.26) had less effect. Post vaccination period, the effects of NPI reduced significantly: cancelation of public events and gatherings (0.25), staying at home (0.22), restrictions in travel (0.14), and school and workplace closure (0.06). Conclusion: Continued efforts are still needed to promote vaccination to build sufficient immunity to COVID-19 in the population. Until herd immunity is achieved, NPI is still important for COVID-19 prevention and control. At the beginning of the COVID-19 pandemic, the stringency of NPI implementation had a significant negative association with COVID-19 mortality; however, this association was no longer significant after the vaccination rate reached 70%. As vaccination progresses, "cancelation of public events and gatherings" become more important for COVID-19 mortality.

Evaluating the Performance of Inclusive Growth Based on the BP Neural Network and Machine Learning Approach.

In this paper, we use the panel data of 281 cities in China from 2005 to 2020 for capturing the factors driving urban inclusive growth (IG). In doing this, we employ the BP neural network algorithm combined with the DEA model to measure the urban inclusive growth efficiency (IGE). Furthermore, a nest of machine learning (ML) algorithms are introduced to explore the drivers of urban IGE, which overcomes the defects of endogeneity and multicollinearity of traditional econometric methods. We find for the overall sample that entrepreneurship and innovation contribute the most to IGE, accounting for about 35%, respectively, and they are the most critical drivers, while the heterogeneity test results reveal that the contribution of influencing factors has changed for different regions such as the eastern region, the central region, and the western region. Based on the experimental results of the ML model, we provide some policy suggestions for China and similar developing countries and emerging economies to promote IG.

Incidence analysis of 1 403 close contacts of corona virus disease 2019 patients in different contact modes

Objective: To study the exposure and incidence of close contacts of corona virus disease 2019 (COVID-19)cases. Methods The retrospective epidemiological method was used to describe and analyze the contact and incidence of 1 403 close contacts from January 23 to February 29, 2020, and the comparative analysis was made using X2 test. Results The frequency of close contacts was mainly occasional(78.62%). There was a difference in the composition of locations and ways of contact between contacts of local and nonlocal cases. The attack rate of close contacts of local cases w as 2.37%, and that of nonlocal cases was 0. The mean attack rate of all close contacts was 1.78%. Conclusion The incidence of close contacts has a correlation with the frequency and degree of contact. Living together results in the frequent contact, which further leads to multiple clusters in families. The attack rate of family cluster is significantly higher than that of other contacts. Implementing family prevention and control measures will help reduce the attack rate of family cluster.

Analysis and evaluation of the isolation medicine observation for close contacts of coronavirus disease 2019 in Jinan city

Objective: To analyze the isolation medicine observation for close contacts of Coronavirus disease 2019 (COVID-19) in Jinan City.

Emergency Preparedness and Management of Mobile Cabin Hospitals in China During the COVID-19 Pandemic.

The healthcare systems in China and globally have faced serious challenges during the coronavirus disease (COVID-19) pandemic. The shortage of beds in traditional hospitals has exacerbated the threat of COVID-19. To increase the number of available beds, China implemented a special public health measure of opening mobile cabin hospitals. Mobile cabin hospitals, also called Fangcang shelter hospitals, refer to large-scale public venues such as indoor stadiums and exhibition centers converted to temporary hospitals. This study is a mini review of the practice of mobile cabin hospitals in China. The first part is regarding emergency preparedness, including site selection, conversion, layout, and zoning before opening the hospital, and the second is on hospital management, including organization management, management of nosocomial infections, information technology support, and material supply. This review provides some practical recommendations for countries that need mobile cabin hospitals to relieve the pressure of the pandemic on the healthcare systems.

Willingness to accept COVID-19 vaccine among the elderly and the chronic disease population in China.

A cross-sectional field survey was conducted from November 2020 to January 2021 among 7259 participants to investigate the public perception, willingness, and information sources for COVID-19 vaccination, with the focus on the elderly and non-communicable chronic disease (NCD) population. Multiple logistic regressions were performed to identify associated factors of the vaccination willingness. The willingness rate of the elderly to accept the future COVID-19 vaccine (79.08%) was lower than that of the adults aged 18-59 (84.75%). The multiple analysis didn't identify significant relationship between NCD status and the vaccination intention. The main reasons for vaccine hesitancy by the public were: concern for vaccine safety, low infection risk, waiting and seeing others getting vaccinated, concern of vaccine effectiveness and price. Their relative importance differed between adults aged 18-59 and the elderly, and between adults aged 18-59 with or without NCD. Perception for vaccination importance, vaccine confidence, and trust in health workers were significant predictors of the vaccination intention in both age groups. The elderly who perceived high infection risk or had trust in governments were more likely to accept the vaccine. Compared with the adults aged 18-59, the elderly used fewer sources for COVID-19 vaccination information and more trusted in traditional media and family, relatives, and friends for getting vaccination recommendations. To promote vaccine uptake, the vaccination campaigns require comprehensive interventions to improve vaccination attitude, vaccine accessibility and affordability, and tailor strategies to address specific concerns among different population groups and conducted via their trusted sources, especially for the elderly.

Psychological impact of mandatory COVID-19 quarantine on small business owners and self-employed in China.

A massive home-quarantine took place in China due to the novel coronavirus in the end of 2019. The purpose of the present study was to explore the potential mental health impact of this forced quarantine and widespread shutdown among small business owners and the self-employed. A semi-structured interview was employed among 14 participants from three different cities in China. Grounded Theory was employed to analyze the data using Nvivo11 plus. Based on a qualitative analysis, 9 categories of responses emerged to describe the experience and actions of participants towards the quarantine: enjoyment of life, emotional disturbance, hope, comparisons to others, social support, patriotism, making changes, and obedience. Further analysis suggested that the mental state of participants was either positive or negative depending on enjoyment of life, loss, emotional disturbance, and hope, and that these were impacted by intervening conditions (national measures, social support, patriotism), personal strategies (exercising, studying, comparisons to others), and personal consequences (making change, obedience). Rather than observing a linear pattern of negative outcomes, mental state was found to be variable in that positive outcomes were experienced earlier in the quarantine (making connections with family), negative states were encountered midway through the quarantine (fear of financial loss, anxiety), and more positive mental states (hope) emerged towards the end of the quarantine depending on intervening conditions, personal strategies, and consequences. It can be concluded that the nature of the impact of mandatory quarantine in China among small business owners and the self-employed is complex and depends on a variety of personal and situational factors.

The Association of Hypertension With the Severity of and Mortality From the COVID-19 in the Early Stage of the Epidemic in Wuhan, China: A Multicenter Retrospective Cohort Study.

Background: Hypertension may affect the prognosis of COVID-19 illness. We analyzed the epidemiological and clinical characteristics associated with the disease severity and mortality in hypertensive vs. non-hypertensive deceased COVID-19 patients. Methods: We included all the deceased patients with laboratory-confirmed COVID-19 admitted to >200 health facilities in Wuhan between December 1 and February 24, 2020. The median survival time in COVID-19 patients with and without hypertension, the association of hypertension with the disease severity, and the risk factors associated with the COVID-19 mortality stratified by the hypertension status were assessed using the Kaplan-Meier survival analysis, logistic regression, and Cox proportional regression, respectively before and after the propensity score-matching (PS) for age and sex. Results: The prevalence of hypertension in the studied 1,833 COVID-19 patients was 40.5%. Patients with hypertension were more likely to have severe COVID-19 illness than patients without hypertension; the PS-matched multivariable-adjusted odds ratio (95% CI) was 2.44 (1.77-3.08). Moreover, the median survival time in the hypertension group was 3-5 days shorter than the non-hypertension group. There was a 2-fold increased risk of COVID-19 mortality in the hypertension group compared with the non-hypertension group; the PS-matched multivariable-adjusted hazard ratio (HR) = 2.04 (1.61-2.72), and the significant increased risk of COVID-19 mortality in the moderate vs. mild COVID-19 illness was confined to patients with hypertension. Additionally, the history and the number of underlying chronic diseases, occupation, and residential location showed stronger associations with the COVID-19 mortality among patients with hypertension than patients without hypertension. Conclusion: Hypertension was associated with the severity and mortality of COVID-19 illness.

The comparison of epidemiological characteristics between confirmed and clinically diagnosed cases with COVID-19 during the early epidemic in Wuhan, China.

BACKGROUND: To put COVID-19 patients into hospital timely, the clinical diagnosis had been implemented in Wuhan in the early epidemic. Here we compared the epidemiological characteristics of laboratory-confirmed and clinically diagnosed cases with COVID-19 in Wuhan. METHODS: Demographics, case severity and outcomes of 29,886 confirmed cases and 21,960 clinically diagnosed cases reported between December 2019 and February 24, 2020, were compared. The risk factors were estimated, and the effective reproduction number (Rt) of SARS-CoV-2 was also calculated. RESULTS: The age and occupation distribution of confirmed cases and clinically diagnosed cases were consistent, and their sex ratio were 1.0 and 0.9, respectively. The epidemic curve of clinical diagnosis cases was similar to that of confirmed cases, and the city centers had more cumulative cases and higher incidence density than suburbs in both of two groups. The proportion of severe and critical cases (21.5 % vs. 14.0 %, P < 0.0001) and case fatality rates (5.2 % vs. 1.2 %, P < 0.0001) of confirmed cases were all higher than those of clinically diagnosed cases. Risk factors for death we observed in both of two groups were older age, male, severe or critical cases. Rt showed the same trend in two groups, it dropped below 1.0 on February 6 among confirmed cases, and February 8 among clinically diagnosed cases. CONCLUSIONS: The demographic characteristics and spatiotemporal distributions of confirmed and clinically diagnosed cases are roughly similar, but the disease severity and clinical outcome of clinically diagnosed cases are better than those of confirmed cases. In cases when detection kits are insufficient during the early epidemic, the implementation of clinical diagnosis is necessary and effective.

The epidemiological characteristics of deaths with COVID-19 in the early stage of epidemic in Wuhan, China.

OBJECTIVES: To analyze the epidemiological characteristics of COVID-19 related deaths in Wuhan, China and comprehend the changing trends of this epidemic along with analyzing the prevention and control measures in Wuhan. METHODS: Through the China's Infectious Disease Information System, we collected information about COVID-19 associated deaths from December 15, 2019 to February 24, 2020 in Wuhan. We analyzed the patient's demographic characteristics, drew epidemiological curve and made geographic distribution maps of the death toll in each district over time, etc. ArcGIS was used to plot the numbers of daily deaths on maps. Statistical analyses were performed using SPSS and @Risk software. RESULTS: As of February 24, 2020, a total of 1833 deaths were included. Among the deaths with COVID-19, mild type accounted for the most (37.2%), followed by severe type (30.1%). The median age was 70.0 (inter quartile range: 63.0-79.0) years. Most of the deaths were distributed in 50-89 age group, whereas no deaths occurred in 0-9 age group. Additionally, the male to female ratio was 1.95:1. A total of 65.7% of the deaths in Wuhan combined with underlying diseases, and was more pronounced among males. Most of the underlying diseases included hypertension, diabetes and cardiovascular diseases. The peak of daily deaths appeared on February 14 and then declined. The median interval from symptom onset to diagnosis was 10.0 (6.0-14.0) days; the interval from onset to diagnosis gradually shortened. The median intervals from diagnosis to death and symptom onset to deaths were 6.0 (2.0-11.0), 17.0 (12.0-22.0) days, respectively. Most of the disease was centralized in central urban area with highest death rate in Jianghan District. CONCLUSION: COVID-19 poses a greater threat to the elderly people and men with more devastating effects, particularly in the presence of underlying diseases. The geographical distributions show that the epidemic in the central area of Wuhan is more serious than that in the surrounding areas. Analysis of deaths as of February 24 indicates that a tremendous improvement of COVID-19 epidemic in Wuhan has achieved by effective control measures taken by Wuhan Government.