Build an Agent-Based Model for COVID-19 Effect of Mitigation Policies

Non-Drug Intervention (NDI) is one of the important means to prevent and control the outbreak of coronavirus disease 2019 (COVID-19), and the implementation of this series of measures plays a key role in the development of the epidemic. The purpose of this paper is to study the impact of different mitigation measures on the situation of the COVID 19, and effectively respond to the prevention and control situation in the "post-epidemic era". The present work is based on the Susceptible-Exposed-Infectious-Remove-Susceptible (SEIRS) Model, and adapted the agent-based model (ABM) to construct the epidemic prevention and control model framework to simulate the COVID-19 epidemic from three aspects: social distance, personal protection, and bed resources. The experiment results show that the above NDI are effective mitigation measures for epidemic prevention and control, and can play a positive role in the recurrence of COVID-19, but a single measure cannot prevent the recurrence of infection peaks and curb the spread of the epidemic;When social distance and personal protection rules are out of control, bed resources will become an important guarantee for epidemic prevention and control. Although the spread of the epidemic cannot be curbed, it can slow down the recurrence of the peak of the epidemic;When people abide by social distance and personal protection rules, the pressure on bed resources will be eased. At the same time, under the interaction of the three measures, not only the death toll can be reduced, but the spread of the epidemic can also be effectively curbed. © 2022 ACM.

Progress in Epidemiology of Tuberculosis in China

9870 thousand people develop tuberculosis (TB) in 2020. Despite being a preventable as well as curable communicable disease, tuberculosis still is the leading communicable disease killer globally. The WHO's End TB Strategy envisions a world free of TB, zero deaths, disease, and suffering due to tuberculosis by 2035. China ranks second for TB cases globally. Over the past 20 years, China has made remarkable achievements in tuberculosis control, with the prevalence and mortality rate of tuberculosis reduced by half compared with 1990. China has achieved the United Nations Millennium Development Goals on tuberculosis control 5 years ahead of schedule. However, in spite of concerted international, regional, and national efforts to address tuberculosis in China, the tuberculosis burden in China is still high. At the same time, China also faces problems such as the high burden of latent TB infection, rifampicin-resistant/ multidrug-resistant tuberculosis, and low detection rate of tuberculosis. China needs to further improve the quality of tuberculosis control work to reduce the incidence of tuberculosis and ultimately achieve the goal of ending tuberculosis. © People's Medical Publishing House, PR of China 2022.

A Literature Review on the Antiviral Mechanism of Luteolin

Background: Viral infections pose some of the most serious human health concerns worldwide. The infections caused by several viruses, including coronavirus, hepatitis virus, and human immunodeficiency virus, are difficult to treat. Method(s): This review details the findings of a literature search performed on the antiviral properties of luteolin. The keywords engaged in the search are "virus" along with "luteolin." Results: Luteolin possesses antiviral properties, which is the basis for the current review. It is an important natural flavonoid with numerous important biological properties, including anti-inflammatory, immune regulatory, and antitumor effects, and is found in vegetables, fruits, and several medicinal plants. Recent studies have revealed that many traditional Chinese medicines that contain luteolin inhibit the replication of coronaviruses. Conclusion(s): Luteolin effectively inhibits the replication of coronavirus, influenza virus, enterovirus, rotavirus, herpes virus, and respiratory syncytial virus, among others. In particular, it prevents viral infection by improving the body's nonspecific immunity and antioxidation capacity and inhibiting many pathways related to virus infection and replication, such as MAPK, PI3K-AKT, TLR4/8, NF-kappaB, Nrf-2/hemeoxygenase-1, and others. It also regulates the expression of some receptors and factors, including hepatocyte nuclear factor 4alpha, p53, NLRP3, TNF-alpha, and interleukins, thereby interfering with the replication of viruses in cells. Luteolin also promotes the repair of damaged cells induced by proinflammatory factors by regulating the expression of inflammatory molecules. The overall effect of these processes is the reduction in viral replication and, consequently, the viral load. This review summarizes the antiviral effect of luteolin and the mechanism underlying this property.Copyright © The Author(s) 2023.

Jing Si Herbal Drink as a prospective adjunctive therapy for COVID-19 treatment: Molecular evidence and mechanisms

Background: SARS-CoV-2 has led to a sharp increase in the number of hospitalizations and deaths from pneumonia and multiorgan disease worldwide;therefore, SARS-CoV-2 has become a global health problem. Supportive therapies remain the mainstay treatments against COVID-19, such as oxygen inhalation, antiviral drugs, and antibiotics. Traditional Chinese medicine (TCM) has been shown clinically to relieve the symptoms of COVID-19 infection, and TCMs can affect the pathogenesis of SARS-CoV-2 infection in vitro. Jing Si Herbal Drink (JSHD), an eight herb formula jointly developed by Tzu Chi University and Tzu Chi Hospital, has shown potential as an adjuvant treatment for COVID-19 infection. A randomized controlled trial (RCT) of JSHD as an adjuvant treatment in patients with COVID-19 infection is underway Objectives: This article aims to explore the efficacy of the herbs in JSHD against COVID-19 infection from a mechanistic standpoint and provide a reference for the rational utilization of JSHD in the treatment of COVID-19. Method(s): We compiled evidence of the herbs in JSHD to treat COVID-19 in vivo and in vitro. Result(s): We described the efficacy and mechanism of action of the active ingredients in JSHD to treat COVID-19 based on experimental evidence. JSHD includes 5 antiviral herbs, 7 antioxidant herbs, and 7 anti-inflammatory herbs. In addition, 2 herbs inhibit the overactive immune system, 1 herb reduces cell apoptosis, and 1 herb possesses antithrombotic ability. Conclusion(s): Although experimental data have confirmed that the ingredients in JSHD are effective against COVID-19, more rigorously designed studies are required to confirm the efficacy and safety of JSHD as a COVID-19 treatment.Copyright © 2021

Evaluating the Impact of COVID-19 on Transportation Infrastructure Funding in the United States

The coronavirus disease 2019 (COVID-19) pandemic has caused a reduction in business and routine activity and resulted in less motor fuel consumption. Thus, the gas tax revenue is reduced, which is the major funding resource supporting the rehabilitation and maintenance of transportation infrastructure systems. The focus of this study is to evaluate the impact of the COVID-19 pandemic on transportation infrastructure funds in the United States through analyzing the motor fuel consumption data. Machine learning models were developed by integrating COVID-19 scenarios, fuel consumptions, and demographic data. The best model achieves an R2-score of more than 95% and captures the fluctuations of fuel consumption during the pandemic. Using the developed model, we project future motor gas consumption for each state. For some states, the gas tax revenues are going to be 10%-15% lower than the pre-pandemic level for at least one or two years. © 2022 International Conference on Transportation and Development

Collective Stress Visualization Enabled by Smart Cushions for Office Chairs

This paper explores the possibility of combining sensory data of multiple individuals into a collective visualization. Using a smart cushion for office chairs that collects several stress-related parameters, namely: heart rate, respiratory rate, and heart-rate variability, individuals’ data can be aggregated into a collective stress visualization. Three different visualizations are designed which ly, grouped and aggregated, and metaphorically visualize the collective stress. Additionally, two more visualizations are explored for the ‘new way of working’ during the COVID-19 epidemic, where people work remotely and from the office. Through expert and user interviews, these visualizations are evaluated. Additionally, there is researched on whether measured heart-rate variability can predict perceived stress levels. The results found an inversed correlation than hypothesized. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

MULTIDISCIPLINARY SPECIALTY CLINIC DECREASES HEALTHCARE UTILIZATION IN CHILDREN WITH FUNCTIONAL GASTROINTESTINAL DISORDERS

Introduction: The biopsychosocial model has been used to describe the complex pathophysiology of functional gastrointestinal disorders (FGIDs), and the literature is clear that conventional medical treatment alone is often inadequate and should be supplemented with behavioral and/or dietary treatment. We hypothesized that the implementation of a multidisciplinary clinic for children with FGIDs would lead to decreased healthcare utilization. Our objective was to compare healthcare utilization before and after the initial visit in a pediatric multidisciplinary FGID clinic. Methods: We performed a retrospective review of children seen in the FGID clinic at our institution for their initial visit from March 2018-November 2019 (to avoid any impact of the COVID-19 pandemic). Our FGID clinic sees patients referred from other gastroenterologists. The initial visit is a 60-minute visit with a pediatric gastroenterologist, psychologist, and at times a dietitian. We recorded baseline characteristics and clinic visit information. To evaluate impact on healthcare utilization, we compared phone calls, electronic messages, additional outpatient GI visits, emergency department (ED) or urgent care (UC) visits, and hospitalizations for GI symptoms three months before and after a patient's initial FGID clinic visit. Results: We included 49 patients (76% female, median age 16 years, range 5-19). Primary FGID diagnoses were functional abdominal pain (45%), irritable bowel syndrome (22%), functional dyspepsia (20%), rumination syndrome (6%), functional constipation (4%), and abdominal migraine (2%). Other diagnoses included anxiety (73%), depression (33%), and inflammatory bowel disease (2%). Prior testing included blood tests (86%), imaging (82%), esophagogastroduodenoscopy (78%), colonoscopy (35%), and manometry testing (31%). At the initial visit, 71% were on a medication for their GI symptoms, 76% were on a supplement or probiotic, and 35% were on a psychiatric medication. During their initial visit, 96% met with a psychologist and 18% met with a dietitian. Recommendations at the initial visit included new medications (76%), follow up with a GI psychologist (45%), dietary treatment (22%), imaging studies (16%), manometry testing (10%), psychiatry referral (10%), blood tests (8%), esophagogastroduodenoscopy (4%), and colonoscopy (2%). As shown in Table 1, total phone calls, electronic messages, and ED/UC visits for GI symptoms decreased after the FGID clinic visit (p<0.001, p<0.001, and p=0.02 respectively). Conclusion: Healthcare utilization decreased significantly after children with FGIDs were seen in a multidisciplinary FGID clinic. Our findings imply that establishing a multidisciplinary FGID clinic improves the care of children with these disorders and may also reduce the time and financial costs of caring for these disorders.(Table Presented)

Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study

Objective To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment. Methods A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University. Results The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant (P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥ 39 °C);other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥ 39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases (P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases (OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively. © 2021 Chinese Medical Association. All rights reserved.

Intensive outpatient treatment of pediatric rumination syndrome in the era of telemedicine

Background: Rumination syndrome is a functional gastrointestinal disorder (FGID) that involves effortless postprandial regurgitation of food followed either by rechewing or expulsion, and can be challenging to both diagnose and treat effectively. Patients with more severe symptoms require intensive management. At our institution, we have had success treating children with severe rumination syndrome using a multidisciplinary intensive outpatient program (IOP) involving multiple treatment sessions daily. Due to the COVID-19 pandemic, we have needed to transition from in-person treatment to telemedicine. The objective of this study is to compare outcomes of patients with rumination syndrome who completed IOP treatment in person versus by telemedicine. Methods: We performed a retrospective review of patients diagnosed with rumination syndrome by Rome IV criteria and participated in IOP treatment from 2018-2020. IOP consists of intensive medical and behavioral treatment provided by a specialized multidisciplinary team. Until March 2020, this program involved 3 in-person treatment sessions with meals per day for up to a week. Similar treatment sessions were performed during telemedicine visits. We compared outcomes of patients who received IOP treatment in person versus by telemedicine. Families/patients were then asked to complete a survey outlining their child's current rumination symptom severity and review of the IOP. Results: We included 34 patients (79% F, median age 15 years, range 7-19 years) with rumination syndrome who completed IOP treatment. Patients had also been diagnosed with anxiety (17/34, 50%), depression (7/34, 21%), gastroesophageal reflux disease (6/34, 18%), constipation (6/34, 18%), functional abdominal pain (5/34, 15%), eating disorder (5/34, 15%), and superior mesenteric artery syndrome (4/34, 12%). At baseline, 9 patients (26%) required tube feeding or parenteral nutrition compared to 2 patients (6%) at follow up. Twenty-six patients (76%) were treated in person and 8 patients (24%) by telemedicine. There were no significant differences in sex, age, likelihood of anxiety or depression, and duration of IOP treatment between in person and telemedicine groups. The median duration of treatment for both groups was 4 days. Symptom severity at baseline and follow up are described in Table 1. For patients treated in person, 76% (19/25) had improvement in symptoms while 16% (4/25) had complete resolution of symptoms. For patients treated by telemedicine, 88% (7/8) had improvement in their symptoms. There were no significant differences between groups in likelihood of improvement. Of the 34 patients who completed the IOP, 23 (68%) completed both surveys. Overall, 78% (18/23) preferred in person therapy while 17% (4/23) did not have a preference. Of the telemedicine patients, 60% (3/5) would have preferred in-person IOP. All 18 of the in-person cohort preferred in-person management. When asked to elaborate, 4 families expressed similar answers including the need for “in-person interaction,” having a “hands-on approach,” and because the psychologist can give “body instructions.” Other reported strengths of in-person treatment included a majority of families believing this would lead to “a stronger connection with the provider” (90%, 19/21), “fewer distractions” (86%, 18/21), and noting “treatment would be more effective in person” (76%, 16/21). In-person challenges included transportation and parking (63%, 12/19) as well as concerns about time commitment (84%, 16/19). The primary strengths of online treatment were that it saves time (72%,13/18) and some parents felt their child was more comfortable at home (39%,7/18). One family described that it was “easier to integrate habits at home” after completing the process online. Online challenges included having more distractions (81%, 13/16) and some parents felt their child was more comfortable talking to someone in person (75%, 12/16). Conclusion: Although multidisciplinary intensive outpatient treatment for children and adolescents with severe rumination syndrome is effective and the likelihood of improvement appears similar when completed in person or by telemedicine, the majority of families prefer in-person therapy.

[Epidemiological characteristics of COVID-19 monitoring cases in Yinzhou district based on health big data platform].

Objective: To understand the epidemiological characteristics of COVID-19 monitoring cases in Yinzhou district based on health big data platform to provide evidence for the construction of COVID-19 monitoring system. Methods: Data on Yinzhou COVID-19 daily surveillance were collected. Information on patients' population classification, epidemiological history, COVID-19 nucleic acid detection rate, positive detection rate and confirmed cases monitoring detection rate were analyzed. Results: Among the 1 595 COVID-19 monitoring cases, 79.94% were community population and 20.06% were key population. The verification rate of monitoring cases was 100.00%. The total percentage of epidemiological history related to Wuhan city or Hubei province was 6.27% in total, and was 2.12% in community population and 22.81% in key population (P<0.001). The total COVID-19 nucleic acid detection rate was 18.24% (291/1 595), and 53.00% in those with epidemiological history and 15.92% in those without (P<0.001).The total positive detection rate was 1.72% (5/291) and the confirmed cases monitoring detection rate was 0.31% (5/1 595). The time interval from the first visit to the first nucleic acid detection of the confirmed monitoring cases and other confirmed cases was statistically insignificant (P>0.05). Conclusions: The monitoring system of COVID-19 based on the health big data platform was working well but the confirmed cases monitoring detection rate need to be improved.

[Application of healthcare big data in active case finding of COVID-19 in Yinzhou district of Ningbo].

During the prevention and control of the COVID-19 epidemic, identifying and controlling the source of infection has become one of the most important prevention and control measures to curb the epidemic in the absence of vaccines and specific therapeutic drugs. While actively taking traditional and comprehensive "early detection" measures, Yinzhou district implemented inter-departmental data sharing through the joint prevention and control mechanism. Relying on a healthcare big data platform that integrates the data from medical, disease control and non-health sectors, Yinzhou district innovatively explored the big data-driven COVID-19 case finding pattern with online suspected case screening and offline verification and disposal. Such effort has laid a solid foundation and gathered experience to conduct the dynamic and continuous surveillance and early warning for infectious disease outbreaks more effectively and efficiently in the future. This article introduces the exploration of this pattern in Yinzhou district and discusses the role of big data-driven disease surveillance in the prevention and control of infectious diseases.