The impact of the COVID-19 pandemic on O-D flow and airport networks in the origin country and in Northeast Asia.

The ongoing COVID-19 pandemic has posed a global threat to human health. In order to prevent the spread of this virus, many countries have imposed travel restrictions. This difficult situation has dramatically affected the airline industry by reducing the passenger volume, number of flights, airline flow patterns, and even has changed the entire airport network, especially in Northeast Asia (because it includes the original disease seed). However, although most scholars have used conventional statistical analysis to describe the changes in passenger volume before and during the COVID-19 outbreak, very few of them have applied statistical assessment or time series analysis, and have not even examined how the impact may be different from place to place. Therefore, the purpose of this study was to identify the impact of COVID-19 on the airline industry and affected areas (including the origin-destination flow and the airport network). First, a Clustering Large Applications (CLARA) algorithm was used to group numerous origin-destination (O-D) flow patterns based on their characteristics and to determine if these characteristics have changed the severity of the impact of each cluster during the COVID-19 outbreak. Second, two statistical tests (the paired t-test and the Wilcoxon signed-rank test) were utilized to determine if the entire airport network and the top 30 hub airports changed during COVID-19. Four centrality measurement indices (degree, closeness, eigenvector, and betweenness centrality) of the airports were used to assess the entire network and ranking of individual hub airports. The study data, provided by The Official Aviation Guide (OAG) from December 2019 to April 2020, indicated that during the COVID-19 outbreak, there was a decrease in passenger volume (60%-98.4%) as well as the number of flights (1.5%-82.6%). However, there were no such significant changes regarding the popularity ranking of most airports during the outbreak. Before this occurred (December 2019), most hub airports were in China (April 2020), and this trend remain similar during the COVID-19 outbreak. However, the values of the centrality measurement decreased significantly for most hub airports due to travel restrictions issued by the government.

Tocotrienol-Rich Vitamin E (Tocovid) Improved Nerve Conduction Velocity in Type 2 Diabetes Mellitus Patients in a Phase II Double-Blind, Randomized Controlled Clinical Trial.

Diabetic peripheral neuropathy (DPN) is the most common microvascular complication of diabetes that affects approximately half of the diabetic population. Up to 53% of DPN patients experience neuropathic pain, which leads to a reduction in the quality of life and work productivity. Tocotrienols have been shown to possess antioxidant, anti-inflammatory, and neuroprotective properties in preclinical and clinical studies. This study aimed to investigate the effects of tocotrienol-rich vitamin E (Tocovid SuprabioTM) on nerve conduction parameters and serum biomarkers among patients with type 2 diabetes mellitus (T2DM). A total of 88 patients were randomized to receive 200 mg of Tocovid twice daily, or a matching placebo for 12 months. Fasting blood samples were collected for measurements of HbA1c, renal profile, lipid profile, and biomarkers. A nerve conduction study (NCS) was performed on all patients at baseline and subsequently at 2, 6, 12 months. Patients were reassessed after 6 months of washout. After 12 months of supplementation, patients in the Tocovid group exhibited highly significant improvements in conduction velocity (CV) of both median and sural sensory nerves as compared to those in the placebo group. The between-intervention-group differences (treatment effects) in CV were 1.60 m/s (95% CI: 0.70, 2.40) for the median nerve and 2.10 m/s (95% CI: 1.50, 2.90) for the sural nerve. A significant difference in peak velocity (PV) was also observed in the sural nerve (2.10 m/s; 95% CI: 1.00, 3.20) after 12 months. Significant improvements in CV were only observed up to 6 months in the tibial motor nerve, 1.30 m/s (95% CI: 0.60, 2.20). There were no significant changes in serum biomarkers, transforming growth factor beta-1 (TGFß-1), or vascular endothelial growth factor A (VEGF-A). After 6 months of washout, there were no significant differences from baseline between groups in nerve conduction parameters of all three nerves. Tocovid at 400 mg/day significantly improve tibial motor nerve CV up to 6 months, but median and sural sensory nerve CV in up to 12 months of supplementation. All improvements diminished after 6 months of washout.

Airline transportation and arrival time of international disease spread: A case study of Covid-19.

In this era of globalization, airline transportation has greatly increased international trade and travel within the World Airport Network (WAN). Unfortunately, this convenience has expanded the scope of infectious disease spread from a local to a worldwide occurrence. Thus, scholars have proposed several methods to measure the distances between airports and define the relationship between the distances and arrival times of infectious diseases in various countries. However, such studies suffer from the following limitations. (1) Only traditional statistical methods or graphical representations were utilized to show that the effective distance performed better than the geographical distance technique. Researchers seldom use the survival model to quantify the actual differences among arrival times via various distance methods. (2) Although scholars have found that most diseases tend to spread via the random walk rather than the shortest path method, this hypothesis may no longer be true because the network has been severally altered due to recent COVID-related travel reductions. Therefore, we used 2017 IATA (International Air Transport Association) to establish an airline network via various chosen path strategies (random walk and shortest path). Then, we employed these two networks to quantify each model's predictive performance in order to estimate the importation probability function of COVID-19 into various countries. The effective distance model was found to more accurately predict arrival dates of COVID-19 than the geographical distance model. However, if pre-Covid airline data is included, the path of disease spread might not follow the random walk theory due to recent flight suspensions and travel restrictions during the epidemic. Lastly, when testing effective distance, the inverse distance survival model and the Cox model yielded very similar importation risk estimates. The results can help authorities design more effective international epidemic prevention and control strategies.

A systems-level study reveals host-targeted repurposable drugs against SARS-CoV-2 infection.

Understanding the mechanism of SARS-CoV-2 infection and identifying potential therapeutics are global imperatives. Using a quantitative systems pharmacology approach, we identified a set of repurposable and investigational drugs as potential therapeutics against COVID-19. These were deduced from the gene expression signature of SARS-CoV-2-infected A549 cells screened against Connectivity Map and prioritized by network proximity analysis with respect to disease modules in the viral-host interactome. We also identified immuno-modulating compounds aiming at suppressing hyperinflammatory responses in severe COVID-19 patients, based on the transcriptome of ACE2-overexpressing A549 cells. Experiments with Vero-E6 cells infected by SARS-CoV-2, as well as independent syncytia formation assays for probing ACE2/SARS-CoV-2 spike protein-mediated cell fusion using HEK293T and Calu-3 cells, showed that several predicted compounds had inhibitory activities. Among them, salmeterol, rottlerin, and mTOR inhibitors exhibited antiviral activities in Vero-E6 cells; imipramine, linsitinib, hexylresorcinol, ezetimibe, and brompheniramine impaired viral entry. These novel findings provide new paths for broadening the repertoire of compounds pursued as therapeutics against COVID-19.

Virus load and virus shedding of SARS-CoV-2 and their impact on patient outcomes.

BACKGROUND: Understanding a virus shedding patterns in body fluids/secretions is important to determine the samples to be used for diagnosis and to formulate infection control measures. AIM: To investigate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding patterns and its risk factors. METHODS: All laboratory-confirmed coronavirus disease 2019 patients with complete medical records admitted to the Shenzhen Third People's Hospital from January 28, 2020 to March 8, 2020 were included. Among 145 patients (54.5% males; median age, 46.1 years), three (2.1%) died. The bronco-alveolar lavage fluid (BALF) had the highest virus load compared with the other samples. The viral load peaked at admission (3.3 × 108 copies) and sharply decreased 10 d after admission. RESULTS: The viral load was associated with prolonged intensive care unit (ICU) duration. Patients in the ICU had significantly longer shedding time compared to those in the wards (P < 0.0001). Age > 60 years [hazard ratio (HR) = 0.6; 95% confidence interval (CI): 0.4-0.9] was an independent risk factor for SARS-CoV-2 shedding, while chloroquine (HR = 22.8; 95%CI: 2.3-224.6) was a protective factor. CONCLUSION: BALF had the highest SARS-CoV-2 load. Elderly patients had higher virus loads, which was associated with a prolonged ICU stay. Chloroquine was associated with shorter shedding duration and increased the chance of viral negativity.

Cataract service redesign in the post-COVID-19 era.

COVID-19 pandemic of 2020 has impacted all aspects of clinical practice in the UK. Cataract services suffered severe disruption due to necessary measures taken to reduce elective surgery in order to release capacity to support intensive care requirements. Faced with a potential 50% increase in cataract surgery workload per week in the post-COVID-19 world, eye units should use this event to innovate, not just survive but to also evolve for a sustainable future. In this article, we discuss the inadequacies of existing service rationing options to tackle the COVID-19 cataract backlog. This includes limiting rationing based on visual acuity, limiting surgery to first or only seeing eyes, and postponing clinic and surgical dates according to referral dates. We propose units use the lockdown time to reset and develop a comprehensive patient-centred care pathway using principles of value-based healthcare: the cataract integrated practice units. Developing an agile surgical database that incorporates all aspects of patient need from education to follow-up in their individual cataract journey will allow units to react and plan quickly in the early phase of recovery and beyond. We also discuss the considerations units should bear in mind on telemedicine, modifications for face-to-face clinics, theatre organisation and options of expanding cataract throughput capacity. The pause in elective surgery due to the pandemic may have provided cataract services a rare opportunity to reset and transform cataract service pathways for the digital era.

Eye care in the intensive care unit during the COVID-19 pandemic.

Ocular complications in critical care patients are common. There has been a surge in intensive care admissions following the COVID-19 outbreak. The management of COVID-19 exposes patients to a number of specific risk factors for developing ocular complications, which include non-invasive ventilation, mechanical ventilation and prone positioning. Consequently, it is likely that there will be an increase in the number of ocular complications secondary to the management of COVID-19 patients in the intensive care unit setting, and these complications could lead to permanent visual loss and blindness. Increased awareness of eye care in the intensive care unit setting is therefore vital to help prevent visual loss and maintain quality of life for patients recovering from COVID-19.