China-Europe freight transportation under the first wave of COVID-19 pandemic and government restriction measures

International freight transportation experienced significant disruptions during the COVID-19 pandemic. The impact of the pandemic and related government restriction measures on international freight transportation is worth analysing for the development of transportation policies and practices in the post-pandemic period, but has received limited attention. To fill the gap, this study applies structural equation models to analyze the impact of the COVID-19 pandemic on the international transportation market and the relationships among the pandemic, government restriction measures, and international transportation market. The impact is also differentiated for different modes of transportation. Results confirm that both demand and supply of international transportation services have been negatively affected by the first wave of the pandemic, with sea transportation being more affected by the reduction of demand and air transportation more by the supply volatility. The government restriction measures are found to play a mediation role, in the way that the impact of the pandemic on the supply of transportation service is suppressed through the government restriction measures. Our findings provide important guidance for transportation industry players and governments in their decision-making process facing with global market shocks such as a pandemic.

Cell-type apoptosis in lung during SARS-CoV-2 infection (preprint)

The SARS-CoV-2 pandemic has inspired renewed interest in understanding the fundamental pathology of acute respiratory distress syndrome (ARDS) following infection because fatal COVID-19 cases are commonly linked to respiratory failure due to ARDS. The pathologic alteration known as diffuse alveolar damage in endothelial and epithelial cells is a critical feature of acute lung injury in ARDS. However, the pathogenesis of ARDS following SRAS-CoV-2 infection remains largely unknown. In the present study, we examined apoptosis in post-mortem lung sections from COVID-19 patients and lung tissues from a non-human primate model of SARS-CoV-2 infection, in a cell-type manner, including type 1 and 2 alveolar cells and vascular endothelial cells (ECs), macrophages, and T cells. Multiple-target immunofluorescence (IF) assays and western blotting suggest both intrinsic and extrinsic apoptotic pathways are activated during SARS-CoV-2 infection. Furthermore, we observed that SARS-CoV-2 fails to induce apoptosis in human bronchial epithelial cells (i.e., BEAS2B cells) and primary human umbilical vein endothelial cells (HUVECs), which are refractory to SARS-CoV-2 infection. However, infection of co-cultured Vero cells and HUVECs or Vero cells and BEAS2B cells with SARS-CoV-2 induced apoptosis in both Vero cells and HUVECs/BEAS2B cells, but did not alter the permissiveness of HUVECs or BEAS2B cells to the virus. Post-exposure treatment of the co-culture of Vero cells and HUVECs with an EPAC1-specific activator ameliorated apoptosis in HUVECs. These findings may help to delineate a novel insight into the pathogenesis of ARDS following SARS-CoV-2 infection.

EPAC regulates von Willebrand factor secretion from endothelial cells in a PI3K/eNOS-dependent manner during inflammation (preprint)

Coagulopathy is associated with both inflammation and infection, including infection with the novel SARS-CoV-2 (COVID-19). Endothelial cells (ECs) fine tune hemostasis via cAMP-mediated secretion of von Willebrand factor (vWF), which promote the process of clot formation. The e xchange p rotein directly a ctivated by c AMP (EPAC) is a ubiquitously expressed intracellular cAMP receptor that plays a key role in stabilizing ECs and suppressing inflammation. To assess whether EPAC could regulate vWF release during inflammation, we utilized our EPAC1 -null mouse model and revealed an increased secretion of vWF in endotoxemic mice in the absence of the EPAC1 gene. Pharmacological inhibition of EPAC1 in vitro mimicked the EPAC1 −/− phenotype. EPAC1 regulated TNFα-triggered vWF secretion from human umbilical vein endothelial cells (HUVECs) in a phosphoinositide 3-kinases (PI3K)/endothelial nitric oxide synthase (eNOS)-dependent manner. Furthermore, EPAC1 activation reduced inflammation-triggered vWF release, both in vivo and in vitro . Our data delineate a novel regulatory role of EPAC1 in vWF secretion and shed light on potential development of new strategies to controlling thrombosis during inflammation. Key Point PI3K/eNOS pathway-mediated, inflammation-triggered vWF secretion is the target of the pharmacological manipulation of the cAMP-EPAC system.

Association between clinical competencies and mental health symptoms among frontline medical staff during the COVID-19 outbreak: A cross-sectional study (preprint)

Background: In China, mental health of frontline medical staff might be influenced by clinicians’ ability to handle the outbreak of coronavirus disease 2019 (COVID-19). Few studies to-date have addressed the association between clinicians’ competencies and mental health in this context. This cross-sectional study has examined the prevalence of mental health symptoms among frontline medical staff handling the COVID-19 outbreak, and explored the associations between their competencies, and separate and concurrent depressive and anxiety symptoms. Methods: A total of 623 frontline medical staff were included in this study, which took place from January 20, 2020 to February 20, 2020. Competencies, depressive symptoms, and anxiety symptoms were assessed using the short form of the Chinese clinical physicians’ competency model, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaire, respectively. Logistic regression models were used to estimate the associations between one standard deviation increase in competency scores and the prevalence of mental health problems. Multivariate-adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated.Results: Among 623 staff members, the prevalence of depressive, anxiety, and comorbid depressive and anxiety symptoms was 40.93%, 31.78%, and 26.00%, respectively. Among the medical staff with higher total competency scores, the prevalence of depressive (OR=0.67, 95% CI: 0.55-0.81), anxiety (OR=0.68, 95% CI: 0.56-0.83), and comorbid anxiety and depressive symptoms (OR=0.69, 95% CI: 0.55-0.83) was lower than among their lower-scoring counterparts. Subgroup analyses stratified by core competency scores revealed similar associations as the main analyses.Conclusions: The present findings highlight the association between high core competency scores and lower prevalence of depressive, anxiety, and comorbid anxiety and depressive symptoms. Improving medical staff’s core competencies might help prevent mental health problems among frontline medical staff responding to COVID-19.