Application of virtual simulation in clinical skills and operation courses.

Aim: This study investigated the effectiveness and prospect of applying virtual simulation operation (VSO) as a novel teaching tool in clinical skill and operation courses. Methods: A comparative test and survey study on the teaching effect of VSO was conducted with the clinical skill and operation course as the test course. The test group students received offline courses combined with online VSO practice. In contrast, the control group students received offline courses combined with instructional video review. The two groups were assessed using the Chinese medical school clinical medicine professional level test and a questionnaire survey. Results: The test group students scored significantly higher than the control group in the skills test (score difference: 3.43, 95% CI: 2.05-4.80) (p < 0.001). Additionally, a significant increase in the percentage of high-and intermediate-score ranges and a decrease in the percentage of low-score ranges was observed (p < 0.001). According to the questionnaire survey, 80.56% of the students were willing to continue using virtual simulation in their subsequent clinical skill and operation learning. Further, 85.19% of the students believed that the VSO is superior because it is unrestricted by time and space and can be performed anywhere and anytime compared to traditional operation training. Conclusion: VSO teaching can improve skills and examination performance. An entirely online operation that does not need special equipment can break through the spatiotemporal limitations of traditional skills courses. VSO teaching also suits the ongoing COVID-19 pandemic situation. Virtual simulation, a new teaching tool, has good application prospects.

Evaluation of the immunogenicity of auxotrophic Lactobacillus with CRISPR-Cas9D10A system-mediated chromosomal editing to express porcine rotavirus capsid protein VP4.

Porcine rotavirus (PoRV) is an important pathogen, leading to the occurrence of viral diarrhoea . As the infection displays obvious enterotropism, intestinal mucosal immunity is the significant line of defence against pathogen invasion. Moreover, as lactic acid bacteria (LAB) show acid resistance, bile salt resistance and immune regulation, it is of great significance to develop an oral vaccine. Most traditional plasmid delivery vectors use antibiotic genes as selective markers, easily leading to antibiotic accumulation. Therefore, to select a food-grade marker in genetically engineering food-grade microorganisms is vital. Based on the CRISPR-Cas9D10A system, we constructed a stable auxotrophic Lactobacillus paracasei HLJ-27 (Lactobacillus △Alr HLJ-27) strain. In addition, as many plasmids replicate in the host bacteria, resulting in internal gene deletions. In this study,we used a temperature-sensitive gene editing plasmidto insert the VP4 gene into the genome, yielding the insertion mutant strains VP4/△Alr HLJ-27, VP4/△Alr W56, and VP4/W56. This recombinant bacterium efficiently induced secretory immunoglobulin A (SIgA)-based mucosal and immunoglobulin G (IgG)-based humoral immune responses. These oral mucosal vaccines have the potential to act as an alternative to the application of antibiotics in the future and induce efficient immune responses against PEDV infection.

Achieving the "Ending the HIV Epidemic in the U.S." incidence reduction goals among at-risk populations in the South.

INTRODUCTION: Antiretroviral medication coverage remains sub-optimal in much of the United States, particularly the Sothern region, and Non-Hispanic Black or African American persons (NHB) continue to be disproportionately impacted by the HIV epidemic. The "Ending the HIV Epidemic in the U.S." (EHE) initiative seeks to reduce HIV incidence nationally by focusing resources towards the most highly impacted localities and populations. This study evaluates the impact of hypothetical improvements in ART and PrEP coverage to estimate the levels of coverage needed to achieve EHE goals in the South. METHODS: We developed a stochastic, agent-based network model of 500,000 individuals to simulate the HIV epidemic and hypothetical improvements in ART and PrEP coverage. RESULTS: New infections declined by 78.6% at 90%/40% ART/PrEP and 94.3% at 100%/50% ART/PrEP. Declines in annual incidence rates surpassed 75% by 2025 with 90%/40% ART/PrEP and 90% by 2030 with 100%/50% ART/PrEP coverage. Increased ART coverage among NHB MSM was associated with a linear decline in incidence among all MSM. Declines in incidence among Hispanic/Latino and White/Other MSM were similar regardless of which MSM race group increased their ART coverage, while the benefit to NHB MSM was greatest when their own ART coverage increased. The incidence rate among NHB women declined by over a third when either NHB heterosexual men or NHB MSM increased their ART use respectively. Increased use of PrEP was associated with a decline in incidence for the groups using PrEP. MSM experienced the largest absolute declines in incidence with increasing PrEP coverage, followed by NHB women. CONCLUSIONS: Our analysis indicates that it is possible to reach EHE goals. The largest reductions in HIV incidence can be achieved by increasing ART coverage among MSM and all race groups benefit regardless of differences in ART initiation by race. Improving ART coverage to > 90% should be prioritized with a particular emphasis on reaching NHB MSM. Such a focus will reduce the largest number of incident cases, reduce racial HIV incidence disparities among both MSM and women, and reduce racial health disparities among persons with HIV. NHB women should also be prioritized for PrEP outreach.

Research progress in methods for detecting neutralizing antibodies against SARS-CoV-2.

The emergence of SARS-CoV-2 has seriously affected the lives of people worldwide. Clarifying the attenuation rule of SARS-CoV-2 neutralizing antibody (NAb) in vivo is the key to prevent reinfection and recurrence of virus. Currently, the commonly used methods for detecting NAb include virus neutralization tests, pseudovirus neutralization assays, lateral flow immunochromatography and enzyme-linked immunosorbent assays. The detection of NAb not only can be used to evaluate the level of immunity after vaccination or infection but also can provide important theoretical support for virus reinfection, recurrence and vaccine iteration. In this research, the related technologies of SARS-CoV-2 NAb detection were reviewed, aiming to provide better research ideas for SARS-CoV-2 epidemic prevention and control.

Single center retrospective study on the distribution of pathogens in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

Objective: To explore the distribution and correlation of pathogens in the elderly patients with AECOPD, so as to guide the rational use of antibiotics and hormones in clinic. Methods: A total of 111 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) admitted to Nanjing First Hospital from January 2019 to January 2020 were retrospectively analyzed. The basic data such as eosinophil, neutrophil and lymphocyte count, the levels of C-reactive protein(CRP) and erythrocyte sedimentation rate (ESR)in blood routine examination were collected. Further, the pathogens were qualified by sputum fluorescence quantitative polymerase chain reaction, and the pathogens distribution was analyzed. Results: The level of ESR and the ratio of cardiovascular diseases showed significant differences between the pathogen-positive group and pathogen-negative group. In this study, the top five pathogens in AECOPD patients were EB virus (21.6%), Haemophilus influenzae (19.8%), Streptococcus pneumoniae (17.1%), herpes simplex virus(14.4%), influenza A virus(14.4%). The detection rate of influenza A virus was correlated with influenza B virus and Aspergillus (P < 0.05);The detection rate of respiratory syncytial virus was correlated with Candida, Moraxella catarrholis, Streptococcus pneumoniae and Haemophilus influenzae (P < 0.05);The detection rate of Escherichia coli was correlated with rhinovirus, adenovirus, Klebsiella pneumoniae and Acinetobacter baumannii (P < 0.05);The detection rate of Candida was correlated with that of Moraxella catarrholis and Pseudomonas aeruginosa(P<0.05);The detection rate of human coronavirus was correlated with Haemophilus influenzae, herpes simplex virus and Streptococcus pneumoniae(P < 0.05). Conclusions: AECOPD are mostly induced by different pathogens, especially mixed infection of bacteria and virus. It is helpful to guide the rational use of antibiotics by analyzing the etiological characteristics in the elderly patients with AECOPD.

Risk connectedness between crude oil, gold and exchange rates in China: Implications of the COVID-19 pandemic.

This study examined the risk connectedness and its asymmetry between oil, gold, and foreign exchange under the realized volatility, spillover index framework, and high-frequency data during the COVID-19 pandemic. It was found that: (1) At the beginning of the pandemic outbreak, the total volatility spillover in the system declined, which may indicate that the pandemic cuts the trading activities in the financial markets by inhibiting personnel mobility, then, the spillover experienced a short-term sharp rise due to panic. (2) The exchange rate had a significant risk connectedness with gold and international crude oil, but a restrict connectedness with domestic crude oil after the outbreak. These variations of risk transmission caused by the pandemic emerged later than the outbreak, reflecting a certain lag. (3) The impact of the pandemic on the asymmetric risk connectedness between oil, gold and the exchange rate was limited, and the risk transfer resulting from bad news was dominant during the sample period; however, gold was less affected by bad news than the oil and exchange rates. These findings suggested that the establishment of Chinese crude oil futures could restrain volatility spillovers from the exchange rate; the foreign exchange reserve structure should be optimized. Gold has been proved to have a hedging function with the crude oil, and its proportion in foreign exchange reserves should be appropriately increased.

Recent advances in the detection of pathogenic microorganisms and toxins based on field-effect transistor biosensors.

In food safety analysis, the detection and control of foodborne pathogens and their toxins are of great importance. Monitoring of virus transmission is equally important, especially in light of recent findings that coronaviruses have been detected in frozen foods and packages during the current global epidemic of coronavirus disease 2019. In recent years, field-effect transistor (FET) biosensors have attracted considerable scholarly attention for pathogenic microorganisms and toxins detection and sensing due to their rapid response time, high sensitivity, wide dynamic range, high specificity, label-free detection, portability, and cost-effectiveness. FET-based biosensors can be modified with specific recognition elements, thus providing real-time qualitative and semiquantitative analysis. Furthermore, with advances in nanotechnology and device design, various high-performance nanomaterials are gradually applied in the detection of FET-based biosensors. In this article, we review specific detection in different biological recognition elements are immobilized on FET biosensors for the detection of pathogenic microorganisms and toxins, and we also discuss nonspecific detection by FET biosensors. In addition, there are still unresolved challenges in the development and application of FET biosensors for achieving efficient, multiplexed, in situ detection of pathogenic microorganisms and toxins. Therefore, directions for future FET biosensor research and applications are discussed.

GMI, a fungal immunomodulatory protein, ameliorates SARS-CoV-2 envelope protein-induced inflammation in macrophages via inhibition of MAPK pathway

Clinically, COVID-19 is often accompanied by a severe immune response (cytokine storm) which produces a large number of cytokines, such as TNF-α, IL-6 and IL-12, and consequently causes acute respiratory distress syndrome (ARDS). GMI is a type of fungal immunomodulatory protein that is cloned from Ganoderma microsporum and acts as modulating immunocyte for various inflammatory diseases. This study identifies GMI as a potential anti-inflammatory agent and determines the effects of GMI on the inhibition of SARS-CoV-2-induced cytokine secretion. Functional studies showed that SARS-CoV-2 envelop (E) protein induces inflammatory process in murine macrophages RAW264.7 and MH-S cells and in phorbol 12-myristate 13-acetate (PMA)-stimulated human THP-1 cells. GMI exhibits a strong inhibitory effect for SARS-CoV-2-E-induced pro-inflammatory mediators, including NO, TNF-α, IL-6, and IL-12 in macrophages. GMI reduces SARS-CoV-2-E-induced intracellular inflammatory molecules, such as iNOS and COX-2, and inhibits SARS-CoV-2-E-stimulated phosphorylation of ERK1/2 and P38. GMI also downregulates pro-inflammatory cytokine levels in lung tissue and serum after the mice inhale SARS-CoV-2-E protein. In conclusion, this study shows that GMI acts as an agent to alleviate SARS-CoV-2-E-induced inflammation.

Impact of COVID-19 on psychological wellbeing.

This cross-sectional study aims to record post-traumatic stress (PTS) and post-traumatic growth (PTG) of the general population of China during the first wave of COVID-19 spread. Method: An online survey was distributed in China during February and March 2020 to record the general population's PTS (using the Post-traumatic Stress Disorder Checklist-Civilian Version, PCL-C) and PTG (using the Post-traumatic Growth Inventory, PTGI) due to COVID-19. Confirmatory Factor Analyses (CFAs) and a Two-Part Model (TPM) of regression analysis were conducted. Results: In total, 29,118 Chinese participants completed the survey (54.20% were in their 20s, 68% were males, and 60.30% had a university education). CFA results illustrated that bifactor models described the Chinese psychometric traits of PTS and PTG over the default models. Results of TPM suggested that female, low-educated, and middle-aged individuals were more vulnerable to PTS. Remarkably, mutual and positive correlations between the PTS and the PTG, though small in statistics, were observed through regression analyses. Conclusions: The current results presented new best-fit structural models, potential predictors, and valuable baseline information on the PTS and the PTG of the Chinese population in the context of COVID-19.

Este estudio transversal se realizó para registrar el estrés postraumático (EPT) y el crecimiento de estrés postraumático (CPT) de la población general de China durante la primera ola de la extensión del COVID-19. Método: Se realizó una encuesta en línea en China durante febrero y marzo del año 2020 para registrar EPT de la población (utilizando el Post-traumatic Stress Disorder Checklist-Civilian Version, PCL-C) y CPT (utilizando el Post-traumatic Growth Inventory, PTGI). Se llevaron a cabo Análisis Factorial Confirmatorio (AFC) y Modelo de Dos Partes (MDP) de análisis de regresión. Resultados: En total, 29.118 chinos completaron la encuesta (54,2% de ellos tenían 20~29 años, 68,0% eran hombres, y 60,3% tenían una Educación Universitaria). Los resultados de AFC ilustraron que los modelos de bifactoriales eran mejores para descubrir los rasgos psicométricos de EPT y CPT de los participantes chinos que los modelos predeterminados. Los resultados de MDP sugirieron que las mujeres, las personas con bajo nivel educativo y de mediana edad eran más vulnerables a EPT. Se observaron correlaciones mutuas y positivas entre EPT y CPT, aunque pequeñas. Conclusiones: Los resultados actuales presentaron nuevos modelos estructurales de mejor ajuste, predictores potenciales e información de referencia valiosa de EPT y CPT de la población China en el contexto de COVID-19.

Renin-Angiotensin System Modulation With Synthetic Angiotensin (1-7) and Angiotensin II Type 1 Receptor-Biased Ligand in Adults With COVID-19: Two Randomized Clinical Trials.

Importance: Preclinical models suggest dysregulation of the renin-angiotensin system (RAS) caused by SARS-CoV-2 infection may increase the relative activity of angiotensin II compared with angiotensin (1-7) and may be an important contributor to COVID-19 pathophysiology. Objective: To evaluate the efficacy and safety of RAS modulation using 2 investigational RAS agents, TXA-127 (synthetic angiotensin [1-7]) and TRV-027 (an angiotensin II type 1 receptor-biased ligand), that are hypothesized to potentiate the action of angiotensin (1-7) and mitigate the action of the angiotensin II. Design, Setting, and Participants: Two randomized clinical trials including adults hospitalized with acute COVID-19 and new-onset hypoxemia were conducted at 35 sites in the US between July 22, 2021, and April 20, 2022; last follow-up visit: July 26, 2022. Interventions: A 0.5-mg/kg intravenous infusion of TXA-127 once daily for 5 days or placebo. A 12-mg/h continuous intravenous infusion of TRV-027 for 5 days or placebo. Main Outcomes and Measures: The primary outcome was oxygen-free days, an ordinal outcome that classifies a patient's status at day 28 based on mortality and duration of supplemental oxygen use; an adjusted odds ratio (OR) greater than 1.0 indicated superiority of the RAS agent vs placebo. A key secondary outcome was 28-day all-cause mortality. Safety outcomes included allergic reaction, new kidney replacement therapy, and hypotension. Results: Both trials met prespecified early stopping criteria for a low probability of efficacy. Of 343 patients in the TXA-127 trial (226 [65.9%] aged 31-64 years, 200 [58.3%] men, 225 [65.6%] White, and 274 [79.9%] not Hispanic), 170 received TXA-127 and 173 received placebo. Of 290 patients in the TRV-027 trial (199 [68.6%] aged 31-64 years, 168 [57.9%] men, 195 [67.2%] White, and 225 [77.6%] not Hispanic), 145 received TRV-027 and 145 received placebo. Compared with placebo, both TXA-127 (unadjusted mean difference, -2.3 [95% CrI, -4.8 to 0.2]; adjusted OR, 0.88 [95% CrI, 0.59 to 1.30]) and TRV-027 (unadjusted mean difference, -2.4 [95% CrI, -5.1 to 0.3]; adjusted OR, 0.74 [95% CrI, 0.48 to 1.13]) resulted in no difference in oxygen-free days. In the TXA-127 trial, 28-day all-cause mortality occurred in 22 of 163 patients (13.5%) in the TXA-127 group vs 22 of 166 patients (13.3%) in the placebo group (adjusted OR, 0.83 [95% CrI, 0.41 to 1.66]). In the TRV-027 trial, 28-day all-cause mortality occurred in 29 of 141 patients (20.6%) in the TRV-027 group vs 18 of 140 patients (12.9%) in the placebo group (adjusted OR, 1.52 [95% CrI, 0.75 to 3.08]). The frequency of the safety outcomes was similar with either TXA-127 or TRV-027 vs placebo. Conclusions and Relevance: In adults with severe COVID-19, RAS modulation (TXA-127 or TRV-027) did not improve oxygen-free days vs placebo. These results do not support the hypotheses that pharmacological interventions that selectively block the angiotensin II type 1 receptor or increase angiotensin (1-7) improve outcomes for patients with severe COVID-19. Trial Registration: ClinicalTrials.gov Identifier: NCT04924660.

Psychoanalysis of COVID-19 Patient Narratives: A Descriptive Study.

Background and Objectives: COVID-19 patients are a psychologically vulnerable patient group who suffer from both physical symptoms and psychological problems. The present study is a psychoanalytic investigation of COVID-19 patients utilizing Lacan's desire theory. We aimed to explore the manner in which patients' desire is presented in their lived experience narratives and sought to discover factors which directly impacted on this process. Materials and Methods: In-depth semi-structural interviews were conducted with 36 COVID-19 patients in China. During each interview, participants narrated their lived experiences of COVID-19 infection. Emotions, metaphors, and behaviors in patient narratives were collated as the main points for psychoanalysis. Results: Our findings demonstrated that the desire for being a healthy person made patients emotionally sensitive to the social environment. Anxiety and obsessive behaviors emerged in the process, which reveals their desire for that which they lack. Furthermore, public fear with respect to COVID-19 was somehow converted to psychological pressure on COVID-19 patients. Thus, these patients attempted to "de-identify" their identity as "patients". Positive responses of COVID-19 patients to the external world included admiring medical personnel, government, and country, while negative responses included interpersonal conflicts or complaints about discrimination. Following the rules of the Other, COVID-19 patients were influenced by the Other's desire in constructing their own image of a healthy person. Conclusions: This study revealed COVID-19 patients' psychological need to rid themselves of the identity of "patient" at the individual and social level. Our findings have clinical implications in helping COVID-19 patients to reshape their identity and to live a normal life.

Exosomes-based particles as inhalable COVID-19 vaccines

Coronavirus disease 2019 (COVID-19), a severely spreading pandemic, has dramatically brought physiological and economical burdens to people. Although the injectable vaccines have some achievements for coronavirus defense, they still generate accompanied pain, untoward reaction and cannot take part in mucosal immunity. Inhalable vaccines, as a safe, facile and efficient strategy, have been presented to protect body from virus by inducing robust mucosal immunity. Here, we give a perspective of an inhalable COVID-19 vaccine composed of lung-derived exosomes (a type of virus-like particle) conjugated with viral receptor-binding domain. The lung-derived exosomes act as carriers, such inhalable particles successfully reach at lung and reveal wider distribution and longer retention on respiratory mucosa. In addition, such vaccines induce the high production of specific antibodies and T cells in lung, significantly protecting host against coronavirus invasion. It is conceived that inhalable virus-like particles with long-term stability wound open a new avenue for vaccines delivery and further achieve vaccine popularization to against with COVID-19 pandemic.

Focus on the Mental Health of Pediatric Medical Workers in China After the COVID-19 Epidemic.

As was previously known, pediatric medical staff in China faced several hurdles including high occupational risk, multiple contradictions, heavy workload, and long working hours. After the outbreak of 2019 novel coronavirus, facing the overload of work and the potential risk of infection, pediatric medical workers may be under great psychological pressure. The purpose of this article was to call attention to the impact of the epidemic on the mental health of Chinese pediatric workers, and developing psychological intervention program that are tailored to them. The experiences from this public health emergency should inform the efficiency and quality of future crisis intervention of the Chinese government and authorities around the world.

The impact of the COVID-19 pandemic on semen quality of uninfected men.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide since its discovery in December 2019. Research published since the COVID-19 outbreak has focused on whether semen quality and reproductive hormone levels are affected by COVID-19. However, there is limited evidence on semen quality of uninfected men. This study aimed to compare semen parameters among uninfected Chinese sperm donors before and after the COVID-19 pandemic to determine the impact of the COVID-19 pandemic-related stress and lifestyle changes on uninfected men. RESULTS: All semen parameters were non-significant except semen volume. The average age of sperm donors was higher after the COVID-19 (all P < 0.05). The average age of qualified sperm donors increased from 25.9 (SD: 5.3) to 27.6 (SD: 6.0) years. Before the COVID-19, 45.0% qualified sperm donors were students, but after the COVID-19, 52.9% were physical laborers (P < 0.05). The proportion of qualified sperm donors with a college education dropped from 80.8 to 64.4% after the COVID-19 (P < 0.05). CONCLUSION: Although the sociodemographic characteristics of sperm donors changed after the COVID-19 pandemic, no decline in semen quality was found. There is no concern about the quality of cryopreserved semen in human sperm banks after the COVID-19 pandemic.

RéSUMé: CONTEXTE: La maladie due au Coronavirus 2019 (COVID-19) s'est propagée rapidement dans le monde entier depuis sa découverte en décembre 2019. Les recherches publiées depuis l'éclosion de la COVID-19 se sont concentrées sur la question de savoir si la qualité du sperme et les niveaux d'hormones reproductives étaient affectés par la COVID-19. Il existe, cependant, peu de preuves sur la qualité du sperme des hommes non infectés. Cette étude visait à comparer, avant et après la pandémie de COVID-19, les paramètres du sperme chez les donneurs de sperme Chinois non infectés, afin de déterminer l'impact du stress lié à la pandémie de COVID-19 et aux changements de mode de vie sur les hommes non infectés. RéSULTATS: Toutes les valeurs des paramètres du sperme étaient non significatives, à l'exception du volume de sperme. L'âge moyen des donneurs de sperme était plus élevé après la COVID-19 (tous p < 0,05). L'âge moyen des donneurs de sperme admissibles est passé de 25,9 ans (ET : 5,3) à 27,6 ans (ET : 6,0). Avant la COVID-19, 45 % des donneurs de sperme admissibles étaient des étudiants, mais après la COVID-19, 53 % étaient des travailleurs physiques (p < 0,05). La proportion de donneurs de sperme admissibles ayant fait des études secondaires est passée de 80,8 % à 64,4 % après la COVID-19 (p < 0,05). CONCLUSION: Bien que les caractéristiques sociodémographiques des donneurs de sperme aient changé après la pandémie de COVID-19, aucune baisse de la qualité du sperme n'a été constatée. Il n'y a aucune préoccupation quant à la qualité du sperme cryoconservé dans les banques de sperme humain après la pandémie de COVID-19. MOTS-CLéS: COVID-19, Qualité du Sperme, Donneur de Sperme, Banque de Sperme humain.

Health Behaviours among Travellers Regarding Risk Compensation Following COVID-19 Vaccination in Taizhou, China.

Background: During the COVID-19 pandemic, public transport was restricted in many countries because of the transmission risk. According to the risk compensation theory, travellers post-COVID-19 vaccination may encounter higher risks; however, no real-world studies provide such evidence. Therefore, we conducted a survey to assess whether risk compensation would occur among travellers' health-related behaviours after COVID-19 vaccination, potentially aggravating the transmission of the virus. Materials and Methods: A self-administered online survey was designed and distributed over WeChat to identify the difference in health behaviours before and after COVID-19 vaccination among travellers at a train station in Taizhou, China, from 13 February to 26 April 2022. Results: A total of 602 individuals completed the questionnaire. The results revealed no statistical difference between the health behaviours reported by the vaccinated and unvaccinated groups. Participants who received the first dose of the vaccine earlier showed no statistical difference in harmful health behaviours (hand washing frequency decreased by 4.1% (P=0.145) and the duration of public transport travel increased by 3.4% (P=0.437)), but showed better protective health behaviours (mask-wearing duration increased by 24.7% (P=0.014)). Compared to those vaccinated less than three times, participants vaccinated against COVID-19 three times showed no statistical differences in harmful health behaviours mask-wearing duration decreased by 7.0% (P=0.927), their hand washing frequency decreased by 4.8% (P=0.905), and the duration of public transport travel increased by 2.5% (P=0.287). After vaccination, when compared to themselves before vaccination, participants exhibited better health behaviours (increased hand washing frequency and mask-wearing duration, and decreased duration of public transport travel) to some extent. Conclusion: In conclusion, this study found no evidence of risk compensation among travellers. After being vaccinated, health behaviours partly improved among travellers.

The safety and immunogenicity of a two-dose schedule of CoronaVac, and the immune persistence of vaccination for six months, in people living with HIV: A multicenter prospective cohort study.

Background: People living with HIV (PLWH) are more vulnerable to SARS-CoV-2. However, evidence on the immunogenicity of coronavirus disease 2019 (COVID-19) vaccines in this population is insufficient. The objective of this study is to assess the immunogenicity and safety of the two-dose schedule of Sinovac CoronaVac for 6 months postvaccination in PLWH. Methods: We conducted a multicenter prospective cohort study among PLWH and HIV-negative adults in China. Participants who received two doses of CoronaVac prior to the recruitment were allocated into two groups and followed up for 6 months. The neutralizing antibodies (nAbs), immunoglobulin G against the receptor-binding domain of the spike protein (S-IgG), and gamma-interferon (IFN-γ) were measured to assess the associations among CoronaVac immunogenicity and related factors. Adverse reactions were collected to evaluate the safety profile of vaccination. Results: A total of 203 PLWH and 100 HIV-negative individuals were enrolled. A small portion of participants reported mild or moderate adverse reactions without serious adverse events. Median nAbs level in PLWH (31.96 IU/mL, IQR: 12.34-76.40) was lower than that in the control group (46.52 IU/mL, IQR: 29.08-77.30) at the 2-4 weeks postvaccination (P=0.002), and the same trend was presented for median S-IgG titer (37.09 vs. 60.02 IU/ml) (both P <0.05). The nAbs seroconversion rate in the PLWH group was also lower than in the control group (75.86% vs. 89.00%). After then, the immune responses reduced over time in term of only 23.04% of PLWH and 36.00% of HIV-negative individuals had a positive seroconversion for nAbs at 6-month. The multivariable generalized estimating equation analysis showed that PLWH with CD4+T count≥350 cells/µL presented higher immune response than PLWH with CD4+T count <350 cells/µL in terms of antibody seroconversion and titers. The immunogenicity did not differ in participants with low or high HIV viral load. The S-antigen specific IFN-γ immunity was generally stable and had a slow attenuation in both two groups for 6 months postvaccination. Conclusion: The Sinovac CoronaVac was generally safe and immunogenic in PLWH, but the immunity response was inferior and the antibodies vanished faster compared to HIV-negative individuals. This study suggested a shorter than 6-month interval of prime-boost vaccination for PLWH to ensure a better protection.

Prevalence, risk factors, and clinical correlates of anxiety, depression, and sleep disorders in chaperones for children in the emergency department in China during COVID-19.

The outbreak of novel coronavirus pneumonia in Wuhan, Hubei Province, in 2019 and its rapid spread across the country caused severe public panic in China. The purpose of this study was to investigate the mental health problems of children's chaperones at the emergency clinic during the coronavirus disease 2019 (COVID-19) outbreak and to analyze the related influencing factors. A total of 260 chaperones for children in the emergency department participated in this cross-sectional study through the questionnaire constellation platform. The survey period was from February to June 2021. Information collected included demographic data and mental health scales. The Self-Assessment Scale for Anxiety, the Self-Rating Scale for Depression, and the Pittsburgh Sleep Quality Index assessed anxiety, depression, and sleep quality, respectively. Logistic regression was used to analyze influential factors associated with mental health problems. The prevalence of depression, anxiety, and sleep disorders among family members accompanying children attending the emergency room was 41.54%, 20.00%, and 93.08%, respectively, with 21.54% of family members suffering from moderate sleep disorders. Univariate analysis showed that being in Wuhan or not during the city closure (X2 = 8.61, P < .01) was strongly associated with the occurrence of depression; female (X2 = 4.87, P = .03), working or not (X2 = 6.39, P = .01) and fear of going to the hospital (X2 = 7.80, P = .01) were key factors for the occurrence of anxiety symptoms; Knowledge of transmission routes and prevention of COVID-19 (X2 = 12.56, P = .03) was a key factor for sleep disorders; logistic stepwise regression analysis showed that fear of going to the hospital was a risk factor for anxiety symptoms (odds ratio = 2.51, P < .01, 95% confidence interval = 1.30-4.85). Our findings suggest that mental health problems were prevalent among family members accompanying children attending the emergency department during the COVID-19 outbreak, with a high prevalence of sleep disturbances in particular. Relevant factors included presence or absence in Wuhan during the outbreak closure, gender, work or absence, and fear of hospital visits. There is a need to focus on the mental health distress of the chaperones for children in the emergency department, and to provide timely intervention and diversion.

Changes in per capita wheat production in China in the context of climate change and population growth.

To address challenges associated with climate change, population growth and decline in international trade linked to the COVID-19 pandemic, determining whether national crop production can meet populations' requirements and contribute to socio-economic resilience is crucial. Three crop models and three global climate models were used in conjunction with predicted population changes. Compared with wheat production in 2000-2010, total production and per capita wheat production were significantly (P < 0.05) increase in 2020-2030, 2030-2040 and 2040-2050, respectively, under RCP4.5 and RCP8.5 due to climate change in China. However, when considering population and climate changes, the predicted per capita production values were 125.3 ± 0.3, 127.1 ± 2.3 and 128.8 ± 2.7 kg during the 2020-2030, 2030-2040, 2040-2050 periods under RCP4.5, or 126.2 ± 0.7, 128.7 ± 2.5, and 131.0 ± 4.1 kg, respectively, under RCP8.5. These values do not significantly differ (P > 0.05) from the baseline level (127.9 ± 1.3 kg). The average per capita production in Loess Plateau and Gansu-Xinjiang subregions declined. In contrast, per capita production in the Huanghuai, Southwestern China, and Middle-Lower Yangtze Valleys subregions increased. The results suggest that climate change will increase total wheat production in China, but population change will partly offset the benefits to the grain market. In addition, domestic grain trade will be influenced by both climate and population changes. Wheat supply capacity will decline in the main supply areas. Further research is required to address effects of the changes on more crops and in more countries to obtain deeper understanding of the implications of climate change and population growth for global food production and assist formulation of robust policies to enhance food security. Supplementary Information: The online version contains supplementary material available at 10.1007/s12571-023-01351-x.

Impacts of the COVID-19 pandemic on carer-employees' well-being: a twelve-country comparison.

The aim of this analysis is to assess the potential ways that the COVID-19 pandemic has impacted Canadian carer-employees (CEs) and identify the needs CEs feel is required for them to continue providing care. We assess the similarities and differences in the stresses CEs faced during COVID-19 globally across countries in the G7, Australia, Spain, Brazil, Taiwan, India, and China. We aim to compare Canada against global trends with respect to the challenges of the COVID-19 pandemic, as well as the supports in place for CEs. The study utilized 2020 Carer Well-Being Index at the country level. Descriptive data on Canadian CEs is first reviewed, followed by comparisons, by country, on responses relating to: (a) time spent caring; (b) sources of support; (c) impact on paid work and career, and; (d) emotional/mental, financial, and physical health. The relationship between government support and emotional/mental health is also explored. When compared to pre-pandemic times, CEs in Canada on average spent more time caregiving, with 34% reporting more difficulty balancing their paid job and caring responsibilities. Seventy-one percent of CEs feel their mental health has deteriorated. Thirty-four percent of Canadian CEs received support from the government, and only 30% received support from their employers. Globally, there was a similar trend, with CEs experiencing deteriorating mental health, work impacts, and unmet needs during the pandemic. Comparing the well-being of Canadian CEs with other countries provides an opportunity to evaluate areas where Canadian policies and programs have been effective, as well as areas needing improvement.

A comparative bibliometric analysis of Omicron and Delta variants during the COVID-19 pandemic.

BACKGROUND: To compare the research hotspots of infections with the Delta and Omicron variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the coronavirus disease 2019 (COVID-19) pandemic and to identify future research trends. METHODS: Studies about Delta and Omicron variant infections published over the last 3 years were retrieved from the Web of Science (WoS) database. A comparative bibliometric analysis was conducted through machine learning and visualization tools, including VOSviewer, Bibliographic Item Co-Occurrence Matrix Builder, and Graphical Clustering Toolkit. Research hotspots and trends in the field were analyzed, and the contributions and collaborations of countries, institutions, and authors were documented. A cross-sectional analysis of the relevant studies registered at ClinicalTrials.gov was also performed to clarify the direction of future research. RESULTS: A total of 1,787 articles distributed in 107 countries and 374 publications from 77 countries focused on the Delta and Omicron variants were included in our bibliometric analysis. The top five productive countries in both variants were the USA, China, the UK, India, and Germany. In 5,999 and 1,107 keywords identified from articles on the Delta and Omicron, the top two frequent keywords were the same: "COVID-19" (occurrence: 713, total link strength: 1,525 in Delta; occurrence: 137, total link strength: 354 in Omicron), followed by "SARS-CoV-2" (occurrence: 553, total link strength: 1,478 in Delta; occurrences 132, total link strength: 395 in Omicron). Five theme clusters from articles on Delta variant were identified: transmission, molecular structure, activation mode, epidemiology, and co-infection. While other three theme clusters were recognized for the Omicron variant: vaccine, human immune response, and infection control. Meanwhile, 21 interventional studies had been registered up to April 2022, most of which aimed to evaluate the immunogenicity and safety of different kinds of vaccines in various populations. CONCLUSIONS: Publications and clinical trials related to COVID-19 increased annually. As the first comparative bibliometric analysis for Delta and Omicron variants, we noticed that the relevant research trends have shifted from vaccine development to infection control and management of complications. The ongoing clinical studies will verify the safety and efficacy of promising drugs.