Hashtag framing and stakeholder targeting: An affordance perspective on China's digital public diplomacy campaign during COVID-19

Social media platforms such as Twitter provide opportunities for governments to connect to foreign publics and influence global public opinion. In the current study, we used social and semantic network analysis to investigate China's digital public diplomacy campaign during COVID-19. Our results show that Chinese state-affiliated media and diplomatic accounts created hashtag frames and targeted stakeholders to challenge the United States or to cooperate with other countries and international organizations, especially the World Health Organization. Telling China's stories was the central theme of the digital campaign. From the perspective of social media platform affordance, we addressed the lack of attention paid to hashtag framing and stakeholder targeting in the public diplomacy literature. [ FROM AUTHOR] Copyright of Journal of Information Technology & Politics is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Discontinuation of Universal Admission Testing for SARS-CoV-2 and Hospital-Onset COVID-19 Infections in England and Scotland.

This quality improvement study examines the association between the discontinuation of universal admission testing for SARS-CoV-2 infections and hospital-onset SARS-CoV-2 infections in England and Scotland.

Diagnosis and Treatment Strategy of Nasogenic Olfactory Dysfunction.

Since the global outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a symptom of the onset of SARS-CoV-2, olfactory dysfunction (OD), has attracted tremendous attention. OD is not only a negative factor for quality of life but also an independent hazard and early biomarker for various diseases, such as Parkinson's and Huntington's diseases. Therefore, early identification and treatment of OD in patients are critical. Many etiological factors are responsible for OD based on current opinions. Sniffin'Sticks are recommended to identify the initial position (central or peripheral) for OD when treating patients clinically. It is worth emphasizing that the olfactory region in nasal cavity is recognized as the primary and critical olfactory receptor. Many nasal diseases, such as those with traumatic, obstructive and inflammatory causes, can lead to OD. The key question is no refined diagnosis or treatment strategy for nasogenic OD currently. This study summarizes the differences in medical history, symptoms, auxiliary examination, treatment and prognosis of different types of nasogenic OD by analyzing the current studies. We propose using olfactory training after 4-6 weeks of initial treatment for nasogenic OD patients with no significant improvement in olfaction. We hope that our research can provide valuable clinical guidance by systematically summarizing the clinical characteristics of nasogenic OD.

Heat waves accelerate the spread of infectious diseases.

COVID-19 pandemic appeared summer surge in 2022 worldwide and this contradicts its seasonal fluctuations. Even as high temperature and intense ultraviolet radiation can inhibit viral activity, the number of new cases worldwide has increased to >78% in only 1 month since the summer of 2022 under unchanged virus mutation influence and control policies. Using the attribution analysis based on the theoretical infectious diseases model simulation, we found the mechanism of the severe COVID-19 outbreak in the summer of 2022 and identified the amplification effect of heat wave events on its magnitude. The results suggest that approximately 69.3% of COVID-19 cases this summer could have been avoided if there is no heat waves. The collision between the pandemic and the heatwave is not an accident. Climate change is leading to more frequent extreme climate events and an increasing number of infectious diseases, posing an urgent threat to human health and life. Therefore, public health authorities must quickly develop coordinated management plans to deal with the simultaneous occurrence of extreme climate events and infectious diseases.

Dose-response and type-dependent effects of antiviral drugs in anaerobic digestion of waste-activated sludge for biogas production.

In the context of the COVID-19 pandemic, antiviral drugs (AVDs) were heavily excreted into wastewater and subsequently enriched in sewage sludge due to their widespread use. The potential ecological risks of AVDs have attracted increasing attention, but information on the effects of AVDs on sludge anaerobic digestion (AD) is limited. In this study, two typical AVDs (lamivudine and ritonavir) were selected to investigate the responses of AD to AVDs by biochemical methane potential tests. The results indicated that the effects of AVDs on methane production from sludge AD were dose- and type-dependent. The increased ritonavir concentration (0.05-50 mg/kg TS) contributed to an 11.27-49.43% increase in methane production compared with the control. However, methane production was significantly decreased at high lamivudine doses (50 mg/kg TS). Correspondingly, bacteria related to acidification were affected when exposed to lamivudine and ritonavir. Acetoclastic and hydrotropic methanogens were inhibited at a high lamivudine dose, while ritonavir enriched methylotrophic and hydrotropic methanogens. Based on the analysis of intermediate metabolites, the inhibition of lamivudine and the promotion of ritonavir on acidification and methanation were confirmed. In addition, the existence of AVDs could affect sludge properties. Sludge solubilization was inhibited when exposed to lamivudine and enhanced by ritonavir, perhaps caused by their different structures and physicochemical properties. Moreover, lamivudine and ritonavir could be partially degraded by AD, but 50.2-68.8% of AVDs remained in digested sludge, implying environmental risks.

An intermestic approach to China's public diplomacy: a case study of Beijing's COVID-19 communication in the early stages

PurposeThe aim of this study was to examine the early stages of the COVID-19 outbreak and the international communication management of Chinese diplomats as a case for extending the definition of intermestic public diplomacy. The goal was to reveal how Beijing subtly used both domestic and foreign social media to organize a network for communication about COVID-19 and purposefully soften the highly centralized and hierarchical political propaganda of the Communist Party of China (CPC).Design/methodology/approachBased on the literature on digital public diplomacy, the authors applied the existing concept of intermestic to Chinese politics in order to demonstrate the digitalization of public diplomacy, along with its forms and strategies under an authoritarian regime. A hybrid methodology combining quantitative network analysis and qualitative discourse analysis permits examination of China's intermestic online communication network dynamics, shedding light on how such an intermestic practice promoted Chinese values and power to international publics in the early stages of the COVID-19 crisis.FindingsThe authors' findings extend the implications of intermestic public diplomacy from a democratic context to an authoritarian one. By analyzing the content of public diplomacy and para-diplomatic social media accounts in China and abroad at the beginning of the COVID-19 crisis, the authors outlined China's early crisis management, explaining its intermestic public diplomacy transmission modes and strategies. Moreover, the authors identified changes in the narrative strategies of Chinese diplomats and journalists during this process.Social implicationsThe findings of this study underline that Beijing established a narrative-making virtual communication structure for disseminating favorable Chinese strategic narratives and voices through differentiated communication on domestic and foreign social media platforms. Such intermestic communication strategies were particularly evident and even further weaponized by Beijing in its large-scale Wolf Warrior diplomacy in the spring of 2020. Thus, the study's findings help readers understand how China digitalized its public diplomacy, its digital communication patterns and strategies.Originality/valueOn the one hand, geopolitical uncertainty and the popularity of social media have contributed to the evolution of the intermestic model of public diplomacy. This model allows actors to coordinate homogenous and differentiated communication practices to deploy their influence. On the other hand, the authors did not examine how intermestic audiences perceive and receive public diplomacy practices. In future studies, scholars should measure the agenda-setting capacity of diplomatic actors by examining the effects of such intermestic communication efforts.

Antibacterial, antiviral, and biodegradable collagen network mask for effective particulate removal and wireless breath monitoring.

Functional face masks that can effectively remove particulate matter and pathogens are critical to addressing the urgent health needs arising from industrial air pollution and the COVID-19 pandemic. However, most commercial masks are manufactured by tedious and complicated network-forming procedures (e.g., meltblowing and electrospinning). In addition, the materials used (e.g., polypropylene) have significant limitations such as a lack of pathogen inactivation and degradability, which can cause secondary infection and serious environmental concerns if discarded. Here, we present a facile and straightforward method for creating biodegradable and self-disinfecting masks based on collagen fiber networks. These masks not only provide superior protection against a wide range of hazardous substances in polluted air, but also address environmental concerns associated with waste disposal. Importantly, collagen fiber networks with naturally existing hierarchical microporous structures can be easily modified by tannic acid to improve its mechanical characteristics and enable the in situ production of silver nanoparticles. The resulting masks exhibit excellent antibacterial (>99.99%, 15 min) and antiviral (>99.999%, 15 min) capabilities, as well as high PM2.5 removal efficiency (>99.9%, 30 s). We further demonstrate the integration of the mask into a wireless platform for respiratory monitoring. Therefore, the smart mask has enormous promise for combating air pollution and contagious viruses, managing personal health, and alleviating waste issues caused by commercial masks.

Development and validation of a prediction nomogram for academic burnout among Chinese adolescents: a cross-sectional study.

OBJECTIVES: This study aimed to screen the potential risk factors for academic burnout among adolescents during the COVID-19 pandemic, develop and validate a predictive tool based on the risk factors for predicting academic burnout. DESIGN: This article presents a cross-sectional study. SETTING: This study surveyed two high schools in Anhui Province, China. PARTICIPANTS: A total of 1472 adolescents were enrolled in this study. OUTCOME MEASURES: The questionnaires included demographic characteristic variables, living and learning states and adolescents' academic burnout scale. Least absolute shrinkage and selection operator and multivariate logistic regression analyses were employed to screen the risk factors for academic burnout and develop a predictive model. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to assess the accuracy and discrimination of the nomogram. RESULTS: In this study, 21.70% of adolescents reported academic burnout. Multivariable logistic regression analysis showed that single-child family (OR=1.742, 95% CI: 1.243 to 2.441, p=0.001), domestic violence (OR=1.694, 95% CI: 1.159 to 2.476, p=0.007), online entertainment (>8 hours/day, OR=3.058, 95% CI: 1.634 to 5.720, p<0.001), physical activity (<3 hours/week, OR=1.686, 95% CI: 1.032 to 2.754, p=0.037), sleep duration (<6 hours/night, OR=2.342, 95% CI: 1.315 to 4.170, p=0.004) and academic performance (<400 score, OR=2.180, 95% CI: 1.201 to 3.958, p=0.010) were independent significant risk factors associated with academic burnout. The area under the curve of ROC with the nomogram was 0.686 in the training set and 0.706 in the validation set. Furthermore, DCA demonstrated that the nomogram had good clinical utility for both sets. CONCLUSIONS: The developed nomogram was a useful predictive model for academic burnout among adolescents during the COVID-19 pandemic. It is essential to emphasise the importance of mental health and promote a healthy lifestyle among adolescents during the future pandemic.

Repurposing Drugs for the Treatment of COVID-19 and Its Cardiovascular Manifestations.

COVID-19 is an infectious disease caused by SARS-CoV-2 leading to the ongoing global pandemic. Infected patients developed a range of respiratory symptoms, including respiratory failure, as well as other extrapulmonary complications. Multiple comorbidities, including hypertension, diabetes, cardiovascular diseases, and chronic kidney diseases, are associated with the severity and increased mortality of COVID-19. SARS-CoV-2 infection also causes a range of cardiovascular complications, including myocarditis, myocardial injury, heart failure, arrhythmias, acute coronary syndrome, and venous thromboembolism. Although a variety of methods have been developed and many clinical trials have been launched for drug repositioning for COVID-19, treatments that consider cardiovascular manifestations and cardiovascular disease comorbidities specifically are limited. In this review, we summarize recent advances in drug repositioning for COVID-19, including experimental drug repositioning, high-throughput drug screening, omics data-based, and network medicine-based computational drug repositioning, with particular attention on those drug treatments that consider cardiovascular manifestations of COVID-19. We discuss prospective opportunities and potential methods for repurposing drugs to treat cardiovascular complications of COVID-19.

Attenuation of a Highly Pathogenic Porcine Deltacoronavirus Strain CZ2020 by a Serial Passage In Vitro

Porcine deltacoronavirus (PDCoV) is an emerging swine coronavirus that causes severe diarrhea to pigs of all ages, especially the suckling piglets under one-week-old. We previously isolated a highly pathogenic PDCoV strain, CZ2020, from a diarrheal piglet and have passaged it for over 100 passages. The adaptability of the CZ2020 increased gradually in vitro as the passage increased. Amino acid mutations were observed in pp1a, pp1ab, spike, envelop, and membrane proteins, and the spike protein accounts for 66.7% of all amino acid mutations. Then, the high passage strains, CZ2020-F80 and CZ2020-F100, were selected for evaluation of the pathogenicity in three-day-old piglets to examine whether these amino acid changes affected their virulence. At 2 days postchallenge (DPC), 2/5 piglets started to show typical diarrhea, and at 4 DPC, severe diarrhea was observed in the CZ2020-challenged piglets. Viral RNA could be detected at 1 DPC in rectal swabs and reached its highest at 4 DPC in the CZ2020-challenged group. CZ2020-F80- and CZ2020-F100-challenged groups have one piglet exhibiting mild diarrhea at 4 and 6 DPC, respectively. Compared with the CZ2020-challenged group, the piglets in CZ2020-F80- and F100-challenged groups had lower viral loads in rectal swabs, intestines, and other organs. No obvious histopathological lesions were observed in the intestines of CZ2020-F80- and F100-challenged piglets. Virulent PDCoV infection could also induce strong interferons and proinflammatory cytokines in vitro and in vivo. These data indicate that the strains, CZ2020-F80 and CZ2020-F100, were significantly attenuated via serial passaging in vitro and have the potential for developing attenuated vaccine candidates.

Specific pupylation as IDEntity reporter (SPIDER) for the identification of protein-biomolecule interactions.

Protein-biomolecule interactions play pivotal roles in almost all biological processes. For a biomolecule of interest, the identification of the interacting protein(s) is essential. For this need, although many assays are available, highly robust and reliable methods are always desired. By combining a substrate-based proximity labeling activity from the pupylation pathway of Mycobacterium tuberculosis and the streptavidin (SA)-biotin system, we developed the Specific Pupylation as IDEntity Reporter (SPIDER) method for identifying protein-biomolecule interactions. Using SPIDER, we validated the interactions between the known binding proteins of protein, DNA, RNA, and small molecule. We successfully applied SPIDER to construct the global protein interactome for m6A and mRNA, identified a variety of uncharacterized m6A binding proteins, and validated SRSF7 as a potential m6A reader. We globally identified the binding proteins for lenalidomide and CobB. Moreover, we identified SARS-CoV-2-specific receptors on the cell membrane. Overall, SPIDER is powerful and highly accessible for the study of protein-biomolecule interactions.

Mental Health Among University Students, Using the 12-item General Health Questionnaire.

Context: To date, researchers have found that poor mental health was common during the COVID-19 epidemic. Even if they had been relatively resistant to suicidal ideation during the first three waves of the pandemic, university students may experience a delayed impact on their mental health. Objective: The study intended to measure mental health among university students in Wuhu City, China and to identify an effective approach to universities can use to prevent mental-health issues. Design: The research team performed a cross-sectional study. Setting: The study took place at Anhui polytechnic university, Wuhu, China. Participants: Participants were 2371 students at Anhui polytechnic university in Wuhu city, China. Outcome Measures: The research team used the two-item General Health Questionnaire-12 (GHQ-12) to measure participants' mental health. Results: Among the 2371 participants, 1727 had poor mental health (72.84%), including 843 males (48.81%) and 884 females (51.19%). Poor mental health was significantly associated with an urban residential location (P > .01), the female gender (p>0.01), the second school year (P > .01), and the parents' education level of junior high school or below (both P > .01). Conclusions: The current study suggests that poor mental health among university students is common. Being female, from an urban area, and in the second year of school and having parents with an education of junior high school or below had poorer mental health than those who were male, from the countryside, and in the first year of school and who had parents with a higher level of education.

Application of remote fetal heart rate monitoring via internet in late pregnancy during the COVID-19 pandemic.

BACKGROUND: Internet-related technologies have rapidly developed and started to impact the traditional medical practices, which combined wireless communication technology as well as "cloud service" technology with electronic fetal heart monitoring have become a mainstream tendency. OBJECTIVE: To investigate the clinical application value of remote fetal heart rate monitoring mode (RFHRM) on late pregnancy during the coronavirus disease (COVID-19) pandemic. METHODS: From March 2021 to February 2022, we recruited 800 cases of pregnant women received prenatal examination at the Anhui Province Maternity and Child Healthcare Hospital. These pregnant women were randomly divided into two groups: the control group (n= 400), which was given traditional management, and the observation group (n= 400), which received remote monitoring technology on this basis. The two groups were compared with neonatal asphyxia, pregnancy outcomes, Edinburgh postnatal depression scale scores (EPDS), prenatal examination expenses and total time consumption. RESULTS: There were no statistically significant differences between the groups in pregnancy outcome and neonatal outcome (P> 0.05). However, total EPDS score of 12.5% pregnant women in the observation group were higher than 12. The TPE group had significantly higher mean EPDS scores compared with the RFHRM group (7.79 ± 3.58 vs 5.10 ± 3.07; P< 0.05). The results showed a significant difference in maternity expenses (2949.83 ± 456.07 vs 2455.37 ± 506.67; P< 0.05) and total time consumption (42.81 ± 7.60 vs 20.43 ± 4.16; P< 0.05) between the groups. CONCLUSION: Remote fetal heart rate monitoring via internet served as an innovative, acceptable, safe and effective reduced-frequency prenatal examination model without affecting the outcome of perinatology of pregnant women with different risk factors.

Does gender really matter? Exploring determinants behind consumers' intention to use contactless fitness services during the COVID-19 pandemic: a focus on health and fitness apps

PurposeThis research created a theoretical framework based on theory of consumption values (TCV) and theory of perceived risk (TPR) to investigate the determinant factors behind consumers' intention to use health and fitness apps during the COVID-19-related lockdown. In addition, based on selectivity hypothesis theory (SHT), this study also explored how gender differences moderate the relationships between the determinants and consumers' behavioral intention.Design/methodology/approachA total of 613 respondents completed a self-reported online questionnaire. Structural equation modeling was conducted to test the role of potential determinants in influencing consumers' behavioral intention. Hierarchical multiple regression was performed to examine the moderating effect of gender.FindingsThe findings of this research revealed that physical appearance, general health, enjoyment, affiliation and condition have positive influences on consumers' behavioral intention, while privacy risk and security risk exert negative impact on consumers' behavioral intention. More importantly, the moderating results indicated that only affiliation, privacy risk and security risk have stronger influences on female, while other predictors showed the same effects on both genders.Practical implicationsFitness providers should embrace health and fitness apps as a new contactless tool to offer services during and after the COVID-19-related lockdown. Fitness providers and app developers need to focus more on the utility and quality of their health and fitness apps. In addition, they should add more gamification elements to health and fitness apps because these elements could increase consumers' hedonic experience especially during the lockdown. Third, the security systems in health and fitness apps should be continuously updated to decline privacy risk during and after the COVID-19-related lockdown. Lastly, when female consumers are targeted during the lockdown, fitness providers should make more efforts to imbue health and fitness apps with more social features and improve the level of security.Originality/valueAlthough the importance of contactless technologies has been highlighted ever since the beginning of the COVID-19 pandemic, there has been very little research on the usage of health and fitness apps during the lockdown based on TCV and TPR. Meanwhile, the moderating role of gender differences in this context remains underexplored. This research is one of the early attempts to fill in these gaps. The findings of this study will enhance the theoretical framework regarding the acceptance and use of health and fitness apps;it also challenges the generalizability of SHT in the context of the COVID-19-related lockdown. Moreover, several important implications for the health and fitness industry during and after the COVID-19 pandemic were suggested.

Regulation of polylactic acid using irradiation and preparation of PLA–SiO2–ZnO melt-blown nonwovens for antibacterial and air filtration† † Electronic supplementary information (ESI) available. See DOI: https://doi.org/10.1039/d2ra08274h

Since the COVID-19 pandemic, polypropylene melt-blown nonwovens (MBs) have been widely used in disposable medical surgical masks and medical protective clothing, seriously threatening the environment. As a bio-based biodegradable polymer, polylactic acid (PLA) has attracted great attention in fabricating MBs. However, there are still issues with the undesirable spinnability of PLA and the limited filtration and antibacterial performance of PLA MBs. Herein, a high-efficiency, low-resistance, and antibacterial PLA filter is fabricated by melt-blown spinning and electret postprocessing technology. The irradiation technique is used to tune PLA chain structure, improving its spinnability. Further, silica (SiO2) nanoparticles are added to enhance the charge storage stability of PLA MBs. With a constant airflow rate of 32 L min−1, the PLA-based MBs exhibit a high particulate filtration efficiency of 94.8 ± 1.5%, an ultralow pressure drop of 14.1 ± 1.8 Pa, and an adequate bacterial filtration efficiency of 98 ± 1.2%, meeting the medical protective equipment standard. In addition, the zinc oxide (ZnO) masterbatches are doped into the blend and the antibacterial rate of PLA-based MBs against Escherichia coli and Staphylococcus aureus is higher than 99%. This successful preparation and modification method paves the way for the large-scale production of PLA MBs as promising candidates for high-efficacy and antibacterial filters. PLA MBs with high filtration efficiency and antibacterial activity were prepared by reducing viscosity by irradiation and blending ZnO and SiO2.

Understanding chinese secondary school students' perceptions of mobile-assisted language learning

ABSTRACT Given the paucity of research on mobile-assisted language learning (MALL) in secondary schools in China, this retrospective case study explored the psychological processes underlying the non-voluntary MALL experiences of Chinese secondary school students during a lockdown to contain the spread of COVID-19. Drawing on prior technology acceptance studies, we proposed a research model comprising nine latent constructs, and tested it with data collected through a questionnaire survey (N = 265). The results of a structural modeling test showed that subjective norms and attitudes toward MALL were significant predictors of the behavioral intention to use it, whereas perceived usefulness and perceived ease of use mediated other factors that influence attitudes. The findings support the use of the technology acceptance model in investigating MALL acceptance. Implications for the better implementation of MALL, especially in the context of secondary schools in China are also discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Regulation of polylactic acid using irradiation and preparation of PLA-SiO2-ZnO melt-blown nonwovens for antibacterial and air filtration.

Since the COVID-19 pandemic, polypropylene melt-blown nonwovens (MBs) have been widely used in disposable medical surgical masks and medical protective clothing, seriously threatening the environment. As a bio-based biodegradable polymer, polylactic acid (PLA) has attracted great attention in fabricating MBs. However, there are still issues with the undesirable spinnability of PLA and the limited filtration and antibacterial performance of PLA MBs. Herein, a high-efficiency, low-resistance, and antibacterial PLA filter is fabricated by melt-blown spinning and electret postprocessing technology. The irradiation technique is used to tune PLA chain structure, improving its spinnability. Further, silica (SiO2) nanoparticles are added to enhance the charge storage stability of PLA MBs. With a constant airflow rate of 32 L min-1, the PLA-based MBs exhibit a high particulate filtration efficiency of 94.8 ± 1.5%, an ultralow pressure drop of 14.1 ± 1.8 Pa, and an adequate bacterial filtration efficiency of 98 ± 1.2%, meeting the medical protective equipment standard. In addition, the zinc oxide (ZnO) masterbatches are doped into the blend and the antibacterial rate of PLA-based MBs against Escherichia coli and Staphylococcus aureus is higher than 99%. This successful preparation and modification method paves the way for the large-scale production of PLA MBs as promising candidates for high-efficacy and antibacterial filters.

Evaluation of COVID-19 vaccines in primary prevention against infections and reduction in severity of illness following the outbreak of SARS-CoV-2 omicron variant in Shanghai.

Objectives: To evaluate COVID-19 vaccines in primary prevention against infections and lessen the severity of illness following the most recent outbreak of the SARS-CoV-2 Omicron variant in Shanghai. Data sources: Data from 153,544 COVID-19 patients admitted to the Shanghai "Four-Leaf Clover" Fangcang makeshift shelter hospital were collected using a structured electronic questionnaire, which was then merged with electronic medical records of the hospital. For healthy controls, data on vaccination status and other information were obtained from 228 community-based residents, using the same structured electronic questionnaire. Methods: To investigate whether inactivated vaccines were effective in protecting against SARS-CoV-2 virus, we estimated the odds ratio (OR) of the vaccination by comparing cases and matched community-based healthy controls. To evaluate the potential benefits of vaccination in lowering the risk of symptomatic infection (vs. asymptomatic), we estimated the relative risk (RR) of symptomatic infections among diagnosed patients. We also applied multivariate stepwise logistic regression analyses to measure the risk of disease severity (symptomatic vs. asymptomatic and moderate/severe vs. mild) in the COVID-19 patient cohort with vaccination status as an independent variable while controlling for potential confounding factors. Results: Of the 153,544 COVID-19 patients included in the analysis, the mean age was 41.59 years and 90,830 were males (59.2%). Of the study cohort, 118,124 patients had been vaccinated (76.9%) and 143,225 were asymptomatic patients (93.3%). Of the 10,319 symptomatic patients, 10,031 (97.2%), 281 (2.7%), and 7 (0.1%) experienced mild, moderate, and severe infections, respectively. Hypertension (8.7%) and diabetes (3.0%) accounted for the majority of comorbidities. There is no evidence that the vaccination helped protect from infections (OR = 0.82, p = 0.613). Vaccination, however, offered a small but significant protection against symptomatic infections (RR = 0.92, p < 0.001) and halved the risk of moderate/severe infections (OR = 0.48, 95% CI: 0.37-0.61). Older age (≥60 years) and malignant tumors were significantly associated with moderate/severe infections. Conclusion: Inactivated COVID-19 vaccines helped provide small but significant protection against symptomatic infections and halved the risk of moderate/severe illness among symptomatic patients. The vaccination was not effective in blocking the SARS-CoV-2 Omicron Variant community spread.

Effectiveness and safety of Qingfei Dayuan granules for treating influenza and upper respiratory tract infections manifested by the pulmonary heat-toxin syndrome: A multicenter, randomized, double-blind, placebo-controlled trial.

Background: Patients diagnosed with influenza and upper respiratory tract infections (URTIs) have similar clinical manifestations and biochemical indices and a low detection rate of viral pathogens, mixed infection with diverse respiratory viruses, and targeted antiviral treatment difficulty in the early stage. According to the treatment strategy of "homotherapy for heteropathy" in traditional Chinese medicine (TCM), different diseases with the same clinical symptoms can be treated with the same medicines. Qingfei Dayuan granules (QFDY), a type of Chinese herbal preparation included in the TCM Diagnosis and Treatment Protocol for COVID-19 of Hubei Province issued by the Health Commission of Hubei Province in 2021, are recommended for patients suffering from COVID-19 with symptoms of fever, cough, and fatigue, among others. Additionally, recent studies have shown that QFDY effectively alleviates fever, cough, and other clinical symptoms in patients with influenza and URTIs. Materials and methods: The study was designed as a multicenter, randomized, double-blind, placebo-controlled clinical trial for treatment for influenza and URTIs manifested by pulmonary heat-toxin syndrome (PHTS) with QFDY. A total of 220 eligible patients were enrolled from eight first-class hospitals in five cities of Hubei Province in China and randomly assigned to receive either 15 g of QFDY or a placebo three times a day for 5 days. The primary outcome was the complete fever relief time. Secondary outcomes included efficacy evaluation of TCM syndromes, scores of TCM syndromes, cure rate of each single symptom, incidence of comorbidities and progression to severe conditions, combined medications, and laboratory tests. Safety evaluations mainly involved adverse events (AEs) and changes in vital signs during the study. Results: Compared with the placebo group, the complete fever relief time was shorter in the QFDY group, 24 h (12.0, 48.0) in the full analysis set (FAS) and 24 h (12.0, 49.5) in the per-protocol set (PPS) (p ≤ 0.001). After a 3-day treatment, the clinical recovery rate (22.3% in the FAS and 21.6% in the PPS) and cure rate of cough (38.6% in the FAS and 37.9% in the PPS), a stuffy and running nose, and sneezing (60.0% in the FAS and 59.5% in the PPS) in the QFDY group were higher than those in the placebo group (p < 0.05). The number of patients taking antibiotics for more than 24 h in the placebo group (nine cases) was significantly higher than that in the QFDY group (one case) (p < 0.05). There were no significant differences between the two groups in terms of scores of TCM syndromes, incidence of comorbidities or progression to severe conditions, combined use of acetaminophen tablets or phlegm-resolving medicines, and laboratory tests (p > 0.05). Meanwhile, no significant difference was found in the incidence of AEs and vital signs between the two groups (p > 0.05). Conclusion: The trial showed that QFDY was an effective and safe treatment modality for influenza and URTIs manifested by PHTS because it shortened the complete fever relief time, accelerated clinical recovery, and alleviated symptoms such as cough, a stuffy and running nose, and sneezing during the course of treatment. Clinical trial registration: https://www.chictr.org.cn/showproj.aspx?proj=131702, identifier ChiCTR2100049695.