International tourism and poverty alleviation: cross-country evidence using panel quantile fixed effects approach

This paper evaluates the impact of tourism on poverty alleviation using a new panel quantile fixed effects method that allows regressors to affect the entire conditional distribution of the dependent variable providing substantial information gains. Our results show statistically significant negative marginal effects of tourism on both absolute poverty measures and Gini income inequality across all quantiles, including the poorest 10%. We also find evidence that international tourism can mitigate the slow improvement in domestic income level for poverty reduction. From a policy perspective, our findings can provide insights into developing targeted tourism policies and strategies to achieve better solutions on poverty alleviation. We also call for special attention to policymakers in developing countries to continue working on tourism product differentiation and targeting a smaller but reachable market in the post COVID-19 recovery era, to prevent the adverse effect of the worldwide income growth stagnation on their poverty rates.

Viral Pneumonia during the COVID-19 Pandemic, 2019-2021 Evoking Needs for SARS-CoV-2 and Additional Vaccinations.

Coronaviruses can cause pneumonia, with clinical symptoms that may be similar to the symptoms of other viral pneumonias. To our knowledge, there have been no reports regarding cases of pneumonia caused by coronaviruses and other viruses among hospitalized patients in the past 3 years before and during coronavirus disease 2019 (COVID-19). Here, we analysed the causes of viral pneumonia among hospitalized patients during the coronavirus disease 2019 (COVID-19) pandemic (2019-2021). Between September 2019 and April 2021, patients hospitalized at Shuang Ho Hospital in north Taiwan with a diagnosis of pneumonia were enrolled in this study. Age, sex, onset date, and season of occurrence were recorded. Respiratory tract pathogens were identified with molecular detection using the FilmArray® platform from nasopharyngeal swabs. In total, 1147 patients (128 patients aged <18 years and 1019 patients aged ≥18 years) with pneumonia and identified respiratory tract pathogens were assessed. Among the 128 children with pneumonia, the dominant viral respiratory pathogen was rhinovirus (24.2%), followed by respiratory syncytial virus (RSV; 22.7%), parainfluenza virus (1 + 2 + 3 + 4) (17.2%), adenovirus (12.5%), metapneumovirus (9.4%), coronavirus (1.6%), and influenza virus (A + B) (1.6%). Among the 1019 adults with pneumonia, the dominant viral respiratory pathogen was rhinovirus (5.0%), followed by RSV (2.0%), coronavirus (2.0%), metapneumovirus (1.5%), parainfluenza virus (1 + 2 + 3 + 4) (1.1%), adenovirus (0.7%), and influenza virus (A + B) (0%). From 2019-2021, older patients (aged >65 years) with pneumonia tested positive for coronavirus most commonly in autumn. Coronavirus was not detected during summer in children or adults. Among children aged 0-6 years, RSV was the most common viral pathogen, and RSV infection occurred most often in autumn. Metapneumovirus infection occurred most often in spring in both children and adults. In contrast, influenza virus was not detected in patients with pneumonia in any season among children or adults from January 2020 to April 2021. Among all patients with pneumonia, the most common viral pathogens were rhinovirus in spring, adenovirus and rhinovirus in summer, RSV and rhinovirus in autumn, and parainfluenza virus in winter. Among children aged 0-6 years, RSV, rhinovirus, and adenovirus were detected in all seasons during the study period. In conclusion, the proportion of pneumonia cases caused by a viral pathogen was higher in children than the proportion in adults. The COVID-19 pandemic period evoked a need for SARS-CoV-2 (severe acute respiratory disease coronavirus 2) vaccination to prevent the severe complications of COVID-19. However, other viruses were also found. Vaccines for influenza were clinically applied. Active vaccines for other viral pathogens such as RSV, rhinovirus, metapneuomoccus, parainfluenza, and adenovirus may need to be developed for special groups in the future.

Barriers to providing internet-based home care services for urban older adults in China: a qualitative study of the service providers.

BACKGROUND: Due to the increasingly aging population in China and the changes in social and family structure, older adults' care problems are becoming more and more prominent. To meet the home care needs of urban older adults, the Chinese government has launched Internet-Based Home Care Services (IBHCS). Although this model innovation can significantly relieve care problems, more and more evidence shows that there are many barriers in the process of IBHCS supply. The current literature is mostly from the perspective of the service users, and there are very few studies on the experience of service providers. METHODS: In this study, we took a qualitative phenomenological approach and used semi-structured interviews to investigate service providers' daily experiences and the barriers they encounter. A total of 34 staff from 14 Home Care Service Centers (HCSCs) were included. Interviews were transcribed and analyzed using thematic analysis. RESULTS: We identified the barriers that service providers encounter in IBHCS supply: (1) bureaucratic repression: unreasonable policy plans, harsh assessment, excessive paperwork, different preferences of government leaders, and obstacles caused by COVID-19 control lead to a shift of focus in their work; (2) profitability crisis in the market: high service costs, dampened effective demand, government intervention in setting prices, and parent companies' excessively high sales targets hinder the service supply process; (3) client-related challenges: the crisis of confidence, the dilemma of popularizing new technology, and communication barriers lead to rejection by older adults; (4) job dissatisfaction: low and unstable salary, heavy tasks, poor social acceptance of occupations, and lack of professional value reduce work enthusiasm. CONCLUSION: We have investigated the barriers faced by service providers when providing IBHCS for urban older adults in China, providing empirical evidence in the Chinese context for the relevant literature. In order to provide IBHCS better, it is necessary to improve the institutional environment and market environment, strengthen publicity and communication, target customer needs, and adjust the working conditions of front-line workers.

Using system biology and bioinformatics to identify the influences of COVID-19 co-infection with influenza virus on COPD.

Coronavirus disease 2019 (COVID-19) has speedily increased mortality globally. Although they are risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), less is known about the common molecular mechanisms behind COVID-19, influenza virus A (IAV), and chronic obstructive pulmonary disease (COPD). This research used bioinformatics and systems biology to find possible medications for treating COVID-19, IAV, and COPD via identifying differentially expressed genes (DEGs) from gene expression datasets (GSE171110, GSE76925, GSE106986, and GSE185576). A total of 78 DEGs were subjected to functional enrichment, pathway analysis, protein-protein interaction (PPI) network construct, hub gene extraction, and other potentially relevant disorders. Then, DEGs were discovered in networks including transcription factor (TF)-gene connections, protein-drug interactions, and DEG-microRNA (miRNA) coregulatory networks by using NetworkAnalyst. The top 12 hub genes were MPO, MMP9, CD8A, HP, ELANE, CD5, CR2, PLA2G7, PIK3R1, SLAMF1, PEX3, and TNFRSF17. We found that 44 TFs-genes, as well as 118 miRNAs, are directly linked to hub genes. Additionally, we searched the Drug Signatures Database (DSigDB) and identified 10 drugs that could potentially treat COVID-19, IAV, and COPD. Therefore, we evaluated the top 12 hub genes that could be promising DEGs for targeted therapy for SARS-CoV-2 and identified several prospective medications that may benefit COPD patients with COVID-19 and IAV co-infection.

Comparison of two frailty screening tools in older patients with colorectal cancer.

INTRODUCTION: Geriatric assessment (GA) is widely used to detect vulnerability in older patients. As this process is time-consuming, prescreening tools have been developed to identify patients at risk for frailty. We aimed to assess whether the Geriatric 8 (G8) or the Korean Cancer Study Group Geriatric Score (KG-7) shows better performance in identifying patients who are in need of full GA. MATERIALS AND METHODS: A consecutive series of patients aged ≥ 60 years with colorectal cancer were included. The sensitivity, specificity, predictive value, and 95% confidence intervals (95% CI) were calculated for the G8 and the KG-7 using the results of GA as the reference standard. ROC(Receiver Operating Characteristic) was used to evaluate the accuracy of the G8 and the KG-7. RESULTS: One hundred four patients were enrolled. A total of 40.4% of patients were frail according to GA, and 42.3% and 50.0% of patients were frail based on the G8 and the KG-7, respectively. The sensitivity and specificity of the G8 were 90.5% (95% CI: 77.4-97.3%) and 90.3% (95% CI: 80.1-96.4%), respectively. For the KG-7, the sensitivity and specificity were 83.3% (95% CI: 68.6-93.0%) and 72.6% (95% CI: 59.8-83.1%), respectively. Compared to the KG-7, the G8 had a higher predictive accuracy (AUC: (95% CI): 0.90 (0.83-0.95) vs. 0.78 (0.69-0.85); p < 0.01). By applying the G8 and the KG-7, 60 and 52 patients would not need a GA assessment, respectively. CONCLUSION: Both the G8 and the KG-7 showed a great ability to detect frailty in older patients with colorectal cancer. In this population, compared to the KG-7, the G8 had a better performance in identifying those in need of a full Geriatric Assessment.

Associations of psychological wellbeing with COVID-19 hospitalization and mortality in adults aged 50 years or older from 25 European countries and Israel.

Background: Lower psychological wellbeing is associated with poor outcomes in a variety of diseases and healthy populations. However, no study has investigated whether psychological wellbeing is associated with the outcomes of COVID-19. This study aimed to determine whether individuals with lower psychological wellbeing are more at risk for poor outcomes of COVID-19. Methods: Data were from the Survey of Health, Aging, and Retirement in Europe (SHARE) in 2017 and SHARE's two COVID-19 surveys in June-September 2020 and June-August 2021. Psychological wellbeing was measured using the CASP-12 scale in 2017. The associations of the CASP-12 score with COVID-19 hospitalization and mortality were assessed using logistic models adjusted for age, sex, body mass index, smoking, physical activity, household income, education level, and chronic conditions. Sensitivity analyses were performed by imputing missing data or excluding cases whose diagnosis of COVID-19 was solely based on symptoms. A confirmatory analysis was conducted using data from the English Longitudinal Study of Aging (ELSA). Data analysis took place in October 2022. Results: In total, 3,886 individuals of 50 years of age or older with COVID-19 were included from 25 European countries and Israel, with 580 hospitalized (14.9%) and 100 deaths (2.6%). Compared with individuals in tertile 3 (highest) of the CASP-12 score, the adjusted odds ratios (ORs) of COVID-19 hospitalization were 1.81 (95% CI, 1.41-2.31) for those in tertile 1 (lowest) and 1.37 (95% CI, 1.07-1.75) for those in tertile 2. As for COVID-19 mortality, the adjusted ORs were 2.05 (95% CI, 1.12-3.77) for tertile 1 and 1.78 (95% CI, 0.98-3.23) for tertile 2, compared with tertile 3. The results were relatively robust to missing data or the exclusion of cases solely based on symptoms. This inverse association of the CASP-12 score with COVID-19 hospitalization risk was also observed in ELSA. Conclusion: This study shows that lower psychological wellbeing is independently associated with increased risks of COVID-19 hospitalization and mortality in European adults aged 50 years or older. Further study is needed to validate these associations in recent and future waves of the COVID-19 pandemic and other populations.

Diagnostic accuracy of SARS-CoV-2 antigen test in the pediatric population: A systematic review and meta-analysis.

BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused the global coronavirus disease 2019 (COVID-19) pandemic. Rapid identification and isolation of patients infected with SARS-CoV-2 are critical methods for blocking COVID-19 transmission. The advantages of antigen tests, such as their relatively low cost and short turnaround time, can contribute to the prompt identification of infectious individuals. However, the diagnostic accuracy of antigen tests for COVID-19 in children remains inconclusive. This meta-analysis aimed to evaluate the diagnostic performance of antigen tests for SARS-CoV-2 in the pediatric population. METHODS: We conducted a literature search for relevant studies in the PubMed, Embase, Google Scholar, and Biomed Central databases. Studies evaluating the diagnostic accuracy of antigen tests for SARS-CoV-2 in pediatric patients were included. In addition, we included studies that provided sufficient data to construct a 2 × 2 table on a per-patient basis. The final literature search was performed on October 10, 2021. Days after symptom onset, asymptomatic and symptomatic individuals may have been potential sources of heterogeneity. The overall sensitivity and specificity of the antigen tests were generated using a bivariate random-effects model. RESULTS: Five studies with 4400 participants were included. The meta-analysis of antigen tests generated a pooled sensitivity of 65.9% (95% CI: 52.8%-77.0%) and pooled specificity of 99.9% (95% CI: 98.9%-100.0%). A subgroup analysis of studies reporting antigen test data for symptomatic patients showed a pooled sensitivity of 64.5% and a pooled specificity of 99.7%. The subgroup analysis of studies that included 881 asymptomatic participants generated a pooled sensitivity of 48.4% and a pooled specificity of 99.5%. CONCLUSION: Antigen tests exhibit moderate sensitivity and high specificity for detecting SARS-CoV-2 in children. Antigen tests might have moderate sensitivity for detecting SARS-CoV-2 in symptomatic children, and serial testing might effectively prevent further SARS-CoV-2 transmission.

Long-term effect of childhood pandemic experience on medical major choice: Evidence from the 2003 severe acute respiratory syndrome outbreak in China.

This study examines the long-term effect of a pandemic on a crucial human capital decision, namely college major choice. Using China's 2008-2016 major-level National College Entrance Examination (Gaokao) entry grades, we find that the 2003 severe acute respiratory syndrome (SARS) had a substantial deterrent effect on the choice of majoring in medicine among high school graduates who experienced the pandemic in their childhood. In provinces with larger intensities of SARS impact, medical majors become less popular as the average Gaokao grades of enrolled students decline. Further evidence from a nationally representative survey shows that the intensity of the SARS impact significantly decreases children's aspirations to pursue medical occupations, but does not affect their parents' expectations for their children to enter the medical profession. Our discussion on the effect mechanism suggests that the adverse influence of SARS on the popularity of medical majors likely originates from students' childhood experiences.

Interferons and Resistance Mechanisms in Tumors and Pathogen-Driven Diseases-Focus on the Major Histocompatibility Complex (MHC) Antigen Processing Pathway.

Interferons (IFNs), divided into type I, type II, and type III IFNs represent proteins that are secreted from cells in response to various stimuli and provide important information for understanding the evolution, structure, and function of the immune system, as well as the signaling pathways of other cytokines and their receptors. They exert comparable, but also distinct physiologic and pathophysiologic activities accompanied by pleiotropic effects, such as the modulation of host responses against bacterial and viral infections, tumor surveillance, innate and adaptive immune responses. IFNs were the first cytokines used for the treatment of tumor patients including hairy leukemia, renal cell carcinoma, and melanoma. However, tumor cells often develop a transient or permanent resistance to IFNs, which has been linked to the escape of tumor cells and unresponsiveness to immunotherapies. In addition, loss-of-function mutations in IFN signaling components have been associated with susceptibility to infectious diseases, such as COVID-19 and mycobacterial infections. In this review, we summarize general features of the three IFN families and their function, the expression and activity of the different IFN signal transduction pathways, and their role in tumor immune evasion and pathogen clearance, with links to alterations in the major histocompatibility complex (MHC) class I and II antigen processing machinery (APM). In addition, we discuss insights regarding the clinical applications of IFNs alone or in combination with other therapeutic options including immunotherapies as well as strategies reversing the deficient IFN signaling. Therefore, this review provides an overview on the function and clinical relevance of the different IFN family members, with a specific focus on the MHC pathways in cancers and infections and their contribution to immune escape of tumors.

The impact of COVID-19 on the productivity of large companies in Taiwan

The outbreak of COVID-19 at the end of 2019 spreads over the world extensively and rapidly. The daily lives are affected by lockdowns, work-from-home, and travel bans. The economic growth is stagnated. Many industries are severely affected by this pandemic. There are, however, also industries that are unexpectedly benefited from the pandemic. The objective of this paper is to investigate the industries in Taiwan that are affected by the pandemic. Samples of the top 1,000 manufacturing and the top 500 service companies in Taiwan are collected to calculate their productivities before the pandemic, in the period of 2016–2019, and during the pandemic, in the year of 2020. The results show that three industries: automobile, tourism, and electronic products distribution, have their productivities significantly decreased by 3.98%, 4.92%, and 1.27%, respectively. There are also four industries: electronic components, optoelectronic, electrical and cable, and oil, gas and electricity, whose productivities are unexpectedly increased significantly by 1.37%, 1.98%, 3.32%, and 4.31%, respectively. The impact of COVID-19 to large companies in Taiwan seems to be not severe. In 2021, approximately five sixths of the industries have their productivities increased. There are only five industries whose productivities become lower;however, the decreases are not significant, indicating that the economy in Taiwan is recovering from the pandemic.

Driving forces and variation in water footprint before and after the COVID-19 lockdown in Fujian Province, China

The COVID-19 outbreak has injured the global industrial supply chain, especially China as the world's largest manufacturing base. Since 2020, China has implemented a rigorous lockdown policy, which has sternly damaged sectoral trade in export-oriented coastal areas. Fujian Province, which mainly processes imported materials, has a more profound influence. Although the COVID-19 lockdown has had some detrimental consequences on the world economy, it also had some favorable benefits on the global ecology. Previous studies have shown that the lockdown has altered the physical water quantity and quality, but the lack of total, virtual, and physical water research that combines water quantity and water quality simultaneously to pinpoint the subject and responsibility of water resources consumption and pollution. This research quantified the physical, virtual, and total water consumption and water pollution among 30 sectors in Fujian Province based on the theory of water footprint and the Economic Input-Output Life Cycle Assessment model. SDA model was then used to investigate the socioeconomic elements that underpin variations in the water footprint. The results show that after the lockdown, the physical water quantity and the physical grey WF in Fujian Province decreased by 2.6 Gm3 (−6.7%) and 0.4 Gm3 (−1.3%) respectively. The virtual water quantity decreased by 2.3 Gm3 (−4.5%), whereas the virtual grey WF rose by 1.5 Gm3 (4.3%). The total water quantity dropped by 3.3 Gm3 (−4.9%), while the grey WF increased by 1.2 Gm3 (2.5%), i.e. the COVID-19 lockdown decreases physical water quantity and improves local water quality. More than 50% of the water comes from virtual water trade outside the province (virtual water is highly dependent on external), and around 60% of the grey WF comes from physical sewage in the province. The COVID-19 lockdown reduced water outsourcing across the province (paid nonlocally decrease) but increased pollution outsourcing (paid nonlocally increase). And gross capital formation's contribution to the growth in water footprint will continue to rise. As a result, this study suggested that Fujian should take advantage of sectoral trade network to enhance the transaction of green water-intensive intermediate products, reduce the physical water consumption of blue water-intensive sectors, and reduce the external dependence on water consumption. Achieving the shared responsibility of upstream and downstream water consumption and reducing the external dependence on water in water-rich regions is crucial to solving the world's water problems. This research provides empirical evidence for the long-term effects of COVID-19 lockdown on the physical and virtual water environment. Graphical abstract Image 1

Comparison of clinical manifestations, liver function, and antibody levels between omicron variant infection patients vaccinated and not vaccinated with COVID-19 vaccine

Objective: To compare the clinical manifestations, liver function, and antibody levels between Omicron variant infection patients vaccinated and not vaccinated with COVID-19 vaccine. Methods: Totally 430 convalescent COVID-19 patients infected with Omicron variant in Tianjin were selected, including 150 patients vaccinated with Corona Vaccine(Sinovac group), 185 patients vaccinated with BBIBP-CorV(Beijing biological group), 41 patients vaccinated with Ad5-nCoV vaccine(CanSino group), 16 patients vaccinated with Anhui Zhifei, Changchun Bio, Lanzhou Bio, Shandong Bio, other adenovirus vector vaccines or mixed vaccination(other group), and 38 unvaccinated patients(unvaccinated group). The clinical manifestations, liver function indexes [alanine aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TB), albumin(ALB), total protein(TP), lactate dehydrogenase(LDH)], and antibody levels(IgG, IgM)were compared retrospectively. Results: There was no statistical difference in the sex composition ratio among groups(P > 0.05). The age of the Beijing biological group was significantly lower than that of other groups, and the proportion of time less than 3 months from the last vaccination to admission in the Beijing biological group and CanSino group was significantly higher than that in the Sinovac group and other groups(all P < 0.01). A total of 110 children aged less than 16 years were enrolled, including 7, 88, 0, 1 and 14 cases in the Sinovac group, Beijing biological group, CanSino group, other group, and unvaccinated group, respectively. There were 6 asymptomatic cases, 13 moderate cases, 91 mild cases and 0 severe case. There was no significant difference in the abnormal rate of ALT between Beijing biological group and unvaccinated group(P > 0.05), but the abnormal rates of ALT were higher in the Sinovac group and CanSino group than in the unvaccinated group and Beijing biological group(all P < 0.05). The abnormal rate of AST in the unvaccinated group was higher than that in other groups(P < 0.05). There were no significant differences in AST, TP or TB among the groups(all P > 0.05). The levels of ALT were higher in the Sinovac group and CanSino group than in Beijing biological Group and unvaccinated group, the level of ALB in the unvaccinated group was lower than that in the other groups, and the level of LDH in the Beijing biological group was higher than those in the Sinovac group and CanSino group(both P < 0.05). The IgG and IgM antibody levels of the unvaccinated group were significantly lower than those of the Sinovac group, Beijing biological group and CanSino group(all P < 0.05). Conclusions: Omicron variant infection patients vaccinated with BBIBP-CorV are younger and have a higher proportion of mild conditions, which can protect the liver function of patients to a certain extent. Patients vaccinated with different COVID-19 vaccines can produce higher levels of IgG and IgM antibodies than the unvaccinated patients.

The SAR-based development of small molecular HBV capsid assembly modulators

Hepatitis B virus (HBV) infected about 296 million people worldwidely, while clinical useful therapeutic agents were still limited. Capsid assembly modulators (CAM) have been validated as efficient anti-HBV virus agents with the potential to achieve functional cure, therefore piqued much attention in recent years. There are various novel scaffold agents been developed and more than ten CAM candidates have been progressed into clinical trials with efficient anti-HBV activities. Herein, we summarised the SAR-based development of CAMs with various scaffolds, including heteroaryldihydropyrimidines (HAPs), phenylacrylamides (PPAs), sulfamoylbenzamides (SBAs), pyridazinone, bis-heterocycle, arylformamides, aminothiazoles, and others, which may provide new suggestions for the further development of CAMs.

Olfactory impairment in COVID-19: Two methods for the assessment of olfactory function

Background Olfactory impairment is a major symptom of COVID-19. Is it necessary for COVID-19 patients to perform the detection of olfactory function, even how to select the olfactory psychophysical assessment tool. Methods Patients infected with SARS-CoV-2 Delta variant were firstly taken into three categories (mild, moderate, and severe) according to the clinical classification. The Odor Stick Identification Test for the Japanese (OSIT-J) and the Simple Olfactory Test were used to assess olfactory function. Moreover, these patients were divided into three groups based on the results of the olfactory degree (euosmia, hyposmia, and dysosmia), too. The statistical analysis of the correlations between olfaction and clinical characteristics of patients were performed. Results Our study demonstrated that the elderly men of Han were more susceptible to infected SARS-CoV-2, the clinical symptoms of the COVID-19 patients showed a clear correspondence with the disease type and the degree of olfactory disturbance. Whether or not to vaccinate and whether to complete the whole course of vaccination was closely related to the patient's condition. OSIT-J Test and Simple Test were consistent in our work, indicating that olfactory grading would worsen with the aggravation of symptoms. Furthermore, the OSIT-J method maybe better than Simple Olfactory Test. Conclusion The vaccination has an important protective effect on the general population, and vaccination should be vigorously promoted. Moreover, it is necessary for COVID-19 patients to perform the detection of olfactory function, and the easier, faster and less expensive method for determination of olfactory function should be utilized to COVID-19 patients as the vital physical examination.

Driving forces and variation in water footprint before and after the COVID-19 lockdown in Fujian Province of China.

The COVID-19 outbreak has injured the global industrial supply chain, especially China as the world's largest manufacturing base. Since 2020, China has implemented a rigorous lockdown policy, which has sternly damaged sectoral trade in export-oriented coastal areas. Fujian Province, which mainly processes imported materials, has a more profound influence. Although the COVID-19 lockdown has had some detrimental consequences on the world economy, it also had some favorable benefits on the global ecology. Previous studies have shown that the lockdown has altered the physical water quantity and quality, but the lack of total, virtual, and physical water research that combines water quantity and water quality simultaneously to pinpoint the subject and responsibility of water resources consumption and pollution. This research quantified the physical, virtual, and total water consumption and water pollution among 30 sectors in Fujian Province based on the theory of water footprint and the Economic Input-Output Life Cycle Assessment model. SDA model was then used to investigate the socioeconomic elements that underpin variations in the water footprint. The results show that after the lockdown, the physical water quantity and the physical grey WF in Fujian Province decreased by 2.6 Gm3 (-6.7%) and 0.4 Gm3 (-1.3%) respectively. The virtual water quantity decreased by 2.3 Gm3 (-4.5%), whereas the virtual grey WF rose by 1.5 Gm3 (4.3%). The total water quantity dropped by 3.3 Gm3 (-4.9%), while the grey WF increased by 1.2 Gm3 (2.5%), i.e. the COVID-19 lockdown decreases physical water quantity and improves local water quality. More than 50% of the water comes from virtual water trade outside the province (virtual water is highly dependent on external), and around 60% of the grey WF comes from physical sewage in the province. The COVID-19 lockdown reduced water outsourcing across the province (paid nonlocally decrease) but increased pollution outsourcing (paid nonlocally increase). And gross capital formation's contribution to the growth in water footprint will continue to rise. As a result, this study suggested that Fujian should take advantage of sectoral trade network to enhance the transaction of green water-intensive intermediate products, reduce the physical water consumption of blue water-intensive sectors, and reduce the external dependence on water consumption. Achieving the shared responsibility of upstream and downstream water consumption and reducing the external dependence on water in water-rich regions is crucial to solving the world's water problems. This research provides empirical evidence for the long-term effects of COVID-19 lockdown on the physical and virtual water environment.

Impact of the COVID-19 pandemic on emergent stroke care in Beijing, China.

The coronavirus disease 2019 (COVID-19) pandemic has caused an unprecedented disruption to health care systems around the globe. Stroke is still an ongoing issue during the pandemic. We investigated the impact of the COVID-19 outbreak on emergent stroke care in Beijing, China. This is a retrospective analysis of two groups of patients with acute ischaemic stroke (AIS) registered in the Beijing Emergency Care Database between January 1, 2019, and December 31, 2020. Based on a database including 77 stroke centres, the quantity and quality of emergency care for stroke were compared. Subgroup analyses based on hospitals in different areas (high-risk and low/medium-risk areas) were carried out. A total of 6440 and 8699 admissions with suspected stroke were recorded in 2020 and 2019, respectively. There were no significant differences in the mean age and sex distribution for the patients between the two observational periods. The number of AIS admissions decreased by approximately 23.9% during the COVID-19 pandemic compared to that during the prepandemic period. The proportions of intravenous thrombolysis and endovascular treatment were 76.4% and 13.1%, respectively, in 2020, which were higher than those in 2019 (71.7% and 9.3%, respectively). There was no statistically significant difference in the time from stroke onset to arrival at the hospital (97.97 ± 23.09 min vs. 99.40 ± 20.76 min, p = 0.832) between the two periods. The door-to-needle time for thrombolysis (44.92 ± 9.20 min vs. 42.37 ± 9.06 min, p < 0.001) and door-to-thrombectomy time (138.56 ± 32.45 min vs. 120.55 ± 32.68 min, p < 0.001) were increased significantly in the pandemic period compared to those in the prepandemic period, especially in hospitals in high-risk areas. The decline in the number of patients with AIS and delay in treatment started after the launch of the level-1 public health emergency response and returned to stability after the release of professional protocols and consensus statements. Disruptions to medical services during the COVID-19 pandemic have substantially impacted AIS patients, with a clear drop in admission and a decline in the quality of emergent AIS care, especially in hospitals in high-risk areas and at the time of the initial outbreak of COVID-19. Health care systems need to maintain rapid adaptation to possible outbreaks of COVID-19 or similar crises in the future.

Characterizing discourses about COVID-19 vaccines on Twitter: a topic modeling and sentiment analysis approach.

BACKGROUND: Evidence-based health communication is crucial for facilitating vaccine-related knowledge and addressing vaccine hesitancy. To that end, it is important to understand the discourses about COVID-19 vaccination and attend to the publics' emotions underlying those discourses. METHODS: We collect tweets related to COVID-19 vaccines from March 2020 to March 2021. In total, 304,292 tweets from 134,015 users are collected. We conduct a Latent Dirichlet Allocation (LDA) modeling analysis and a sentiment analysis to analyze the discourse themes and sentiments. RESULTS: This study identifies seven themes of COVID-19 vaccine-related discourses. Vaccine advocacy (24.82%) is the most widely discussed topic about COVID-19 vaccines, followed by vaccine hesitancy (22.29%), vaccine rollout (12.99%), vaccine facts (12.61%), recognition for healthcare workers (12.47%), vaccine side effects (10.07%), and vaccine policies (4.75%). Trust is the most salient emotion associated with COVID-19 vaccine discourses, followed by anticipation, fear, joy, sadness, anger, surprise, and disgust. Among the seven topics, vaccine advocacy tweets are most likely to receive likes and comments, and vaccine fact tweets are most likely to receive retweets. CONCLUSIONS: When talking about vaccines, publics' emotions are dominated by trust and anticipation, yet mixed with fear and sadness. Although tweets about vaccine hesitancy are prevalent on Twitter, those messages receive fewer likes and comments than vaccine advocacy messages. Over time, tweets about vaccine advocacy and vaccine facts become more dominant whereas tweets about vaccine hesitancy become less dominant among COVID-19 vaccine discourses, suggesting that publics become more confident about COVID-19 vaccines as they obtain more information.

Understanding the psychological antecedents of COVID-19 vaccine acceptance among Black Americans: implications for vaccine communication.

BACKGROUND: Guided by the 5C (confidence, complacency, constraints, calculation, and collective responsibility) model of vaccination behavior, we examine the psychological antecedents of COVID-19 vaccine acceptance (i.e. attitudes and intentions toward COVID-19 vaccination) among Black Americans, a group disproportionately affected by the coronavirus pandemic. METHOD: We conducted a national survey of Black Americans (N = 1,497) in February/March 2021. RESULTS: We found that, among the five psychological antecedents, three (confidence, calculation - or extensive information searching, and collective responsibility) significantly predicted attitudes toward COVID-19 vaccination and had indirect effects on vaccination intentions through vaccination attitudes. Two antecedents (confidence and collective responsibility) also directly predicted vaccination intentions. Our analysis suggests that a partially mediated model produced better fit than a fully mediated model. CONCLUSIONS: Developing culturally tailored interventions for Black Americans that build confidence in COVID-19 vaccines, highlight collective responsibility, and attend to Black Americans' information sources is key to boosting Black Americans' COVID-19 vaccine acceptance. Future research is needed to understand how historical and ongoing racism affects the psychological antecedents of COVID-19 vaccine acceptance among Black Americans.

Olfactory impairment in COVID-19: Two methods for the assessment of olfactory function.

Background: Olfactory impairment is a major symptom of COVID-19. Is it necessary for COVID-19 patients to perform the detection of olfactory function, even how to select the olfactory psychophysical assessment tool. Methods: Patients infected with SARS-CoV-2 Delta variant were firstly taken into three categories (mild, moderate, and severe) according to the clinical classification. The Odor Stick Identification Test for the Japanese (OSIT-J) and the Simple Olfactory Test were used to assess olfactory function. Moreover, these patients were divided into three groups based on the results of the olfactory degree (euosmia, hyposmia, and dysosmia), too. The statistical analysis of the correlations between olfaction and clinical characteristics of patients were performed. Results: Our study demonstrated that the elderly men of Han were more susceptible to infected SARS-CoV-2, the clinical symptoms of the COVID-19 patients showed a clear correspondence with the disease type and the degree of olfactory disturbance. Whether or not to vaccinate and whether to complete the whole course of vaccination was closely related to the patient's condition. OSIT-J Test and Simple Test were consistent in our work, indicating that olfactory grading would worsen with the aggravation of symptoms. Furthermore, the OSIT-J method maybe better than Simple Olfactory Test. Conclusion: The vaccination has an important protective effect on the general population, and vaccination should be vigorously promoted. Moreover, it is necessary for COVID-19 patients to perform the detection of olfactory function, and the easier, faster and less expensive method for determination of olfactory function should be utilized to COVID-19 patients as the vital physical examination.

How health organizations communicate about COVID-19 on social media: a comparative content analysis.

BACKGROUND: This study examined how different health organizations (i.e., the Chinese CDC, the Korean CDC, the United States CDC, and WHO) communicated about the COVID-19 pandemic on social media, thus providing implications for organizations touse social media effectively in global health crises in the future. METHODS: Three bilingual researchers conducted a content analysis ofsocial media posts (N = 1,343) of these health organizations on Twitter and Sina Weibo to explore the frames of the COVID-19 pandemic, the purposes, and the strategies to communicate about it. RESULTS: Prevention was the dominant frame of the social media content of these four health organizations. Information update was the major communication purpose for WHO, the United States CDC, and the Korean CDC; however, guidance was the primary communication purpose for the Chinese CDC. The United States CDC, the Chinese CDC, and the Korean CDC heavily relied on multiple social media strategies (i.e., visual, hyperlink, and authority quotation) in their communication to the public about the COVID-19 pandemic, whereas WHO primarily employed quoting authorities. Significantdifferences were revealed across these health organizations in frames, communication purposes, and strategies. Theoretical and practical implications and limitations were discussed. CONCLUSIONS: This study examined how different global health organizations communicate about the COVID-19 pandemic on social media. We discussed how and why these global health organizations communicate the COVID-19 pandemic, which would help health-related organizations design messages strategically on global public health issues in the future.