Patients with Omicron variant infection can safely undergo elective orthopedic surgery: a retrospective cohort study (preprint)

Background COVID-19 is believed to be associated with significantly increased risks of morbidity and mortality. However, there are lack of reports on how infection with the COVID-19 Omicron variant affects the perioperative prognosis. Therefore, this study sought to find out perioperative differences in laboratory test results and complications between orthopedic surgery patients who were COVID-19 positive and negative at admission, to explore whether patients infected with the Omicron variant need to delay their orthopedic elective surgery.Methods A single-center cohort study of 54 orthopedic inpatients with COVID-19 Omicron variant infection were 1:1 matched to those who did not have a history of COVID-19, laboratory parameters including blood routine, inflammatory factors, coagulogram markers and postoperative complications were recorded and compared.Results Differences can not be found in the incidence of perioperative complications and mortality rates between the group infected with the SARS-CoV-2 Omicron variant and the uninfected group, as well as no statistical differences in laboratory test indicators.Conclusions The SARS-CoV-2 Omicron variant does not appear to pose a huge threat to elective orthopedic surgery, patients with Omicron variant infection can safely undergo elective orthopedic surgery without delay.

Extending X-reality technologies to digital twin in cultural heritage risk management：A comparative evaluation from the perspective of situation awareness (preprint)

Digital twins possess characteristics such as real-time capability, high precision, and high integration. The digital twin system for cultural heritage risk management includes comprehensive information about heritage, contextual data, and expert knowledge. Considering the role of Situational Awareness (SA), it facilitates more efficient risk assessment, analysis, and strategic decision-making for management personnel, thereby reducing damage to cultural heritage.This study extends X-reality technologies into the digital twin system for cultural heritage risk management. It simulates three sets of procedures for remote risk management of cultural heritage (2D desktop, VR, and AR) and explores the effectiveness of VR and AR in enhancing situational awareness from three dimensions of SART (SART-DAR, SART-SAR, SART-UOS). Additionally, we further analyze how the technological attributes of VR and AR (immersion and interactivity) impact the functional mechanism of situational awareness.The results indicate that, compared to the traditional 2D desktop, VR and AR have advantages in enhancing situational awareness of heritage risk. However, in AR mode, SART-DAR and SART-SAR dimensions did not show significant improvement. Furthermore, there is a significant difference in immersion's impact on the SART-DAR dimension. Regarding interactivity, although the results show differences in the impact on the SART-DAR dimension between VR and AR, no significant differences were observed.This study provides design references for building a digital twin system for cultural heritage risk management by deeply understanding the impact of X-reality technologies on the functional mechanism of cultural heritage risk situational awareness. Simultaneously, it offers insights for heritage site managers, heritage experts, and relevant stakeholders to enhance efficiency in risk perception.

Using the concept of circular economy to reduce the environmental impact of COVID-19 face mask waste

COVID-19 pandemic has posed severe threats to the society globally. World Health Organization (WHO) guidelines suggest that people wear face masks as a precautionary measure daily. This has resulted in the generation of massive amounts of mask-associated waste in the environment. Owing to the criticality of the epidemic, there has not been a large-scale investigation on where to discard masks, making this situation daunting. As the pandemic continues, the use of masks continues to increase, repeated use and disposal of masks has become an imperative issue. Most disposable masks comprise chemical fibers in the filter layer. Without proper treatment and disposal, these large amounts of chemical waste will eventually flow into rivers or oceans, leading to serious pollution. Therefore, to reduce the negative effects on the marine environment, it is crucial that we produce reusable masks and reduce disposable wearing habits. This study aimed to resolve this challenge using textile materials created by recycling fish-scale waste. Functional and comfortable masks manufactured without chemical additives to achieve multiple functions can increase the willingness to wear and be reused. Hence, product use can be prolonged, and the use of disposable masks can be curtailed. The product manufactured herein is biodegradable in nature, thus conforming to the green sustainable initiative.

Utility of monocyte distribution width for diagnosing colonic diverticulitis in the emergency department: a retrospective cohort study (preprint)

Background Colonic diverticulitis is a leading cause of abdominal pain. The monocyte distribution width (MDW) is a novel inflammatory biomarker with prognostic significance for coronavirus disease and pancreatitis; however, no study has assessed its correlation with the severity of colonic diverticulitis. Methods This single-center retrospective cohort study included patients older than 18 years who presented to the emergency department between November 1, 2020, and May 31, 2021, and received a diagnosis of acute colonic diverticulitis after abdominal computed tomography. The characteristics and laboratory parameters of patients with simple versus complicated diverticulitis were compared. The significance of categorical data was assessed using the chi-square or Fisher’s exact test. The Mann–Whitney U test was used for continuous variables. Multivariate regression analysis was performed to identify predictors of complicated colonic diverticulitis. Receiver operator characteristic (ROC) curves were used to test the efficacy of inflammatory biomarkers in distinguishing simple from complicated cases. Results Of the 160 patients enrolled, 21 (13.125%) had complicated diverticulitis. Although right-sided was more prevalent than left-sided colonic diverticulitis (70% versus 30%), complicated diverticulitis was more common in those with left-sided colonic diverticulitis (61.905%, p = 0.001). Age, white blood cell (WBC) count, neutrophil count, C-reactive protein (CRP) level, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and MDW were significantly higher in the complicated diverticulitis group (p < 0.05). Logistic regression analysis indicated that the left-sided location and the MDW were significant and independent predictors of complicated diverticulitis. The area under the ROC curve (AUC) was as follows: MDW, 0.870 (95% confidence interval [CI], 0.784–0.956); CRP, 0.800 (95% CI, 0.707–0.892); NLR, 0.724 (95% CI, 0.616–0.832); PLR, 0.662 (95% CI, 0.525–0.798); and WBC, 0.679 (95% CI, 0.563–0.795). The MDW had the largest AUC for diagnosing complicated diverticulitis; when the MDW cutoff was 20.38, the sensitivity and specificity were maximized to 90.5% and 80.6%, respectively. Conclusions Patients with complicated diverticulitis were significantly older and predominantly had left-sided colonic diverticulitis. A large MDW was a significant and independent predictor of complicated diverticulitis. The MDW may aid in planning antibiotic therapy for patients with colonic diverticulitis in the emergency department.

Virofree, an Herbal Medicine-Based Formula, Interrupts the Viral Infection of Delta and Omicron Variants of SARS-CoV-2

Coronavirus disease 2019 (COVID-19) remains a threat with the emergence of new variants, especially Delta and Omicron, without specific effective therapeutic drugs. The infection causes dysregulation of the immune system with a cytokine storm that eventually leads to fatal acute respiratory distress syndrome (ARDS) and further irreversible pulmonary fibrosis. Therefore, the promising way to inhibit infection is to disrupt the binding and fusion between the viral spike and the host ACE2 receptor. A transcriptome-based drug screening platform has been developed for COVID-19 to explore the possibility and potential of the long-established drugs or herbal medicines to reverse the unique genetic signature of COVID-19. In silico analysis showed that Virofree, an herbal medicine, reversed the genetic signature of COVID-19 and ARDS. Biochemical validations showed that Virofree could disrupt the binding of wild-type and Delta-variant spike proteins to ACE2 and its syncytial formation via cell-based pseudo-typed viral assays, as well as suppress binding between several variant recombinant spikes to ACE2, especially Delta and Omicron. Additionally, Virofree elevated miR-148b-5p levels, inhibited the main protease of SARS-CoV-2 (Mpro), and reduced LPS-induced TNF-α release. Virofree also prevented cellular iron accumulation leading to ferroptosis which occurs in SARS-CoV-2 patients. Furthermore, Virofree was able to reduce pulmonary fibrosis-related protein expression levels in vitro. In conclusion, Virofree was repurposed as a potential herbal medicine to combat COVID-19. This study highlights the inhibitory effect of Virofree on the entry of Delta and Omicron variants of SARS-CoV-2, which have not had any effective treatments during the emergence of the new variants spreading.

The Construction and Application of E-Learning Curricula Evaluation Metrics for Competency-Based Teacher Professional Development

Today, students at universities in advanced countries typically enroll in colleges, such as the College of Education, which offer interdisciplinary programs for undergraduates in their first and second years, allowing them to explore personal interests, experience educational research fields, complete their integrated curricula, and then choose a major in their third year. To cooperate with the government's epidemic prevention policies and measures in the post-COVID-19 era, the trend of e-learning and distance teaching has accelerated the establishment of integrated online curricula with interdisciplinary programs for undergraduates in the College of Education to facilitate effective future teacher professional development (TPD). Therefore, it is very important to construct e-learning curricula evaluation metrics for competency-based teacher professional development (CB-TPD) and to implement them in teaching practice. This research used social network analysis (SNA) methods, approaches, and theoretical concepts, such as affiliation networks and bipartite graphs comprised of educational occupational titles and common professional competencies (i.e., Element Name and ID), as well as knowledge, skills, abilities, and other characteristics (KSAOs), from the U.S. occupational information network (O*NET) 26.1 OnLine database, to collect data on the occupations of educational professionals. This study also used Gephi network analysis and visualization software to carry out descriptive statistics of keyword co-occurrences to measure their centrality metrics, including weighted degree centrality, degree centrality, betweenness centrality, and closeness centrality, and to verify their importance and ranking in professional competency in eight categories of educational professionals (i.e., three categories of special education teachers and five categories of teachers, except special education). The analysis of the centrality metrics identified the educational common professional competency (ECPC) keyword co-occurrences, which were then used to design, develop, and apply e-learning curricula evaluation metrics for CB-TPD. The results of this study can be used as a reference for conducting related academic research and cultivating educational professionals' online curricula, including ECPC keywords, integrated curricula design and the development of transdisciplinary programs, and teacher education, as well as to facilitate the construction and application of future e-learning curricula evaluation metrics for CB-TPD.

Titers and capacity of neutralizing antibodies against SARS-CoV-2 variants after heterologous booster vaccination in health care workers primed with two doses of ChAdOx1 nCov-19: a single-blinded, randomized clinical trial (preprint)

Background Booster vaccination is important because of waning immunity and variant immune evasion. We conducted a single-blinded, randomized trial to evaluate the safety, reactogenicity, and immunogenicity of heterologous booster vaccination in health care workers (HCW) who had received two doses of ChAdOx1 nCov-19. Methods and findings HCW at least 90 days after the second dose were enrolled to receive one of the four vaccines: BNT162b2, half-dose mRNA-1273, mRNA-1273, and MVC-COV1901. The primary outcomes were humoral and cellular immunogenicity and the secondary outcomes safety and reactogenicity 28 days post-booster. 340 HCW were enrolled: 83 received BNT162b2 (2 excluded), 85 half-dose mRNA-1273, 85 mRNA-1273, and 85 MVC-COV1901. mRNA vaccines had more reactogenicity than protein vaccine. Anti-spike IgG increased by a fold of 8.4 for MCV-COV1901, 32.2 for BNT162b2, 47.6 for half-dose mRNA-1273 and 63.2 for mRNA1273. The live virus microneutralization assay (LVMNA) against the wild type, alpha and delta variants were consistent with anti-spike IgG for all booster vaccines. The LVMNA in the four groups against omicron variant were 6.4 to 13.5 times lower than those against the wild type. Serum neutralizing antibody against omicron variant was undetectable in 60% of the participants who received MCV-COV1901 as a booster by LVMNA. By using pseudovirus neutralizing assay, we found that neutralization activity in the four groups against omicron variant were 4.6 to 5.2 times lower than that against the D614G. All booster vaccines induced comparable T cell response. Conclusions Third dose booster not only increases neutralizing antibody titer but also enhances antibody capacity against SARS-CoV-2 variants. mRNA vaccines are preferred booster vaccines for those after primary series of ChAdOx1 nCov-19.

Utility of Monocyte Distribution Width for Diagnosing Colonic Diverticulitis in the Emergency Department (preprint)

BackgroundColonic diverticulitis is a leading cause of abdominal pain. The monocyte distribution width (MDW) is a novel inflammatory biomarker with prognostic significance for coronavirus disease and pancreatitis; however, no study has assessed its correlation with the severity of colonic diverticulitis.MethodsThis single-center retrospective cohort study included patients older than 18 years who presented to the emergency department between November 1, 2020, and May 31, 2021, and received a diagnosis of acute colonic diverticulitis after abdominal computed tomography. The characteristics and laboratory parameters of patients with simple versus complicated diverticulitis were compared. The significance of categorical data was assessed using the chi-square or Fisher’s exact test. The Mann–Whitney U test was used for continuous variables. Multivariate regression analysis was performed to identify predictors of complicated colonic diverticulitis. Receiver operator characteristic (ROC) curves were used to test the efficacy of inflammatory biomarkers in distinguishing simple from complicated cases.ResultsOf the 160 patients enrolled, 21 (13.125%) had complicated diverticulitis. Although right-sided was more prevalent than left-sided colonic diverticulitis (70% versus 30%), complicated diverticulitis was more common in those with left-sided colonic diverticulitis (61.905%, p = 0.001). Age, white blood cell (WBC) count, neutrophil count, C-reactive protein (CRP) level, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and MDW were significantly higher in the complicated diverticulitis group (p < 0.05). Logistic regression analysis indicated that left-sided location and the MDW were significant and independent predictors of complicated diverticulitis. The area under the ROC curve (AUC) was as follows: MDW, 0.870 (95% confidence interval [CI], 0.784–0.956); CRP, 0.800 (95% CI, 0.707–0.892); NLR, 0.724 (95% CI, 0.616–0.832); PLR, 0.662 (95% CI, 0.525–0.798); and WBC, 0.679 (95% CI, 0.563–0.795). The MDW had the largest AUC for diagnosing complicated diverticulitis; when the MDW cutoff was 20.38, the sensitivity and specificity were maximized to 90.5% and 80.6%, respectively.ConclusionsPatients with complicated diverticulitis were significantly older and predominantly had left-sided colonic diverticulitis. A large MDW was a significant and independent predictor of complicated diverticulitis. The MDW may aid in planning antibiotic therapy for patients with colonic diverticulitis in the emergency department.

Does Information-and-Communication-Technology Market Openness Promote Digital Service Exports?

ICT has become an important support for the booming trade in services in the digital era. However, the extent to which trade activities can benefit from ICT will depend on the regulatory constraints and the market-openness level of the ICT market. This study empirically examines the impact of ICT market openness on digital service exports on the basis of bilateral trade data at the industry level from 2007 to 2019 from 50 countries. The results show that: (1) ICT market openness seeks the combination of effective regulation and moderate openness, which is mainly reflected in three policy areas: improving information interconnection and sharing, reducing access restrictions and promoting fair competition;(2) The ICT market openness in both exporting and importing countries can significantly boost digital service exports, but in different ways. Exporting countries expand digital service exports mainly by promoting fair competition, while importing countries have the most obvious positive impact on exports through the reduction of access restrictions;(3) The greater the gap between the ICT development levels, and the lower the bilateral risk levels between the two trading countries, the greater the marginal effect that ICT market openness will have on the promotion of digital service exports. Thus, improving market openness indicates an important direction for ICT regulatory reform, but the impact on digital service exports will vary by specific policy area and by trading-partner country.

Attitude and behavior toward bystander cardiopulmonary resuscitation during COVID-19 outbreak

Background: Outbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on bystander cardiopulmonary resuscitation (BCPR) for fear of transmission while breaking social distancing rules. The latest guidelines recommend hands-only cardiopulmonary resuscitation (CPR) and facemask use. However, public willingness in this setup remains unknown. Methods: A cross-sectional, unrestricted volunteer Internet survey was conducted to assess individuals' attitudes and behaviors toward performing BCPR, pre-existing CPR training, occupational identity, age group, and gender. The raking method for weights and a regression analysis for the predictors of willingness were performed. Results: Among 1,347 eligible respondents, 822 (61%) had negative attitudes toward performing BCPR. Healthcare providers (HCPs) and those with pre-existing CPR training had fewer negative attitudes (p < 0.001);HCPs and those with pre-existing CPR training and unchanged attitude showed more positive behaviors toward BCPR (p < 0.001). Further, 9.7% of the respondents would absolutely refuse to perform BCPR. In contrast, 16.9% would perform BCPR directly despite the outbreak. Approximately 9.9% would perform it if they were instructed, 23.5%, if they wore facemasks, and 40.1%, if they were to perform hands-only CPR. Interestingly, among the 822 respondents with negative attitudes, over 85% still tended to perform BCPR in the abovementioned situations. The weighted analysis showed similar results. The adjusted predictors for lower negative attitudes toward BCPR were younger age, being a man, and being an HCP;those for more positive behaviors were younger age and being an HCP. Conclusions: Outbreaks of emerging infectious diseases, such as COVID-19, have negative impacts on attitudes and behaviors toward BCPR. Younger individuals, men, HCPs, and those with pre-existing CPR training tended to show fewer negative attitudes and behaviors. Meanwhile, most individuals with negative attitudes still expressed positive behaviors under safer measures such as facemask protection, hands-only CPR, and available dispatch instructions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Super-immunity by broadly protective nanobodies to sarbecoviruses (preprint)

Vaccine boosters and infection can facilitate the development of SARS-CoV-2 antibodies with improved potency and breadth. Here, we observed super-immunity in a camelid extensively immunized with the SARS-CoV-2 receptor-binding domain (RBD). We rapidly isolated a large repertoire of specific ultrahigh-affinity nanobodies that bind strongly to all known sarbecovirus clades using integrative proteomics. These pan-sarbecovirus nanobodies (psNbs) are highly effective against SARS-CoV and SARS-CoV-2 variants including the Omicron, with the best median neutralization potency at single-digit ng/ml. Structural determinations of 13 psNbs with the SARS-CoV-2 spike or RBD revealed five epitope classes, providing insights into the mechanisms and evolution of their broad activities. The highly evolved psNbs target small, flat, and flexible epitopes that contain over 75% of conserved RBD surface residues. Their potencies are strongly and negatively correlated with the distance of the epitopes to the receptor binding sites. A highly potent, inhalable and bispecific psNb (PiN-31) was developed. Our findings inform on the development of broadly protective vaccines and therapeutics.

The Self-examination Physiological Health Level of Medical Staffs under Three-level Protection and Analysis

Abstract: Objective: To investigate the self-examination physiological health level of medical staffs under the tertiary protection, and analyze the physiological health problems and influencing factors of the medical staffs under the three-level protection. Methods: from March 19, 2020 to April 3, 2020, using snowball sampling method, a total of 103 anti epidemic medical staffs from two top three hospitals in Guangdong Province were invited to conduct a network questionnaire survey. Results: a total of 102 valid online questionnaires were analyzed. The results showed that the health status and organ function of medical staffs were 6.37％ ± 77, daily life function was 10. 19 ± 63 and 9. 97 respectively ± 22 points, all above the middle level;The analysis showed that the self-examination physiological health level was affected by the gender of medical staffs, whether drinking, health status and intuitive feelings under three-level protection. Conclusion: the self-examination physiological health of medical staffs under the three-level protection is in the upper middle level, so we should pay more attention to and support the physiological health of medical staffs under the three-level protection.

Prevention and control strategies for emergency, limited-term, and elective operations in pediatric surgery during the epidemic period of COVID-19

The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to more than 100 countries. Children approved to be susceptible to SARS-CoV-2 infection. Preventing and controlling the epidemic while ensuring orderly flows of pediatric surgery clinical work has proven to be a big challenge for both patients and clinicians during the epidemic. Based on the transmission characteristics of SARS-CoV-2 and the requirements for prevention and control of COVID-19, the authors proposed some concrete measures and practical strategies of managing emergency, limited-term, and elective pediatric surgeries during the epidemic period.

Heterogeneous network-based drug repurposing for COVID-19 (preprint)

The Corona Virus Disease 2019 (COVID-19) belongs to human coronaviruses (HCoVs), which spreads rapidly around the world. Compared with new drug development, drug repurposing may be the best shortcut for treating COVID-19. Therefore, we constructed a comprehensive heterogeneous network based on the HCoVs-related target proteins and use the previously proposed deepDTnet, to discover potential drug candidates for COVID-19. We obtain high performance in predicting the possible drugs effective for COVID-19 related proteins. In summary, this work utilizes a powerful heterogeneous network-based deep learning method, which may be beneficial to quickly identify candidate repurposable drugs toward future clinical trials for COVID-19. The code and data are available at https://github.com/stjin-XMU/HnDR-COVID.

The impact of COVID-19 pandemic on influenza transmission: molecular and epidemiological evidence (preprint)

To quantify the impact of COVID-19-related control measures on the spread of human influenza virus, we analyzed case numbers, viral molecular sequences, personal behavior data, and policy stringency data from various countries, and found consistent evidence of decrease in influenza incidence after the emergence of COVID-19.

CoVac501, a self-adjuvanting peptide vaccine conjugated with TLR7 agonists, against SARS-CoV-2 induces protective immunity (preprint)

Safe, economical and effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are needed to achieve adequate herd immunity and halt the pandemic. We have constructed a novel SARS-CoV-2 vaccine, CoVac501, which is a self-adjuvanting peptide vaccine conjugated with Toll-like receptor 7 (TLR7) agonists. The vaccine contains two immunodominant peptides screened from receptor-binding domain (RBD) and is fully chemically synthesized. And the vaccine has optimized nanoemulsion formulation, outstanding stability and safety. In non-human primates (NHPs), CoVac501 elicited high and persistent titers of RBD-specific and protective neutralizing antibodies (NAbs), which were also effective to RBD mutations. CoVac501 was found to elicit the increase of memory T cells, antigen-specific CD8 + T cell responses and Th1-biased CD4 + T cell immune responses in NHPs. More importantly, the sera from the immunized NHPs can prevent infection of live SARS-CoV-2 in vitro. One-Sentence Summary A novel SARS-CoV-2 vaccine we developed, CoVac501, which is a fully chemically synthesized and self-adjuvanting peptides conjugated with TLR7 agonists, can induce high-efficient humoral and cellular immune responses against SARS-CoV-2.

Potent neutralizing nanobodies resist convergent circulating variants of SARS-CoV-2 by targeting novel and conserved epitopes (preprint)

There is an urgent need to develop effective interventions resistant to the evolving variants of SARS-CoV-2. Nanobodies (Nbs) are stable and cost-effective agents that can be delivered by novel aerosolization route to treat SARS-CoV-2 infections efficiently. However, it remains unknown if they possess broadly neutralizing activities against the prevalent circulating strains. We found that potent neutralizing Nbs are highly resistant to the convergent variants of concern that evade a large panel of neutralizing antibodies (Abs) and significantly reduce the activities of convalescent or vaccine-elicited sera. Subsequent determination of 9 high-resolution structures involving 6 potent neutralizing Nbs by cryoelectron microscopy reveals conserved and novel epitopes on virus spike inaccessible to Abs. Systematic structural comparison of neutralizing Abs and Nbs provides critical insights into how Nbs uniquely target the spike to achieve high-affinity and broadly neutralizing activity against the evolving virus. Our study will inform the rational design of novel pan-coronavirus vaccines and therapeutics.