Skills Training of Infectious Diseases in the Community：a Survey Research of Questions

Background As the most basic unit of infectious disease prevention and control，community health service institutions are the frontline and important gateway for the prevention and control of infectious disease. Primary care physicians are responsible for epidemic surveillance，vaccination，health promotion and assistance to centers for disease control in investigating and disposing outbreaks and public health emergencies in their districts，and play an active role in disease prevention and control by groups，susceptible population protection，infectious source control and health education，as well as the effective prevention and control of infectious diseases. Objective To understand the ability of primary care physicians to diagnose and treat infectious diseases in the community，analyse their existing problems and shortcomings，design and conduct a series of intensive training related to infectious diseases for improving the capacity of infectious disease prevention and control at the primary level；To evaluate the effectiveness of online continuing medical education，so as to provide a reference for better continuing medical education on infectious diseases in the community. Methods All participants of the National Community Infectious Diseases Continuing Education Conference held by the Department of Family Medicine of the University of Hong Kong-Shenzhen Hospital in November 2021 were selected as research subjects from November 2021 to March 2022. The questionnaires were distributed to all registered attendees before and after the conference through the QR code of the questionnaire star，and the content of pre-conference questionnaire included demographic characteristics of the participants，participation in infectious disease training in the community since started working，diagnosis and treatment of infectious diseases in the community，subjective attitudes towards the prevention and control of infectious diseases in the community（willingness to manage infectious diseases in the community，satisfaction with their own infectious disease management skills），expertise in infectious disease prevention and control and knowledge related to conference content，attitude towards hepatitis B. The content of the post-conference questionnaire mainly included knowledge about the content of conference，attitude towards hepatitis B and satisfaction survey of this online conference. A total of 301 primary care physicians completed the questionnaire before and after the conference，and a total of 194 completed the questionnaire before and after the conference. Results Among all participants，166 （55.1%） had attended infectious disease training in the community，of whom 49（29.5%） were satisfied with their infectious disease diagnosis and treatment ability；135（44.8%） had not attended the training，of whom 22（16.3%） were satisfied with their infectious disease diagnosis and treatment ability. 143（86.1 %） of 166 participants who had attended infectious disease training in the community indicated their willingness to manage community infectious diseases，99（73.3%） of 135 participants who had not attended infectious disease training in the community indicated their willingness to manage community infectious diseases. 66（27.3%） of participants who were satisfied with their infectious disease diagnosis and treatment ability indicated their willingness to manage community infectious diseases. The top three infectious disease tests conducted by the institutions were hepatitis B，AIDS，and hepatitis C；the top three infectious diseases treated in the past six months were hepatitis B，influenza，hand，foot and mouth disease. Different self-evaluation and willingness to train may affect the willingness to manage community infectious diseases（P<0.05）. Among the participants who completed the questionnaire both before and after the conference，the highest correct answer rate for compulsory management of statutory infectious diseases before the conference was 89.7%，the owest accuracy rate for the type of disinfection of the COVID-19 infection was only 17.0%，the correct rates of other questions ranged from 34.0% to 40.7%. The correct rates of the questions after the conference were higher than those before the conference，and the correct rates ranged from 48.9% to 52.6%. The score of attitude towards hepatitis B after the conference was higher than that before the conference （P<0.05）. In terms of feedback after conference，254（98.1%） expressed satisfaction in the total of 259 questionnaires. In terms of suggestions for online conference，179（69.1%） and 174（67.2%） participants believed that online fluency and online interaction need to be improved. Conclusion The primary care physicians receive relatively less infectious diseases training in the community，inadequate infectious diseases training in the community can improve the confidence of self-competence，attitude of active management of infectious diseases and diagnosis and treatment ability in the primary care physicians. The future direction of continuing medical education should focus on the training of emerging infectious diseases and novel medical concepts，relevant experts should be invited to comment on the necessity and effectiveness of training in the community. © 2023 Chinese General Practice. All rights reserved.

Has COVID-19 Changed Consumers' Satisfiers and Dissatisfiers? Evidence from Online Reviews of 5-Star Hotels in Shanghai and Beijing

Many studies have analyzed the asymmetric relationship between hotel service quality attributes and satisfaction, and tried to find consumers' satisfiers and dissatisfiers, aiming at enhancing satisfaction more efficiently. However, the impact of COVID-19 has led to changes in consumers' expectations for hotel services, and the above findings might face invalidation. To date, we are still unknown whether consumers' satisfiers/dissatisfiers changed. This study fills this research gap by mining online reviews of five-star hotels from Shanghai and Beijing before and during the pandemic. The results found that the asymmetric categories of Sleep quality and Internet/Wi-Fi attributes have changed. Specifically, Sleep quality and Internet/Wi-Fi became dissatisfiers from hybrids, indicating that hoteliers only need to maintain their normal performance, and do not invest too many resources because they bring no satisfaction;attributes like Room, decoration, etc. remain hybrids. Additionally, we performed opinion extraction for the dissatisfier attributes to further understand what causes consumer dissatisfaction. The results contribute to the literature by shedding light on the pandemic's impacts on the asymmetric effects of service quality attributes. The cause analysis can help hoteliers develop specific measures to mitigate the adverse effects of COVID-19.

Exploring Social Media for Early Detection of Depression in COVID-19 Patients

The COVID-19 pandemic has caused substantial damage to global health. Even though three years have passed, the world continues to struggle with the virus. Concerns are growing about the impact of COVID-19 on the mental health of infected individuals, who are more likely to experience depression, which can have long-lasting consequences for both the affected individuals and the world. Detection and intervention at an early stage can reduce the risk of depression in COVID-19 patients. In this paper, we investigated the relationship between COVID-19 infection and depression through social media analysis. Firstly, we managed a dataset of COVID-19 patients that contains information about their social media activity both before and after infection. Secondly, We conducted an extensive analysis of this dataset to investigate the characteristic of COVID-19 patients with a higher risk of depression. Thirdly, we proposed a deep neural network for early prediction of depression risk. This model considers daily mood swings as a psychiatric signal and incorporates textual and emotional characteristics via knowledge distillation. Experimental results demonstrate that our proposed framework outperforms baselines in detecting depression risk, with an AUROC of 0.9317 and an AUPRC of 0.8116. Our model has the potential to enable public health organizations to initiate prompt intervention with high-risk patients. © 2023 ACM.

Winter-autumn air pollution control plan in North China modified the PM2.5 compositions and sources in Central China

The additional impact of emission-reduction measures in North China (NC) during autumn and winter on the air quality of downwind regions is an interesting but less addressed topic. The mass concentrations of routine air pollutants, the chemical compositions, and sources of fine particles (PM2.5) for January 2018, 2019, and 2020 at a megacity of Central China were identified, and meteorology-isolated by a machine-learning technique. Their variations were classified according to air mass direction. An unexpectedly sharp increase in emission-related PM2.5 by 22.7% (18.0 mug m-3) and 25.7% (19.4 mug m-3) for air masses from local and NC in 2019 was observed compared to those of 2018. Organic materials exhibited the highest increase in PM2.5 compositions by 6.90 mug m-3 and 6.23 mug m-3 for the air masses from local and NC. PM2.5 source contributions related to emission showed an upsurge from 1.39 mug m-3 (biomass burning) to 24.9 mug m-3 (secondary inorganic aerosol) in 2019 except for industrial processes, while all reduced in 2020. From 2018 to 2020, the emission-related contribution of coal combustion to PM2.5 increased from 10.0% to 19.0% for air masses from the local area. To support the priority natural gas quotas in northern China, additional coal in cities of southern China was consumed, raising related emissions from transportation activities and road dust in urban regions, as well as additional biofuel consumption in suburban or rural regions. All these activities could explain the increased primary PM2.5 and related precursor NO2. This study gave substantial evidence of air pollution control measures impacting the downwind regions and promote the necessity of air pollution joint control across the administration.Copyright © 2023 Elsevier Ltd

Face mask detection based on improved YOLOv3 algorithm

In the current situation of COVID-19 prevention and control, wearing masks remains an important way to prevent the transmission of the Novel Coronavirus. Aiming at the problem that the detection accuracy of the traditional YOLOv3 algorithm can still be improved, this paper proposes an improved yolov3 algorithm and applies it to the practical problem of detecting whether to wear a mask. Firstly, the algorithm introduces the residual structure of structural reparameterization in the feature extraction network named Darknet53 of YOLOv3 to obtain the input features;Secondly, the SimSPPF (Simplified Spatial Pyramid Pooling-Fast) is introduced to enhance feature extraction;Finally, an improved attention mechanism is introduced to make the model focus on regions with more prominent features. Besides, in order to ensure the accuracy of target detection, CIoU and Focal loss function was used in the training process. The results show that compared with the traditional YOLOv3, the detection accuracy of the improved algorithm for normal face and mask face is improved by 16.98% and 7.30% respectively, and the mAP is improved by 12.14%, which can meet the requirements of daily use and lay a foundation for rapid face recognition when wearing mask. () © 2023 IEEE.

Week 48 results of a phase 3 randomized controlled trial of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) vs dolutegravir 1 emtricitabine/tenofovir disoproxil fumarate (DTG 1 F/TDF) as initial treatment in HIV-1/HBV-coinfected adults (ALLIANCE)

Background/Aims: The clinical course of hepatitis B virus (HBV) infection in individuals with HIV-1 coinfection is marked by accelerated disease progression. A tenofovir-containing antiretroviral regimen is recommended in most people with HIV-1/HBV-coinfection, but there have not been randomized studies of tenofovir disoproxil fumarate (TDF) vs tenofovir alafenamide (TAF) in treatment- naive HIV-1/HBV-coinfected individuals. We report primary endpoint results from a Phase 3 study comparing bictegravir/emtricitabine/ TAF (B/F/TAF) vs dolutegravir + emtricitabine/TDF (DTG + F/TDF) at Week (W)48 in participants initiating treatment for both viruses. Method(s): Adults with HIV-1/HBV coinfection were randomized 1:1 to initiate blinded treatment with B/F/TAF or DTG + F/TDF (with placebo). Primary endpoints were the proportion of participants with HIV-1 RNA<50 copies/mL (FDA Snapshot) and plasma HBV DNA<29 IU/mL (missing = failure) at W48. Noninferiority was assessed with 95% CI (12% margin). Secondary and other endpoints included change from baseline cluster of differentiation 4 (CD4) count, proportion with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) loss/seroconversion, and alanine transaminase (ALT) normalization (AASLD criteria). Result(s): Participants (N = 243) were randomized and treated (B/F/ TAF [n = 121], DTG + F/TDF [n = 122]) from 11 countries in Asia, Europe, North, and Latin America. Baseline characteristics were median age of 32 years, 4.5% female, 88% Asian, 30% HIV-1 RNA>100,000 c/mL, 40% CD4<200 cells/lL, median HBV DNA 8.1 log10 IU/mL, 78% HBeAg+. At W48, B/F/TAF was noninferior to DTG + F/TDF at achieving HIV-1 RNA<50 copies/mL (95% vs 91%, difference 4.1%;95% CI -2.5%-10.8%;P = 0.21), with mean CD4 gains of + 200 and + 175 cells/lL, respectively. B/F/TAF was superior to DTG + F/TDF at achieving HBV DNA<29 IU/mL (63% vs 43%, difference 16.6%;95% CI 5.9%-27.3%;P = 0.0023). Participants treated with B/F/TAF vs DTG + F/TDF had numerically higher HBsAg loss (13% vs 6%;P = 0.059), HBeAg loss (26% vs 14%;P = 0.055), HBeAg seroconversion (23% vs 11%;P = 0.031), and ALT normalization (73% vs 55%;P = 0.066). The most frequent adverse events among participants treated with B/F/TAF vs DTG + F/TDF were upper respiratory tract infection (17% vs 11%), COVID- 19 (13% vs 11%), pyrexia (9% vs 12%), ALT increase (7% vs 11%), and nasopharyngitis (11% vs 4%). ALT flares (elevations at >= 2 consecutive postbaseline visits) occurred in 11 participants (7 B/F/ TAF, 4 DTG + F/TDF), and all resolved. Conclusion(s): Among adults with HIV-1/HBV-coinfection starting antiviral therapy, both B/F/TAF and DTG + F/TDF had high HIV-1 suppression at year 1, with B/F/TAF resulting in superior HBV DNA suppression and significantly more HBeAg seroconversion. Safety findings were similar between groups.

Application of GIS in Vaccine Distribution During COVID-19

The relationship between geography and health has long been established, yet new insights continue to develop as technology advances. Geographic Information Systems (GIS) is one such example. This computer system is capable of manipulating all types of data but is most distinct for its ability to analyze and display geographically referenced information. This technology supports decision-makers who seek to make targeted, data-informed decisions inclusive of local and global spatial trends. GIS is used broadly for operational and research purposes in health, and during the novel coronavirus (COVID-19) and has proven useful for supporting vaccine distribution workflows such as visualizing global disease spread and patterns, tracking intervention impact, collating mass amounts of pertinent distribution factors, constituent engagement for internal or public consumption, and more. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Safety and Pharmacokinetics of a Novel Double Prodrug Asc10 in Healthy Subjects

Background: ASC10 is an oral double prodrug of the active antiviral ribonucleoside analog, ASC10-A (also known as beta-d-N4-hydroxycytidine), which is a potent inhibitor of SARS-CoV-2. ASC10 is rapidly metabolized into ASC10-A in vivo after oral dosing. Here, we report the results of the first-in-human, phase 1 study to determine the safety, tolerability, and pharmacokinetics (PK) of ASC10 in healthy subjects, and to assess the food effect on the pharmacokinetics. Method(s): This study included 2 parts. Part 1 (multiple-ascending-dose) consisted of 6 cohorts (8 or 12 subjects per cohort). Eligible subjects were randomized in a 3:1 ratio to receive either twice-daily (BID) doses of 50 to 800 mg ASC10 or placebo for 5.5 days, and were then followed for 7 days for safety. In Part 2 (food effect), 12 subjects were randomized in a 1:1 ratio to either 800 mg ASC10 in the fed state followed by 800 mg in the fasted state, or vice versa, with a 7-day washout period between doses. PK blood samples were collected and measured for ASC10-A along with ASC10 and molnupiravir. Safety assessments included monitoring of adverse events (AEs), measurement of vital signs, clinical laboratory tests, and physical examinations. Result(s): ASC10-A was the major circulating metabolite ( >99.94%) in subjects after oral dosing of ASC10. ASC10-A appeared rapidly in plasma, with a median Tmax of 1.00 to 2.00 h, and declined with a geometric t1/2 of approximately 1.10 to 3.04 h. After multiple dosing for 5.5 days, both Cmax and AUC of ASC10-A increased in a dose-proportional manner from doses of 50 to 800 mg BID without accumulation. of ASC10-A in the fed state occurred slightly later, with a median of 3.99 h postdose versus 2.00 h (fasted state). However, Cmax and AUC were very similar or the same between fed and fasted states. Thus, administration of ASC10 with food is unlikely to have an effect on exposure. The incidence of AEs was similar between subjects receiving ASC10 or placebo (both 66.7%) and 95.0% of AEs were mild. There were no serious adverse events as well as no clinically significant findings in clinical laboratory, vital signs, or electrocardiography. Conclusion(s): Results of this study showed that ASC10 was well tolerated, and the increase in plasma exposure of ASC10-A was dose proportional across the range of doses tested with no accumulation and no food effect. 800 mg ASC10 BID is selected for further studies in patients infected with SARS-CoV-2.

Understanding Digital Identity during the Pandemic: An Investigation of Two Chinese Spanish Teachers

During combatting the COVID-19 pandemic, the most widespread change in Spanish as a foreign language instruction is imperative online teaching. It demands that language teachers move all teaching activities to virtual platforms, facilitating the construction of their digital identities. However, there is scarce attention on Spanish teachers' professional development, given the necessity of understanding the evolvement of their identities across virtual learning platforms. Through the lens of a case study, this research explores the digital identities of Spanish as a foreign language teachers during the school lockdown in 2022. The data includes semi-structured interviews, virtual classroom discourse, lesson plans, and reflective writing. The results show that Spanish teachers formed multiple digital identities, including curriculum innovators, vulnerable actors, involuntary team workers, overseas returnees, and academic researchers. Among them, the first three are core identities, while overseas returnees and academic researchers are peripheral identities. Regardless, they were formed and negotiated under the influence of teachers' past experiences, the exercise of agency, emotional vulnerability, and social context. In addition, a contradictory belief in teaching was also identified during the formation of Chinese Spanish teachers' digital identities.

Tracking the Evolution of Clusters in Social Media Streams

Tracking the evolution of clusters in social media streams is becoming increasingly important for many applications, such as early detection and monitoring of natural disasters or pandemics. In contrast to clustering on a static set of data, streaming data clustering does not have a global view of the complete data. The local (or partial) view in a high-speed stream makes clustering a challenging task. In this paper, we propose a novel density peak based algorithm, TStream, for tracking the evolution of clusters and outliers in social media streams, via the evolutionary actions of cluster adjustment, emergence, disappearance, split, and merge. TStream is based on a temporal decay model and text stream summarisation. The decay model captures the decreasing importance of textual documents over time. The stream summarisation compactly represents them with the help of cells (aka micro-clusters) in the memory. We also propose a novel efficient index called shared dependency tree (aka SD-Tree) based on the ideas of density peak and shared dependency. It maintains the dynamic dependency relationships in TStream and thereby improves the overall efficiency. We conduct extensive experiments on five real datasets. TStream outperforms the existing state-of-the-art solutions based on MStream, MStreamF, EDMStream, OSGM, and EStream, in terms of cluster mapping measure (CMM) by up to 17.8%, 18.6%, 6.9%, 16.4%, and 20.1%, respectively. It is also significantly more efficient than MStream, MStreamF, OSGM, and EStream, in terms of response time and throughput.

Negotiating the temporal and spatial complexities: Chinese international students' learning experience at home during the COVID-19

Many Chinese international students had to or chose to leave their host universities, receiving online international higher education (HE) at ‘homes' during the COVID-19. Inspired by the ‘glonacal' mode of thought, this qualitative study interviewed 16 Chinese international students at ‘homes' to explore the potential complexities of spatiality and temporality regarding their online international HE experiences during COVID-19. Physically separating from host universities, our participants lost the sense of belongingness to the campus and felt disconnected with their academic communities. Their stories revealed a different ‘money' value between gaining and losing regarding online international HE experiences at ‘homes', and the disadvantages they experienced at host countries/universities. Our participants experienced temporal flexibility, temporal conflicts and temporal asymmetry simultaneously. Such spatial and temporal complexities intertwined with each other, making international student experience (ISE) during the COVID-19 unique. This article contributes to understanding of ISE and internationalisation of HE for a post-pandemic era. © 2023 HERDSA.

Co-Evolutionary Location-Routing Model of Medical Isolation Areas for Major Public Health Emergencies Considering the Uncertainty of Future Traffic Environment

With the continuous development of the COVID-19 pandemic, the selection of locations for medical isolation areas has not always been optimal for the timely transportation of infected people, or those suspected of being infected. This has resulted in failure to control the rate of spread of infection cases in time. To address this problem, this paper proposes a co-evolutionary location-routing optimization (CELRO) model of medical isolation areas for use in major public health emergencies to develop a rapid location-routing scheme for epidemic isolation, including the selection of locations of medical isolation facilities per area and the optimal route per vehicle to each infected person. Specifically, this paper solves the following two sub-problems: (i) calculate the shortest transportation times and corresponding routes from any medical isolation area to any person infected or suspected of being infected, and (ii) calculate the location scheme for distribution of isolation areas. Different from previous studies, the vehicle operating characteristics and the interference of uncertainty of the traffic environment are considered in the proposed model. To find an appropriate scheme for location of medical isolation areas with the shortest travel times, a co-evolutionary clustering algorithm (CECA), which is a combination of some separated evolutionary programming operations, is proposed to solve the model. Various network sizes and uncertainty combinations are used to design some comparative tests, which aim to verify the effectiveness of the proposed model. In the experiment section, CELRO reduced travel time by at least 14% compared with other methods. This finding can provide an effective theoretical basis for optimizing the spatial layout of medical isolation areas or the location planning of new medical facilities. © National Academy of Sciences.

Updated efficacy and safety of taletrectinib in patients (pts) with ROS1+ non-small cell lung cancer (NSCLC)

Background Taletrectinib is a potent, next-generation, CNS-active, ROS1 tyrosine kinase inhibitor (TKI) with selectivity over TRKB. In previous reports from TRUST-I, taletrectinib showed meaningful clinical efficacy and was well tolerated in pts with ROS1+ NSCLC (n = 109) regardless of crizotinib (CRZ) pretreatment status. We report updated efficacy and safety data with ~1.5 yr follow-up. Methods TRUST-I is a multicenter, open-label, single-arm study with two cohorts: ROS1 TKI-naive and CRZ-pretreated. Pts in both cohorts received taletrectinib 600 mg QD. Key study endpoints included IRC-confirmed ORR (cORR), DoR, disease control rate (DCR), PFS, and safety. A pooled analysis of ORR, PFS, and safety including pts from additional clinical trials was also conducted. Results In the 109 pts from TRUST-I (enrolled prior to Feb 2022) the median follow-up was 18.0 mo in TKI-naive (n = 67) and 16.9 mo in CRZ-pretreated pts (n = 42). cORR was 92.5% in TKI-naive and 52.6% in CRZ-pretreated pts (table). Median DoR (mDoR) and mPFS were not reached. Intracranial-ORR was 91.6%;ORR in pts with G2032R was 80.0%. In a pooled analysis with phase I studies, ORR was 89.5% and 50.0% for TKI-naive and CRZ-pretreated pts, respectively;mPFS was 33.2 mo and 9.8 mo. In 178 pts treated at 600 mg QD, treatment-emergent adverse events (TEAEs) were 92.7%;most (64.0%) were grade 1-2. The most common TEAEs were increased AST (60.7%), increased ALT (55.6%), and diarrhea (55.6%). Neurological TEAEs (dizziness, 18.5%;dysgeusia, 12.4%) and discontinuations due to TEAEs (3.4%) were low. Further updated results will be presented. [Formula presented] Conclusions With additional follow-up, taletrectinib continued to demonstrate meaningful efficacy outcomes including high response rates, prolonged PFS, robust intracranial activity, activity against G2032R, and tolerable safety with low incidence of neurological AEs. Clinical trial identification NCT04395677. Editorial acknowledgement Medical writing and editorial assistance were provided by Arpita Kulshrestha of Peloton Advantage, LLC, an OPEN Health company, and funded by AnHeart Therapeutics, Inc Legal entity responsible for the study AnHeart Therapeutics, Inc. Funding AnHeart Therapeutics, Inc. Disclosure S. He: Financial Interests, Personal, Other, Employment: AnHeart Therapeutics. T. Seto: Financial Interests, Institutional, Research Grant: AbbVie, Chugai Pharmaceutical, Daiichi Sankyo, Eli Lilly Japan, Kissei Pharmaceutical, MSD, Novartis Pharma, Pfizer Japan, Takeda Pharmaceutical;Financial Interests, Personal, Other, Employment: Precision Medicine Asia;Financial Interests, Personal, Speaker's Bureau, Honoraria for lectures: AstraZeneca, Bristol-Myers Squibb, Chugai Pharmaceutical, Covidien Japan, Daiichi Sankyo, Eli Lilly Japan, Kyowa Hakko Kirin, MSD, Mochida Pharmaceutical, Nippon Boehringer Ingelheim, Novartis Pharma, Ono Pharmaceutical, Pfizer Japan, Taiho Pharmaceutical, Takeda Pharmaceutical, Towa Pharmaceutical. C. Zhou: Financial Interests, Personal, Other, Consulting fees: Innovent Biologics Qilu, Hengrui, TopAlliance Biosciences Inc;Financial Interests, Personal, Speaker's Bureau, Payment or honoraria: Eli Lilly China, Sanofi, BI, Roche, MSD, Qilu, Hengrui, Innovent Biologics, C-Stone LUYE Pharma, TopAlliance Biosciences Inc, Amoy Diagnositics, AnHeart. All other authors have declared no conflicts of interest.Copyright © 2023 International Association for the Study of Lung Cancer. Published by Elsevier Inc.

The COVID-19 Pandemic Experience for Patients with Central Nervous System (CNS) Tumors: Differences in Patient- Reported Outcomes (PROs) and Practice Recommendations

Background/Purpose: The COVID-19 pandemic and associated mitigation procedures have significantly altered daily life in ways that may disproportionately affect patients with CNS tumors. This study aimed to explore differences in symptom burden and interference, mood disturbance, and health-related quality of life in the CNS tumor patient population during the COVID-19 pandemic, compared to a normative sample of pre-pandemic data. Method(s): Data from the Neuro-Oncology Branch (NOB) Natural History Study, including demographic and clinical data, as well as PROs including PROMIS Anxiety and Depression Short-Forms, EQ- 5D-3L, MDASI-Brain Tumor/Spine Tumor, and NeuroQOL-Cognition Function, were collected and compared across groups ('NOB normative sample' and 'COVID year' patients) using one-sample proportion tests. Result(s): 178 COVID year CNS tumor patients (55% male, 82% Caucasian, median age 45 years) were compared with 678 NOB normative sample patients with similar demographic and clinical characteristics. Symptom burden remained comparably high during the COVID year compared to the NOB normative sample with the most common moderate-severe symptoms being fatigue (31% vs. 35%), difficulty remembering (28% vs. 24%), drowsiness (22% vs. 25%), disturbed sleep (20% vs. 22%), and distress (20% for both). However, a significantly greater proportion of COVID year assessments endorsed moderate-severe depression on the PROMIS compared to the NOB normative sample (17% vs. 12%, p = 0.023, Cohen's h = 0.22) and moderate-severe depression/anxiety on the EQ-5D-3L was also more prevalent (53% vs. 43%, p = 0.009, Cohen's h = 0.28). There were no other significant differences in PROs between groups. Conclusions and Implications: These findings demonstrated that while objective symptom burden for CNS tumor patients was unchanged, there was an increase in depression reported during the COVID-19 pandemic. Future work should investigate potential pandemic-era interventions for screening, targeting, and improving both mood disturbance and other disease-specific symptoms to improve symptom burden and quality of life.

Oversampling techniques for predicting COVID-19 patient length of stay

COVID-19 is a respiratory disease that caused a global pandemic in 2019. It is highly infectious and has the following symptoms: fever or chills, cough, shortness of breath, fatigue, muscle or body aches, headache, the new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea. These symptoms vary in severity;some people with many risk factors have been known to have lengthy hospital stays or die from the disease. In this paper, we analyze patients' electronic health records (EHR) to predict the severity of their COVID-19 infection using the length of stay (LOS) as our measurement of severity. This is an imbalanced classification problem, as many people have a shorter LOS rather than a longer one. To combat this problem, we synthetically create alternate oversampled training data sets. Once we have this oversampled data, we run it through an Artificial Neural Network (ANN), which during training has its hyperparameters tuned by using bayesian optimization. We select the model with the best F1 score and then evaluate it and discuss it. © 2022 IEEE.

Lipid carriers for mRNA delivery

Messenger RNA (mRNA) is the template for protein biosynthesis and is emerging as an essential active molecule to combat various diseases, including viral infection and cancer. Especially, mRNA-based vaccines, as a new type of vaccine, have played a leading role in fighting against the current global pandemic of COVID-19. However, the inherent drawbacks, including large size, negative charge, and instability, hinder its use as a therapeutic agent. Lipid carriers are distinguishable and promising vehicles for mRNA delivery, owning the capacity to encapsulate and deliver negatively charged drugs to the targeted tissues and release cargoes at the desired time. Here, we first summarized the structure and properties of different lipid carriers, such as liposomes, liposome-like nanoparticles, solid lipid nanoparticles, lipid-polymer hybrid nanoparticles, nanoemulsions, exosomes and lipoprotein particles, and their applications in delivering mRNA. Then, the development of lipid-based formulations as vaccine delivery systems was discussed and highlighted. Recent advancements in the mRNA vaccine of COVID-19 were emphasized. Finally, we described our future vision and perspectives in this field.Copyright © 2023 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences

A Review of Mathematical Models of COVID-19 Transmission

Corona Virus Disease 2019 (COVID-19) is a disease caused by the novel coronavirus, and due to its rapid spread, the World Health Organization has declared it a worldwide outbreak. Since the first case was detected in December 2019, the fight against this deadly disease has begun. Numerous studies have been done on the COVID-19 outbreak's model of dissemination and epidemic patterns. It mainly focuses on the selection of methods, the determination of parameters, and the evaluation of prevention and control measures. Taking the spread of the COVID-19 epidemic as the research object, combined with the current development of the COVID-19 epidemic, this paper sorts out the relevant mathematical models for the study of the spread of COVID-19, among which the models based on Susceptible-Infected-Recovered (SIR) model and Susceptible-Exposed-Infectious-Removed (SEIR) model and the mathematical models combined with these two models are mainly selected. Finally, the importance of reasonable and effective control of parameters and multi-model combined modeling is pointed out in the future. © 2023 Xiaolin Lin, et al.

The Risk of COVID-19 Infection in Individuals with Alopecia Areata

OBJECTIVE: We sought to determine the risk of contracting coronavirus disease (COVID-19) in individuals with alopecia areata (AA) compared to individuals without AA. METHOD(S): We queried the Symphony Health-derived data from the COVID-19 Research Database, and individuals with a diagnosis of AA from 2019 to 2020 were included in the AA cohort. Subjects with no record of AA diagnosis from 2019 to 2020 were randomly placed in the control group in a 4:1 size ratio compared with the AA group. Laboratory-confirmed cases of COVID-19 between January 1, 2020, and September 1, 2021, were identified. RESULT(S): The AA and non-AA cohorts included 73,784 and 280,991 subjects, respectively. The COVID-19 incidence rate ratio (IRR) for adults with AA was 0.72 (95% CI 0.68, 0.76) compared with adults without AA (p<0.001). Within the AA cohort, moderate-severe AA showed a similar decreased risk in COVID-19 infection compared to mild AA. LIMITATIONS: This study is limited by its retrospective nature and the use of ICD-10 codes for the identification of individuals with AA and COVID-19, which may underestimate the true burden of disease. CONCLUSION(S): Individuals with AA have a slightly decreased risk of contracting COVID-19. Notably, it has been demonstrated that interferon-gamma (IFN- gamma) leads to the downregulation of the angiotensin-converting enzyme 2 (ACE2), the SARS-CoV receptor.1 Thus, it is possible that increased levels of IFN- gamma seen in individuals with AA confer some protection against this viral infection.Copyright © 2022 Matrix Medical Communications. All rights reserved.

Etrasimod for the treatment of ulcerative colitis: analysis of infection rates from the phase 3 ELEVATE UC 52 and ELEVATE UC 12 clinical trials

Background: Infections are an important safety concern in patients with IBD and may be due to its therapies, such as corticosteroids. Etrasimod is an investigational, once-daily, oral, selective sphingosine 1-phosphate receptor 1,4,5 (S1P1,4,5) modulator in development for the treatment of moderately to severely active ulcerative colitis (UC). The biologic effect of etrasimod leads to selective and reversible lymphocyte retention in lymph nodes with a decrease in peripheral lymphocyte count. We report the infection events from the phase 3 ELEVATE programme. Method(s): Infection events were evaluated in the pivotal UC pooled safety analyses set comprising two phase 3 studies: ELEVATE UC 52 (NCT03945188) and ELEVATE UC 12 (NCT03996369). Subjects (16- 80 years) with moderately to severely active UC were randomised 2:1 to once-daily etrasimod 2 mg or placebo (PBO). We report the n (%) and exposure-adjusted incidence rate (EAIR) of infections including serious infections, severe infections, opportunistic infections (including tuberculosis), and herpes infections. Infections were considered adverse events of special interest (AESI) if they were severe (>= CTCAE Grade 3), were opportunistic infections, or were herpes zoster or herpes simplex infections. Result(s): From the pooled ELEVATE UC 12 and ELEVATE UC 52 trials, 527 subjects received >=1 dose of etrasimod 2 mg (265.6 subject-years of exposure) and 260 subjects were randomised to PBO (103.0 subjectyears of exposure). Infections were similar between treatment groups (etrasimod: 99 [18.8%], EAIR=0.41;PBO: 46 [17.7%], EAIR=0.52). The most frequent infections in both groups were COVID-19, urinary tract infections, and nasopharyngitis (Table 1). Serious infections occurred in 3 (0.6%) subjects in the etrasimod arm (EAIR=0.01) and 5 (1.9%) in PBO arm (EAIR=0.05). Two cases of herpes zoster were reported in each treatment group (etrasimod: 0.4%, EAIR<0.01;PBO: 0.8%, EAIR=0.02);these were localised and nonserious. One opportunistic infection was reported in each arm (etrasimod: Subject withdrew from the study on day 20, the AE of Cytomegalovirus infection [Grade 2] was reported on day 36;PBO: Tuberculosis [Grade 2]). Overall, 3 cases of infection led to discontinuation: 2 in the etrasimod arm (both mild) and 1 in the PBO arm (Table 2). No subject with an absolute lymphocyte count <0.2x109/L subsequently reported a serious/ severe or opportunistic infection. There were no deaths. Downloaded from https://academic.oup.com/ecco-jcc/article/17/Supplement-1/i689/7010119 by guest on 04 February 2023 Sample output to test PDF Combine only i690 Poster presentations In these trials, etrasimod-treated subjects reported no in-crease in infections relative to PBO. Serious infections and herpes zoster were more commonly reported in the PBO-treated group. Longer-term follow-up data from the ongoing 5-year open-label extension will fur-ther characterize the etrasimod safety profile.

Farmer Households' Livelihood Resilience in Ethnic Tourism Villages: A Case Study of the Wuling Mountain Area, China

Farmer households in tourist villages have been severely impacted by the COVID-19 pandemic, and the recovery of livelihood is proving difficult. In order to improve farmer households' ability to cope with external shocks, we have applied the theoretical framework of resilience to study farmer households' livelihood in ethnic tourism villages. Based on the survey data of 480 farmer households from 10 ethnic tourism villages in the Wuling Mountain area, this study constructs a livelihood resilience evaluation index system from three of the following dimensions: buffer capacity, adaptive capacity, and transformation capacity. These households are classified into three types: government-led, company-led, and community-led. In addition, the livelihood resilience and its influencing factors of each type is quantitatively assessed. The results show that the livelihood resilience of farmer households administered by the government, companies, and communities is 0.2984, 0.3250, and 0.2442, respectively. Government-led farmer households have the greatest transformation capacity, company-led farmer households have the largest buffer capacity and adaptive capacity, and community-led farmer households have the least capacity across the board. The results indicated that the company-led management of tourism development is currently the most appropriate mode of management for the local area. Four factors, namely, the number of family members engaged in tourism, the training opportunities for the development of professional skills, the education level of core family members, and the type of assistance subsidy available to a family, are the dominant obstacle factors with respect to the livelihood resilience of different types of farmer households. Finally, some recommendations are made to improve the farmer households' livelihood resilience in ethnic tourism villages based on two aspects of organization management and farmer households' behavior. The findings of this study can be used as a theoretical foundation for future research on farmer households' resilience to poverty in underdeveloped ethnic tourism villages. © 2022 by the authors.