An Improved Granulated Convolutional Neural Network Data Analysis Model for COVID-19 Prediction

As COVID-19 poses a major threat to people's health and economy, there is an urgent need for forecasting methodologies that can anticipate its trajectory efficiently. In non-stationary time series forecasting jobs, there is frequently a hysteresis in the anticipated values relative to the real values. The multilayer deep-time convolutional network and a feature fusion network are combined in this paper's proposal of an enhanced Multilayer Deep Time Convolutional Neural Network (MDTCNet) for COVID-19 prediction to address this problem. In particular, it is possible to record the deep features and temporal dependencies in uncertain time series, and the features may then be combined using a feature fusion network and a multilayer perceptron. Last but not least, the experimental verification is conducted on the prediction task of COVID-19 real daily confirmed cases in the world and the United States with uncertainty, realizing the short-term and long-term prediction of COVID-19 daily confirmed cases, and verifying the effectiveness and accuracy of the suggested prediction method, as well as reducing the hysteresis of the prediction results.

Impact of the COVID-19 pandemic on patients with osteogenesis imperfecta

OBJECTIVES: On March 11, 2020, the WHO classified COVID-19 as a global pandemic. Measures to quell the pandemic included limiting non-essential activities including clinic visits and procedures. It is unclear if individuals with OI had disruptions in their access to healthcare or medications, and if such disruptions affected patients' symptoms. METHOD(S): A REDCap survey was distributed through the OI Foundation on August 31. Surveys completed through September 11 by individuals with OI or their caregiver are included in this analysis. Participants were asked to compare their symptoms and access to healthcare during the first 4 months of the pandemic to the 4 months before the pandemic. RESULT(S): 85 surveys were completed, and 6 were partially completed. The median age of participants was 40 years;35% were children. 32% of participants self-identified as having severe OI. Although most reported no changes in bone pain or fractures, 46% reported they were less likely to seek emergency medical care to treat a fracture, while 33% reported they were more likely to treat fractures at home (Fig 1A). There were delays in accessing all services, with greatest delays accessing dentistry (74%) and aquatic therapy (84%) (Fig 1B). 36% of participants receiving bisphosphonate infusions had delayed infusions because of the pandemic (Fig 1C). Of note, 50% of planned surgeries were delayed. CONCLUSION(S): Although many individuals with OI and their caregivers reported delays in accessing bone-related services/clinics during this 4-month period, there was not a concomitant increase in reported symptoms. This may have related to shelter-in-place restrictions and decreased activity. Limitations of this study include small sample size and potential selection bias because responses were obtained only from OIF members. To address these limitations, we are distributing the survey through healthcare providers of individuals with OI across major regions of the US from a variety of practice types including endocrine, orthopedics and multidisciplinary clinics. Furthermore, as the COVID-19 pandemic continues, we hope that this survey will provide information to address what aspects of healthcare may be in greatest need, as well as the modality through which services may be met. (Figure Presented).

Effect of the capsid assembly modulator (CAM) ALG-000184 on HBsAg Levels in subjects with HBeAg positive chronic hepatitis B (CHB)

Background: ALG-000184 is a prodrug of ALG-001075, a novel, potent, pan-genotypic Class II CAM. CAMs are thought to have two mechanisms of action (MoA). The primary MoA affects pgRNA encapsidation resulting in inhibition of HBV DNA/RNA replication, as confirmed in CHB subjects receiving ALG-000184. The secondary MoA, which occurs at higher concentrations, regulates the establishment and replenishment of cccDNA, resulting in lowering of HBsAg, an effect that has not been reported to date with ALG- 000184. Method(s): ALG-000184-201 is a multi-part, multicenter, doubleblind, randomized, placebo-controlled study. In healthy volunteers (HVs), single doses up to 500 mg and multiple doses up to 250 mg were well tolerated with linear PK (Gane E., HBV TAG and APASL 2021). In treatment naive (TN) subjects with CHB, daily oral doses of 10-100 mg ALG-000184 for 28 days were well tolerated with linear PK and were associated with profound reductions of DNA/RNA regardless of HBeAg status or dose (Yuen MF, EASL 2022). Plasma exposures required to engage the secondary MoA are expected to be achieved at the 300 mg dose level. Data from a 300 mg cohort treated for 28 days are described here. Data from another ongoing cohort treated with 300 mg for 12 weeks will be presented at the conference. Result(s): Ten subjects were randomized to 300 mg ALG-000184 for 28 days and two to placebo. Two subjects randomized to ALG- 000184 were replaced due to missing data due to Covid-19 lockdown. Subjects were Asian, HBeAg positive, and genotype B or C. Mean baseline HBV DNA and RNA levels were 8.4 log10 IU/mL and 7.3 log10 copies/mL, respectively. One subject experienced a serious adverse event (AE) of pneumothorax>8 weeks after last dose which was considered unlikely related to study drug. No subjects prematurely discontinued study drug. All treatment emergent AEs were Grade <= 2 except for 4 Grade >= 3 alanine aminotransferase (ALT) elevations, which an independent ALT Flare Committee assessed as not related to study drug toxicity. PK was similar to HBeAg negative and HV cohorts following body weight adjustment. Subjects dosed with 300 mg ALG-000184 experienced mean declines of 4.0 log10 IU/mL and 2.6 log10 copies/mL in HBV DNA and RNA levels, respectively, at Day 28. Three of 7 evaluable subjects who received ALG-000184 had HBsAg declines>0.2 log10 IU/mL (0.23-0.78 log10 IU/mL). One subject receiving ALG-000184 had unquantifiable HBsAg throughout the study. Additionally, one HBeAg positive subject in a prior 100 mg cohort had plasma exposures equivalent to the 300 mg dose level and experienced a 0.5 log10 IU/mL HBsAg decline. Conclusion(s): In TN HBeAg positive CHB subjects, 300 mg ALG- 000184 for 28 days was well tolerated, exhibited predictable PK and resulted in rapid and substantial declines in HBV DNA and RNA. Notably, 3 of 7 evaluable subjects from this cohort experienced HBsAg declines of up to 0.78 log10 IU/mL. These data suggest that ALG-000184 can engage the secondary MoA of CAM II. Cohorts evaluating 300 mg over longer durations are planned or ongoing.

Analysis of how different disease control and prevention strategies influence the spread of COVID-19 in a susceptible-infected-quarantined-recovered-died model

This paper analyzes the influence different disease control and prevention strategies on the out- break of COVID-19 in a susceptible-infected-quarantined-recovered-died (SIQDR) model. This paper builds a continuous dynamical system model and a discrete Monte Carlo model to simulate the spread of COVID-19. This paper discusses how different control and prevention policies affect the spread of COVID-19. Besides, this paper also measures the impact of different policies on the economy to help the government choose a more appropriate policy. © 2023 SPIE.

From Yellow Peril to Model Minority: Asian stereotypes in social media during the COVID-19 pandemic

Heightened racial tensions during the COVID-19 pandemic contributed to the increase and rapid propagation of online hate speech towards Asians. In this work, we study the relationship between the racist narratives and conspiracy theories that emerged related to COVID-19 and historical stereotypes underpinning Asian hate and counter-hate speech on Twitter, in particular the Yellow Peril and model minority tropes. We find that the pandemic catalyzed a broad increase in discourse engaging with racist stereotypes extending beyond COVID-19 specifically. We also find that racist narratives and conspiracy theories which emerged during the pandemic and gained widespread attention were rooted in deeply-embedded Asian stereotypes. In alignment with theories of idea habitat and processing fluency, our work suggests that historical stereotypes provided an environment vulnerable to the racist narratives and conspiracy theories which emerged during the pandemic. Our work offers insight for ongoing and future anti-racist efforts. © 2023 ACM.

A Joint Analysis of Two Randomized Controlled Trials on Enoxaparin for Covid-19

Background: COVID-19 carries a high risk of vascular thrombosis. This joint analysis of two randomized-controlled trials (RCTs) aims to assess the safety and efficacy of enoxaparin at therapeutic dose compared to prophylactic dose in people hospitalized with COVID-19. Method(s): A joint analysis of two RCTs, COVID-19 HD (NCT044082359) and EMOS-COVID (NCT04646655), was performed. Both studies enrolled inpatients with COVID-19- associated respiratory compromise (as identified by respiratory rate >=25 breaths/min or arterial oxygen saturation <=93% at rest or PaO2/FiO2 <=300 mmHg for COVID-19 HD and by PaO2/FiO2 <=250 mmHg for EMOS-COVID) and/or coagulopathy (D-dimer > 2000 ng/ml for both RCTs or sepsis-Induced coagulopathy score >4 for COVIDHD). In both RCTs patients were randomly assigned to two arms: enoxaparin at prophylactic dose (standard 4.000 IU;in the EMOS-COVID 6000 IU if body weight >100 kg) and at therapeutic dose (70 U/Kg every 12 h). The primary efficacy endpoint of the joint analysis was clinical worsening, defined as the occurrence of at least one among: in-hospital death;acute myocardial infarction;symptomatic arterial or venous thromboembolism;need of either Continuous Positive Airway Pressure (Cpap) or Non-Invasive Ventilation (NIV) in patients who were in standard oxygen therapy at randomization;need for IMV in any patient. The primary outcome was assessed as time-to-event, described with hazard ratio (HR) and with Kaplan-Meier survival estimate. The primary safety endpoint was major bleeding for both trials and for the joint analysis. Result(s): COVID-19 HD enrolled 142 people between July 2, 2020 and February 15, 2022, while EMOS-COVID enrolled 141 people from July 27, 2020 to June 5, 2021, resulting in 283 patients included in this joint analysis. Two-hundredseven (73.1%) were males, with a mean age of 61.1 years (SD +/-10.7), a mean BMI of 29.7 kg/m2 (SD +/-5.0), and 115 (40.6%) were on NIV or Cpap at randomization, with no significant difference between the study groups. 21/139 people in the high dose group reached the primary endpoint compared to 32/144 in the prophylactic group (HR 0.63, 95%CI 0.36 to 1.10). Figure 1 shows the Kaplan- Meier survival estimates of clinical worsening. No major bleeding was observed during the study time. Conclusion(s): The results of this joint analysis did not highlight significant differences in clinical worsening between COVID-19 patients that received enoxaparin at therapeutic compared to prophylactic dose. (Figure Presented).

Reform and Practice of "Integrated” Innovation and Entrepreneurship Education Based on New Engineering

Build and practice innovation and entrepreneurship education reform combining the revision of training programs with experimental platform construction under the background of new engineering. The reform solves the problems of poor cognition, low positioning, and an imperfect practical teaching system. The reform also provides a coping strategy for the highly difficult situation of student employment in the context of COVID-19. Based on improving the experimental platform and following the OBE (Outcome Based Education) education concept, the "integrated” innovation and entrepreneurship education reform and practice plan appears. It builds a progressive, organic, scientific, and reasonable experimental teaching system. It forms a platform to consolidate primary practical teaching, improve professional practical ability, exercise innovation and entrepreneurship ability. Based on "course ideology and politics”, the reform enhances the quality of teachers and creates a good atmosphere for students to establish correct socialist core values. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Telecytology Makes Significant Contribution in ROSE with Great Accuracy - Experience During the COVID-19 Pandemic at Stony Brook University Hospital

Introduction: Telecytology (TC) has been used in rapid onsite evaluation (ROSE) of touch preparations (TPs) from core biopsies and smears from fine-needle aspiration (FNA) procedures. Although TC was established at our institution in 2010, utilization has fluctuated. The COVID-19 pandemic highlighted the value of TC for maintaining high-quality patient care with the advantages of minimizing contact with hospital personnel and patients, conserving personal protective equipment (PPE), and saving cytopathologists' time. However, the accuracy of TC compared to on site evaluation by cytopathologists has been a concern. This study aimed to address this question. Material(s) and Method(s): 697 ROSEs were identified from our quality assurance (QA) data base in 2021 (Q2-Q4) including 1) TC;2) onsite cytopathologist (OC);and 3) onsite cytotechnologistonly (OCT). Discrepancy rates between ROSE and final diagnoses were compared between TC and OC groups. A student T-test was performed to determine the statistical significance of the discrepancy rate between TC and OC. Result(s): Results are summarized in Table 1. On average, there were 26% FNA and 74% Cores by TP. The difference in discrepancy rates between TC and OC during the 3 quarters in 2021 is not statistically significant (p=0.5012). The type of discrepancy for TC was all minor while 17% major and 83% minor for OC. Conclusion(s): The value of TC for ROSE was highlighted during the pandemic, allowing cytopathologists to participate in ROSE while minimizing interpersonal contact at procedures, conserving PPE, and saving cytopathologists' time. TC provides as high quality as OC for ROSE service with statistically insignificant minor discrepancies with the final diagnosis. Although pandemic-related restrictions are easing, we anticipate that TC will continue to play a major role in ROSE.

An Evidence Study of Long-term Impacts on Mobility Patterns Brought by COVID-19

The outbreak of COVID-19 at the end of 2019 has posed an enormous threat to people's physical and psychological health, especially those who are infected during the epidemic. Understanding how the infected people behaved during the pandemic and whether long-term effects are exerted even after they were cured is essential for guiding them to conduct a more comprehensive recovery. Large scale crowd-sourced data provides a chance to investigate their behavior patterns. In this paper, we explore the possible differences in mobility patterns between the infected and the uninfected, relying on a large volume of crowd -sourced location data contributed by smartphone users consisting of 11,414 infected cases and 12,793 uninfected people between Jun. 1, 2019 and Dec 31, 2020 in Wuhan, China. We characterize mobility distinctions of the two groups by introducing five mobility indicators that accurately capture spatio-temporal patterns of human mobility. We reveal that the infected kept higher mobility level during the pandemic. Moreover, the COVID-19 caused lower recovery efficiency on mobility of the infected, including later recovery time, lower speed and worse status. © 2022 IEEE.

Incidence and Severity of Type 1 Diabetes Mellitus during COVID-19 Pandemic

Background. The COVID-19 pandemic continues to impact healthcare overall particularly in relation to diabetes. Initial studies showed delays in emergent healthcare utilization, decreased preventative care visits, and more severe presentations of new onset diabetes. However, the pathophysiologic relationship between COVID-19 and type 1 diabetes is not yet well understood. Objective(s): Our primary objective was to compare the annual rates of new type 1 diabetes diagnoses between the pre-pandemic (1/2015-12/2019) and pandemic (1/2020-12/2021) periods. We hypothesized that the number of new-onset pediatric cases of type 1 diabetes increased during the COVID-19 pandemic compared to the preceding 5-year period. Method(s): We performed a retrospective review of EMR data from one pediatric tertiary care center from 1/1/2015 to 12/31/2021. Initial data were extracted based on ICD-10 codes (E08, E09, E10, E11, E13). Data were validated and excluded according to the following criteria: age >21 years at diagnosis, diagnosis date outside of study period, confirmed other form of diabetes, complex disease without confirmed auto-antibodies, and inadequate data at time of diagnosis. Result(s): Ultimately 1,057 patients met inclusion criteria. In the pre-pandemic period annual new onset cases ranged from 120-147 cases/year with a mean of 135.4 (Table 1). During the COVID-19 pandemic a mean of 182.5 cases/year were diagnosed (168 in 2020 and 197 in 2021). Cases increased 16% from 2019 to 2020 and further increased 17% from 2020 to 2021. Overall, cases increased 35% during the pandemic period (2020-2021) compared to the pre-pandemic period. Prior to the sharp rise in cases, new diagnoses declined in February-May 2020 (4 cases/ month in May 2020 compared to pre-pandemic average of 11.6 cases/month). Discussion(s): Quantifying the increase in new diagnoses of type 1 diabetes during the COVID-19 pandemic is important to understand the true impact of the global health crisis on this population. The increase in cases during the pandemic is likely multifactorial and continuing to understand this relationship may have important implications for public health policy and understanding type 1 diabetes pathophysiology in the future.

When and how digital platforms empower professional services firms: an agility perspective

PurposeDrawing on a strategic agility perspective, the authors develop a theoretical framework and empirically examine how digital platform adoption and capability impact business performance via digital-enabled strategic agility in the context of professional service firms.Design/methodology/approachThe authors propose and examine a conceptual framework based on survey data from 127 professional service firms in New Zealand.FindingsThis study reveals the impact of digital platform capability on the business performance of professional service firms that employ digital platform technologies. The results suggest that organizational innovation and managers' creative efficacy will be used as distal antecedents and contribute to digital platform capabilities. In addition, digital strategic agility can mediate the link between digital platform capabilities and business performance.Originality/valueThis study is one of the first to investigate when and how digital platforms empower professional service firms. This study reveals the role of digital strategic agility and digital platform capabilities in knowledge-intensive enterprises. This research advances the development of knowledge-based economy in the information age by applying and extending strategic agility to the uncertain and volatile business environment. The authors' new conceptualization provides a deeper understanding of how and why professional services business and organizations can adapt to the post-COVID era smoothly and successfully.

Leveraging Human Mobility Data for Efficient Parameter Estimation in Epidemic Models of COVID-19

Effectively predicting the evolution of COVID-19 is of great significance to contain the pandemic. Extensive previous studies proposed a great number of SIR variants, which are efficient to capture the transmission characteristics of COVID-19. However, the parameter estimation methods in previous studies are based on data from epidemiological investigations, which inevitably have caused a large delay. The popularity of digital trajectory data world-wide makes it possible to understand epidemic spreading from human mobility perspective. The major advantage of digital trajectory data lies in that the co-location level of a population is reflected at every moment, making it possible to forecast the evolution in advance. We showed that the mobility data contributed by mobile phone users could be exploited to estimate the contact probability between individuals, thus revealing the dynamic transmission of COVID-19. Specifically, we developed an estimation method to obtain human co-location levels and quantified the variations of human mobility during the epidemic. Then, we extended the infection rate with a real-time co-location level to further forecast the transmission of an epidemic, predicting the epidemic size much more accurately than conventional methods. Finally, the proposed method was applied to evaluate the quantitative effect of different non-pharmacological interventions by predicting the epidemic situations with various mobility characteristics. The empirical results and simulations corroborated our theoretical analysis, providing effective guidance to contain the pandemic. IEEE

Analysis of National Surveillance Data to Support Case Definition Revisions for Multisystem Inflammatory Syndrome in Children (MIS-C), United States, February 2020-April 2022

Background. Classification of MIS-C, COVID-19, and other pediatric inflammatory conditions is challenged by phenotypic overlap and absence of diagnostic laboratory evidence. Due to public health need and based on limited data from early cases, CDC developed a necessarily broad MIS-C surveillance case definition in May 2020. Studies have since shown that some criteria do not distinguish between MIS-C and other conditions and may contribute to misclassification. To inform planned revision to the CDC definition, we evaluated the impact of narrowing these criteria on case inclusion in national MIS-C surveillance. Methods. Of state and local health-department reported cases meeting the current MIS-C case definition as of 04/14/2022, we describe the proportion that met revised criteria under consideration including fever duration, C-reactive protein (CRP) elevation using a defined cutoff, and organ involvement represented by specific criteria. We also evaluated cases identified using potential combinations of revised criteria. Results. Of 8,096 MIS-C cases fulfilling the original case definition, 6,332 (78%) had sufficient data for evaluation of criteria. Of these, 96% had fever for >=2 days and 94% had a CRP >= 3.0 mg/dL (Table 1). Cardiac involvement defined by key features of MIS-C was present in 84% of cases (62% if BNP/proBNP elevation was excluded);43% had shock. Dermatologic, gastrointestinal (GI) and hematologic involvement were present in 75%, 89% and 37% of cases, respectively. Neurologic (excluding headache), renal, and respiratory involvement were present in 16%, 20%, and 63% of cases, respectively. The number of cases with >= 2 of cardiac (without BNP/proBNP elevation), shock, dermatologic, GI, or hematologic involvement was 5,733 (91%). SARS-CoV-2 testing results are shown in Table 2. Conclusion. The CDC MIS-C case definition is intentionally broad. Using national surveillance data, we evaluated case inclusion under narrower criteria, prioritizing features of MIS-C that distinguish it from similar pediatric inflammatory conditions. A surveillance case definition may not capture all cases and is not intended to replace clinical judgment. We plan to assess additional criteria combinations, describe potentially excluded cases, and incorporate findings into a revised definition.

Multisystem Inflammatory Syndrome in Children (MIS-C) in Persons Fully Vaccinated with Two Doses of mRNA COVID-19 Vaccine Compared with Persons with Partial or No Vaccination Reported, U.S. National MIS-C Surveillance

Background. CDC began collecting COVID-19 vaccination status of persons with MIS-C as part of national surveillance inMay, 2021. We describe and compare MIS-C in fully vaccinated persons withMIS-C in persons with partial or no vaccination reported. Methods. We identified COVID-19 vaccine age-eligible persons meeting the CDC MIS-C case definition reported by health departments as of March 28, 2022 and divided theminto 3 groups for this analysis: 1) fully vaccinated (receipt of a 2-dosemRNAprimary vaccine series with MIS-C onset >=28 days after vaccine dose 2 to account for the delay between infection and MIS-C), 2) partially vaccinated (MIS-C onset after dose 1 or < 28 days from dose 2 or receipt of Janssen [Johnson & Johnson] vaccine and 3) no vaccination reported. We compared characteristics between the groups. Results. Of 7,880 MIS-C cases reported, 1,085 were vaccine eligible: 45 were fully vaccinated, 64 partially vaccinated, and 976 had no vaccine reported. Demographic characteristics were similar, although the Northeast had the lowest percentage of persons with vaccination not reported (Table). Though not statistically significant, fully vaccinated persons less frequently had severe cardiac involvement (67% vs 74%), shock (33% vs 44%), severe hematologic involvement (47% vs 54%), and mucocutaneous involvement (53% vs 63%) compared with those with no vaccine reported (Table). Forty-four percent of those fully vaccinated required ICU-level care vs 59% with no vaccine reported (p=0.053). Nineteen (2%) of those without vaccine reported died;no fully or partially vaccinated persons died. (Table Presented) Conclusion. Persons who acquire SARS-CoV-2 infection after being fully vaccinated can develop MIS-C, with similar clinical characteristics to those with no vaccination reported. A lower but not statistically significant percentage of fully vaccinated persons required ICU-level care compared with those without vaccination, and there were no deaths in the fully vaccinated group. These data do not account for trends in MIS-C over time, including the influence of circulating SARS-CoV-2 variants on MIS-C clinical manifestations. We will continue to evaluate these comparisons as the sample size of reported MIS-C cases increases.

A Case-Control Study Investigating Household, Community, and Clinical Risk Factors Associated with Multisystem Inflammatory Syndrome in Children (MIS-C) after SARS-CoV-2 Infection

Background. Risk factors for MIS-C, a rare but serious hyperinflammatory syndrome associated with SARS-CoV-2 infection, remain unclear. We evaluated household, clinical, and environmental risk factors potentially associated with MIS-C. Methods. This investigation included MIS-C cases hospitalized in 14 US pediatric hospitals in 2021. Outpatient controls were frequency-matched to case-patients by age group and site and had a positive SARS-CoV-2 viral test within 3 months of the admission of their matched MIS-C case (Figure 1). We conducted telephone surveys with caregivers and evaluated potential risk factors using mixed effects multivariable logistic regression, including site as a random effect. We queried regarding exposures within the month before hospitalization for MIS-C cases or the month after a positive COVID-19 test for controls. Enrollment scheme for MIS-C case-patients and SARS-CoV-2-positive outpatient controls. MIS-C case-patients were identified through hospital electronic medical records, while two outpatient controls per case were identified through registries of outpatient SARS-CoV-2 testing logs at facilities affiliated with that medical center. Caregivers of outpatient controls were interviewed at least four weeks after their positive test to ensure they did not develop MIS-C after their infection. Results. We compared 275 MIS-C case-patients with 494 outpatient SARS-CoV-2-positive controls. Race, ethnicity and social vulnerability indices were similar. MIS-C was more likely among persons who resided in households with >1 resident per room (aOR=1.6, 95% CI: 1.1-2.2), attended a large (>=10 people) event with little to no mask-wearing (aOR=2.2, 95% CI: 1.4-3.5), used public transportation (aOR=1.6, 95% CI: 1.2-2.1), attended school >2 days per week with little to no mask wearing (aOR=2.1, 95% CI: 1.0-4.4), or had a household member test positive for COVID-19 (aOR=2.1, 95% CI: 1.3-3.3). MIS-C was less likely among children with comorbidities (aOR=0.5, 95% CI: 0.3-0.9) and in those who had >1 positive SARS-CoV-2 test at least 1 month apart (aOR=0.4, 95% CI: 0.2-0.6). MIS-C was not associated with a medical history of recurrent infections or family history of underlying rheumatologic disease. Conclusion. Household crowding, limited masking at large indoor events or schools and use of public transportation were associated with increased likelihood of developing MIS-C after SARS-CoV-2 infection. In contrast, decreased likelihood of MIS-C was associated with having >1 SARS-CoV-2 positive test separated by at least a month. Our data suggest that additional studies are needed to determine if viral load, and/or recurrent infections in the month prior to MIS-C contribute to MIS-C risk. Medical and family history were not associated with MIS-C in our analysis.

Three Necessities of Inbound and Outbound Tourism in China after COVID-19

Global tourists have started to conquer their fear and anxiety, recover travel interest instead, while mounting countries have paused territorial lockdown. Municipal administration and civic willingness also offer hope to tourism in China. Chinese inbound and outbound tourism is coming into light. Among those entry-exit travel demand, three necessary travel motivations overwhelm leisure orientation, namely family-visiting, medical and business demand.

[Clinical characteristics of patients infected with 2019-nCoV Omicron variants BA.2 and BA.5 in Xi'an city, China].

Objective: To analyze the epidemiological and clinical characteristics of patients infected with different subtype of 2019-nCoV Omicron variants BA.2 and BA.5 in Xi'an city. Methods: A retrospective observational study was conducted to collect data of 168 patients infected with Omicron variant admitted to the designated hospital for COVID-19 charged by Xi'an Chest Hospital during 2022. Data were collected including epidemiological, clinical features, laboratory and viral load, and the difference between BA.2 and BA.5 subtype was analyzed. Results: A total of 168 patients were admitted, including 122 cases infected with BA.2 subtype, and 46 cases infected with BA.5 subtype. Patients infected with BA.2 subtype had a higher rate of cough than BA.5 subtype (43.44%∶23.91%; P=0.021). Compared with the Omicron variant BA.2, patients infected with BA.5 subtype had a higher proportion of asymptomatic and mild infections (89.13%∶68.85%; P<0.001), higher rate of vaccination (95.66%∶68.03%; P<0.001), shorter time to nucleic acid negative conversion (8.62; P=0.047), and a higher viral load at admission (P=0.005, P=0.017). Conclusions: The Omicron variant is extremely infectious with aggregated onset, but its clinical symptoms are mild. The vaccine, especially the booster vaccination, remains effective in preventing severe stage progression and improving prognosis in patients with Omicron variant infection.

Identification of a red cell hemostatic mechanism causing COVID-19 microvascular obstruction

Background: Severe COVID-19 infection is associated with a wide spectrum of clinical manifestations, leading to systemic thromboinflammation and multiorgan dysfunction. The primary cause of multiorgan damage is widespread endothelial injury, leading to microangiopathy and organ ischemia. The molecular mechanisms by which ischemic endothelial cells causes microvascular obstruction remains ill defined. Aim(s): Identification of distinct microvascular occlusion mechanisms in COVID-19. Method(s): The microvasculature of multiple organs from patients dying from COVID-19, myocardial infarction or stroke were analyzed by H&E, immunohistochemistry, SEM and CLEM. Animal models of gut ischemia and stroke were also examined. Intravital confocal microscopy examined endothelial injury and microvascular obstruction mechanisms mediated by platelets, red cells and fibrin. Result(s): We demonstrate the existence of a distinct microvascular hemostatic mechanism mediated by hemolyzed red blood cells (RBC), independent of platelets and fibrin. Extensive RBC hemolysis was apparent in the microvasculature of COVID-19 patients and in humans with major organ ischemia, leading to widespread microvascular obstruction. This RBC hemostatic mechanism was triggered by organ ischemia and associated with localized accumulation of hemolyzed RBCs at sites of endothelial necroptosis. RBC hemolysis was impaired in animals lacking the necroptosis mediator, MLKL or the C9 component of complement, indicating the involvement of cell intrinsic and extrinsic membrane lytic processes. Intravital microscopy revealed that the RBC hemostatic mechanism was triggered by the fragmentation of lyzed RBCs and the deposition of RBC membranes on the surface of dying endothelial cells, forming an endovascular sealant that prevents interstitial bleeding. Conclusion(s): Our studies demonstrate the existence of a previously unidentified microvascular hemostatic mechanism mediated by hemolyzed RBCs. Dysregulation of this hemostatic mechanism is linked to microvascular obstruction and bleeding in COVID-19 and ischemic diseases.

A Comparison of Local-and Foreign-funded Hydropower Station Construction in Nepal based on Remote Sensing

International investors in large infrastructure projects face numerous risks. To explore this issue, this paper compares the development of two hydropower stations in Rasuwa District, Nepal: Upper Trishuli 3A, which is fully funded by a Chinese government bank, and Rasuwagadhi, which is fully funded by local government banks. The construction of these two plants was compared between 2012 and 2020 using a visual interpretation method to extract data on roads, buildings, dams, and vehicles from 1-m-resolution remote sensing imagery. Two methods were used to compare the environmental impacts of each plant. Landsat 7/8 30-m imagery was used to monitor changes in the normalized difference vegetation index around the Upper Trishuli 3A hydropower station from 2012 to 2020 and around the Rasuwagadhi hydropower station from 2014 to 2020. Then, 1-m-resolution imagery was used to observe land-cover differences in these areas and time periods. The results indicate that: (1) despite vari-ous challenges, such as geological disasters, the COVID-19 pandemic, and a blockade by the Indian government, there was no difference in construction progress between the two hydropower stations. (2) The Upper Trishuli 3A Hydropower Station was associated with better environmental protection work, as there were continuous declines in vegetation growth near Rasuwagadhi and increased overall vegetation growth near Upper Trishuli 3A. (3) Energy projects funded by the Belt and Road Initiative have benefited developing countries enormously. Finally, local conditions should be thoroughly investigated during the construction of foreign-funded power stations. © 2022, Editorial office of Journal of Resources and Ecology. All rights reserved.

Research on the spread trend of COVID-19 based on SEIR-C model

The latent and insidious nature of COVID-19 transmission poses a great challenge to epidemic prevention and control. In order to predict its transmission trend more accurately, optimal epidemic prevention and control strategies and measures can be formulated. In this paper, we propose a SEIR-C epidemic transmission trend prediction model, which improves the traditional SEIR infectious disease model and combines it with the GRU model, and experiments show that the model has better results in epidemic transmission prediction. The paper also analyses the situation of isolation measures and vaccines in epidemic prevention and control, providing some reference for the formulation of epidemic prevention and control policies. © 2022 ACM.