GPU libraries speed performance analysis for RCWA simulation matrix operations

Rigorous Coupled Wave Analysis (RCWA) method is highly efficient for the simulation of diffraction efficiency and field distribution patterns in periodic structures and textured optoelectronic devices. GPU has been increasingly used in complex scientific problems such as climate simulation and the latest Covid-19 spread model. In this paper, we break down the RCWA simulation problem to key computational steps (eigensystem solution, matrix inversion/multiplication) and investigate speed performance provided by optimized linear algebra GPU libraries in comparison to multithreaded Intel MKL CPU library running on IRIDIS 5 supercomputer (1 NVIDIA v100 GPU and 40 Intel Xeon Gold 6138 cores CPU). Our work shows that GPU outperforms CPU significantly for all required steps. Eigensystem solution becomes 60% faster, Matrix inversion improves with size achieving 8x faster for large matrixes. Most significantly, matrix multiplication becomes 40x faster for small and 5x faster for large matrix sizes. © 2023 SPIE.

Establishment of differential diagnostic model for COVID-19 and influenza A based on laboratory indicators and its clinical significance. TT -.

Objective:To explore the differences in laboratory indicators test results of coronavirus disease 2019 (COVID-19) and influenza A and to establish a differential diagnosis model for the two diseases, and to clarify the clinical significance of the model for distinguishing the two diseases. Methods :A total of 56 common COVID-19 patients and 54 influenza A patients were enrolled , and 24 common COVID-19 patients and 30 influenza A patients were used for model validation. The average values of the laboratory indicators of the patients 5 d after admission were calculated,and the elastic network model and the stepwise Logistic regression model were used to screen the indicators for identifying COVID-19 and influenza A. Elastic network models were used for the first round of selection,in which the optimal cutoff of lambda was chosen by performing 10-fold cross validations. With different random seeds,the elastic net models were fit for 200 times to select the high-frequency indexes ( frequency>90% ). A Logistic regression model with AIC as the selection criterions was used in the second round of screening uses;a nomogram was used to represent the final model;an independent data were used as an external validation set,and the area under the curve (AUC) of the validation set were calculate to evaluate the predictive the performance of the model. Results:After the first round of screening, 16 laboratory indicators were selected as the high-frequency indicators. After the second round of screening,albumin/ globulin (A/G),total bilirubin (TBIL) and erythrocyte volume (HCT) were identified as the final indicators. The model had good predictive performance , and the AUC of the verification set was 0. 844 (95% CI:0. 747-0. 941). Conclusion:A differential diagnosis model for COVID-19 and influenza A based on laboratory indicators is successfully established,and it will help clinical and timely diagnosis of both diseases.Copyright © 2022 Jilin University Press. All rights reserved.

Disease X Testing: The results of an international external quality assessment exercise

The United Nations Secretary-General Mechanism (UNSGM) for investigation of the alleged use of chemical and biological weapons is the only established international mechanism of this type under the UN. The UNGSM may launch an international investigation, relying on a roster of expert consultants, qualified experts, and analytical laboratories nominated by the member states. Under the framework of the UNSGM, we organized an external quality assurance exercise for nominated laboratories, named the Disease X Test, to improve the ability to discover and identify new pathogens that may cause possible epidemics and to determine their animal origin. The "what-if" scenario was to identify the etiological agent responsible for an outbreak that has tested negative for many known pathogens, including viruses and bacteria. Three microbes were added to the samples, Dabie bandavirus, Mammarenavirus, and Gemella spp., of which the last two have not been taxonomically named or published. The animal samples were from Rattus norvegicus, Marmota himalayana, New Zealand white rabbit, and the tick Haemaphysalis longicornis. Of the 11 international laboratories that participated in this activity, six accurately identified pathogen X as a new Mammarenavirus, and five correctly identified the animal origin as R. norvegicus. These results showed that many laboratories under the UNSGM have the capacity and ability to identify a new virus during a possible international investigation of a suspected biological event. The technical details are discussed in this report.Copyright © 2022

Design of upper limb rehabilitation evaluation system based on deep learning

The topic of non-contact diagnosis became a hot topic during COVID-19 and online consultation gained popularity. In this research, a deep learning-based autonomous limb evaluation system is developed for online consultation and remote rehabilitation training for people with physical limitations. Its main goal is to collect and analyze information about limb states. The patient can evaluate the limb state at home using the mobile app, and the doctor can view the data and connect with the patient via the web's chat module to offer diagnostic opinions. Deep learning is used for the Start/End Attitude Determination Model and OpenCV for the limb and hand evaluation model, with the results being uploaded to the server. © The Authors. Published under a Creative Commons Attribution CC-BY 3.0 License.

Mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors.

Objective To investigate the mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors. Methods A total of 540 military healthcare workers in shelter hospitals in Shanghai were investigated with patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Athens insomnia scale (AIS) to explore their mental health status, and logistic regression was used to analyze the influencing factors. Results A total of 536 valid questionnaires were collected, with an effective rate of 99.3% (536/540). The incidence of depression, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai was 45.5% (244/536), 26.1% (140/536) and 59.5% (319/536), respectively. Logistic regression analysis showed that whether people resided in Shanghai, the proportion of negative information in daily browsing information and diet status in shelter hospitals were the influencing factors of depression, anxiety and insomnia (all P<0.05);age and confidence in the future of Shanghai were the influencing factors of depression and insomnia (all P<0.05);and the time spent daily on epidemic-related information was an influencing factor of insomnia (P=0.021). Conclusion The incidence of depressive, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai is high during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant. Psychological consequences of the epidemic should be monitored regularly and continuously to promote the mental health of military healthcare workers.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors

Objective To investigate the mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors. Methods A total of 540 military healthcare workers in shelter hospitals in Shanghai were investigated with patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Athens insomnia scale (AIS) to explore their mental health status, and logistic regression was used to analyze the influencing factors. Results A total of 536 valid questionnaires were collected, with an effective rate of 99.3% (536/540). The incidence of depression, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai was 45.5% (244/536), 26.1% (140/536) and 59.5% (319/536), respectively. Logistic regression analysis showed that whether people resided in Shanghai, the proportion of negative information in daily browsing information and diet status in shelter hospitals were the influencing factors of depression, anxiety and insomnia (all P<0.05);age and confidence in the future of Shanghai were the influencing factors of depression and insomnia (all P<0.05);and the time spent daily on epidemic-related information was an influencing factor of insomnia (P=0.021). Conclusion The incidence of depressive, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai is high during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant. Psychological consequences of the epidemic should be monitored regularly and continuously to promote the mental health of military healthcare workers.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Early-Career Researchers in China during the Pandemic: Qualitative Evidence from a Longitudinal Study

The outbreak of COVID-19 has changed the world in many aspects, and global scientific research has also been challenged. Early-career researchers (ECRs) who just start academic careers are prominently affected by the pandemic. To explore how Chinese ECRs have been affected, longitudinal qualitative interviews were conducted with twenty-four Chinese ECRs from different disciplines and universities in 2020 and 2021. As the results show, Chinese ECRs worry that their future prospects are limited by increased workloads and reduced productivity. However, the new wave of change did not occur for them, and their work resumed its routine and was relatively stable. Over two years, Chinese ECRs got used to working from home and giving online courses, but they were increasingly confused about when the pandemic will end. What bothers ECRs most is the inefficiency of communication and collaboration due to the travel bans, although they became familiar with the online way. © University of Toronto Press, 2023.

Mediating role of psychological resilience in relationship between stress and anxiety symptoms of medical students in post COVID-19 period

[Background] In the post-pandemic period, attention has been paid to the study of psychological stage changes in various groups. Under the stress of pandemics, how to control negative emotions such as anxiety symptoms will have an important impact on medical students' professional identity and future professional competence. [Objective] This study is designed to explore the characteristics of stress and anxiety symptoms of medical students in different stages of the post COVID-19 period, and potential mediating role of psychological resilience in the relationship between stress and anxiety symptoms. [Methods] By convenience sampling method, 3 000 medical students from three medical colleges in Shaanxi Province were selected and completed an online survey reporting the Self-Rating Anxiety Scale (SAS), Stress Scale for College Student (SSCS), and Resilience Scale of Adults (RSA) to assess their stress, psychological resilience, and anxiety symptoms in September and November 2020. SPSS 25.0 software was used to perform dependent-sample t test, variance analysis, Pearson correlation analysis, and mediating effect test (hierarchical regression analysis). [Results] A total of 2 894 valid questionnaires were recovered and the valid recovery rate was 96.5%. The overall scores of stress, psychological resilience, and anxiety symptoms of selected medical students were 56.61+/-17.17, 166.88+/-28.55, and 40.45+/-9.67, respectively in the post COVID-19 period. The positive rate of high stress was 72.2%, and the positive rate of anxiety symptoms was 16.0%. There were significant differences in anxiety symptoms scores between the high and the low stress level groups (42.16+/-9.92, 35.99+/-7.30) (P < 0.01). There were significant differences in scores of stress, psychological resilience, and anxiety symptoms among different grade groups (P < 0.01). The pearson correlation analysis results showed that the stress score was positively correlated with the anxiety symptom score (r=0.417, P < 0.01) and negatively correlated with the psychological resilience score (r=-0.344, P < 0.01);the psychological resilience score was negatively correlated with the anxiety symptom score (r=-0.495, P < 0.01). The hierarchical regression analysis results found that stress had a positive effect on anxiety symptoms (b=0.280, P < 0.01), and a negative effect on psychological resilience (b=-0.344, P < 0.01);psychological resilience negatively affected anxiety symptoms (b=-0.398, P < 0.01), and played a partial mediating role in the relationship between stress and anxiety symptoms (effect value was 0.137) that accounted for 32.8% of the total effect. [Conclusion] In the post COVID-19 period, medical students have a superposition of high stress and high anxiety symptoms. Psychological resilience is a protective factor for anxiety symptoms and plays a partial mediating role in the relationship between stress and anxiety symptoms.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.

Long-Term Efficacy and Safety of Zanubrutinib in Patients with Relapsed/Refractory (R/R) Marginal Zone Lymphoma (MZL): Final Analysis of the Magnolia (BGB-3111-214) Trial

Introduction: Advanced MZL is generally incurable, with periods of remission and relapse. Zanubrutinib (BGB-3111), a potent and highly specific next-generation Bruton tyrosine kinase (BTK) inhibitor, was approved in the US and Canada for R/R MZL based on the MAGNOLIA primary analysis (BGB- 3111-214;NCT03846427);here, the final MAGNOLIA analysis is presented. Method(s): This was a phase 2, multicenter, single-arm study of adult patients (pts) with R/R MZL (>=1 prior CD20-directed therapy). Zanubrutinib (160 mg twice daily) was given until disease progression or unacceptable toxicity. The primary endpoint was overall response rate (ORR) by independent review committee (IRC) per Lugano classification. Secondary endpoints were investigator-assessed ORR, duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety. Efficacy was assessed by positron emission tomography (PET)-based Lugano criteria for IRC-confirmed fluorodeoxyglucose (FDG)-avid disease at baseline;non-avid disease was assessed by computed tomography (CT)-based criteria. Result(s): As of May 4, 2022, 68 pts were treated (median age=70 y [range 37-95];>=75 y=27.9%). MZL subtypes included extranodal (38.2%), nodal (38.2%), splenic (17.6%), and unknown (5.9%). The median number of prior therapies was 2 (range 1-6);32.4% of pts had disease refractory to last therapy, most (89.7%) had prior chemoimmunotherapy, and 7 (10.3%) had rituximab monotherapy as their only prior treatment. Sixty-one pts (89.7%) had FDG-avid disease. After a median follow-up of 28.0 mos (range 1.6-32.9) and a median treatment duration of 24.2 mos (range 0.9-32.9), 66 pts were efficacy- evaluable. IRC-assessed ORR (complete response [CR]+partial response [PR]) was 68.2% (CR=25.8%). By subtype, (Figure Presented)(Figure Presented)ORR/CR rates were 64.0%/40.0% (extranodal), 76.0%/20.0% (nodal), 66.7%/8.3% (splenic), and 50.0%/25.0% (unknown). Median DOR, PFS, and OS were not reached. Over 70.0% of pts were alive or progression-free after 2 years (Figure). Sensitivity analysis using only CT-based criteria (n=66) showed an ORR of 66.7% and CR of 24.2%. The most common treatment-emergent AEs were bruising (23.5%), diarrhea (22.1%), and constipation (17.6%). Neutropenia (8.8%) and COVID-19 pneumonia (5.9%) were the most common Grade >=3 AEs. Five pts (7.4%) died due to unrelated AEs: COVID-19 pneumonia=2, acute myeloid leukemia=1, myocardial infarction=1, septic encephalopathy=1. Hypertension occurred in 3 pts (4.4%), atrial fibrillation and atrial flutter in 1 pt (1.5%) each;none led to treatment withdrawal. One pt (1.5%) had a Grade 3 gastrointestinal hemorrhage while receiving rivaroxaban. None of the pts required dose reduction. Conclusion(s): In this final analysis with over 2 years of median follow-up, zanubrutinib continues to demonstrate durable disease control and was generally well tolerated, with no new safety signals observedCopyright © 2023 American Society for Transplantation and Cellular Therapy

Data-Driven COVID-19 Vaccine Development for Janssen

The COVID-19 pandemic has spurred extensive vaccine research worldwide. One crucial part of vaccine development is the phase III clinical trial that assesses the vaccine for safety and efficacy in the prevention of COVID-19. In this work, we enumerate the first successful implementation of using machine learning models to accelerate phase III vaccine trials, working with the single-dose Johnson & Johnson vaccine to predictively select trial sites with naturally high incidence rates ("hotspots"). We develop DELPHI, a novel, accurate, policy-driven machine learning model that serves as the basis of our predictions. During the second half of 2020, the DELPHI-driven site selection identified hotspots with more than 90% accuracy, shortened trial duration by six to eight weeks (approximately 33%), and reduced enrollment by 15,000 (approximately 25%). In turn, this accelerated time to market enabled Janssen's vaccine to receive its emergency use authorization and realize its public health impact earlier than expected. Several geographies identified by DELPHI have since been the first areas to report variants of concern (e.g., Omicron in South Africa), and thus DELPHI's choice of these areas also produced early data on how the vaccine responds to new threats. Johnson & Johnson has also implemented a similar approach across its business including supporting trial site selection for other vaccine programs, modeling surgical procedure demand for its Medical Device unit, and providing guidance on return-to-work programs for its 130,000 employees. Continued application of this methodology can help shorten clinical development and change the economics of drug development by reducing the level of risk and cost associated with investing in novel therapies. This will allow Johnson & Johnson and others to enable more effective delivery of medicines to patients.

A Randomized Experiment on the Effects of Moral Appeals on US Parents? Intentions to Vaccinate Their 5e11-Year-Old Children Against COVID-19

Background: Democrats and Republicans in the United States were divided on their COVID-related risk perceptions and their adoption of preventive measures (e.g., getting vaccinated). Based on moral foundations theory and the matching hypothesis, this study hypothesized that parents with a Democratic affiliation would be persuaded by mes-sages featuring a harm/care or a fairness moral appeal, whereas parents with a Republican affiliation would be persuaded by messages featuring an authority or ingroup loyalty appeal.Method: An experiment was conducted among 567 parents with children aged 5-11, whereby each participant was randomly assigned to read one of the four moral appeals or a control message. Each participant then completed a questionnaire.Results: The results showed that, in general, the moral appeals did not interact with parents' political affiliations, and the moral appeal messages did not significantly increase the parents' risk perceptions or vaccine uptake intent for their children. Additional analysis showed that trust in government and future orientation were strong predictors of parents' risk perceptions and vaccine uptake intent, whereas COVID fatigue was a weak predictor of their message evaluation.Conclusion: Moral framing in persuasive messages may have limited effects on a health problem widely known to the public. Instead, participants' internalized value orientations and personal differences may be more predictive of their attitudes and adoption of preventive measures.

Investigation on the blood glucose management of diabetic patients during COVID-19 in Wuhan.

Objective: To investigate the blood glucose management of diabetic patients during the fight against corona virus disease 2019 (COVID-19) in Wuhan, China. Method(s): A questionnaire survey was conducted on diabetic patients receiving hypoglycemic drugs in wuhan, hubei province from February 16, 2020 to February 20, 2020. The questionnaire included participants' basic information, the management of blood glucose, and the prevention and control of COVID-19. SPSS 19.0 was used for statistical analysis, and chi2 test was used for comparison between the two groups. Result(s): A total of 152 valid questionnaires were retrieved. 86 cases (56.6%) diabetic patients achieved glycemic control. 80 cases (52.6%) could regularly monitor their blood glucose. 48 cases (31.6%) had the difficulty in the management of blood glucose for purchasing medicines. They also had the difficulties in adjusting blood glucose in the outpatient of endocrinology departments (31 cases, 20.4%), adherence to appropriate exercise (28 cases, 18.4%) and eating the balanced diet (16 cases, 10.5%). When faced with medical problems, 73 cases (48.0%) seek help from hospital out-patient clinics. Nearby pharmacies (78 case, 51.3%) or hospital outpatient (63 cases, 41.5%) were the main ways to purchase medicines for diabetic patients. 133 cases (87.5%) took medicines regularly. 39 cases (25.7%) and 17 (11.2%) diabetic patients were affected by the COVID-19 epidemic and changed or discontinued the original treatments. There was statistically significant in the proportion of discontinuation of hypoglycemic drugs between different drug treatment regiments and subgroups with diabetes course (chi2=13.30, P<0.01;chi2=8.72, P<0.05). Only 16 cases (10.5%) showed that their community health service organizations had specially trained diabetic management team. Conclusion(s): This survey suggests that the diabetic patients in Wuhan had not paid enough attention to blood glucose monitoring, and their blood glucose control standards need to be further improved. In terms of the present problems, more comprehensive blood glucose management measures need to be developed to help diabetic patients fighting against COVID-19.Copyright © 2020 by the Chinese Medical Association.

Research progress in antiviral therapy for novel coronavirus pneumonia.

Since the outbreak of novel coronavirus pneumonia (COVID-19), a number of clinical studies have been carried out globally in order to explore efficacy and safety of drugs for novel coronavirus (2019-nCoV). These studies were mainly focused on drugs with anti-2019-nCoV activity tested in vitro and those previously used for the treatment of SARS and Middle East respiratory syndrome, including remdesivir, lopinavir/ritonavir, chloroquine, hydroxychloroquine, arbidol, interferon, ribavirin, and etc. The recent clinical studies on anti-2019-nCoV drugs are reviewed in this article, but the current research results are inconsistent, which are insufficient to constitute evidence for the efficacy and safety of these drugs in the treatment of COVID-19. In the absence of specific antiviral agents, remdesivir can be a treatment option for patients with critical illness or rapid progress. Some clinical studies are still in progress. We are looking forward to more large-scale and multicenter clinical trials to provide safe and effective evidence for antiviral treatment in the future.Copyright © 2020 by the Chinese Medical Association.

How Do Multiple Actors Conduct Science Communication About Omicron on Weibo: A Mixed‐Method Study

This article explores science communication about Omicron on Weibo by eight actors from November 2021 to June 2022. Regarding the themes of vaccines, symptoms, and medicines, we examined the actors' communication with content analysis, presented the interactions of different actors using social network analysis, and assessed the impact of weibos on public sentiment using SnowNLP and descriptive statistics. The results showed that scientists are still the most important actors, focusing on science issues and using contrasting and contextual frames. Central‐level media play an essential mediating role, relaying scientific knowledge. Science communication on Weibo had a positive impact on public sentiment. © 2023 by the author(s);licensee Cogitatio Press (Lisbon, Portugal). This article is licensed under a Creative Commons Attribution 4.0 International License (CC BY).

Massive-scale genomic analysis reveals SARS-CoV-2 mutation characteristics and evolutionary trends

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic resulted in significant societal costs. Hence, an in-depth understanding of SARS-CoV-2 virus mutation and its evolution will help determine the direction of the COVID-19 pandemic. In this study, we identified 296,728 de novo mutations in more than 2,800,000 high-quality SARS-CoV-2 genomes. All possible factors affecting the mutation frequency of SARS-CoV-2 in human hosts were analyzed, including zinc finger antiviral proteins, sequence context, amino acid change, and translation efficiency. As a result, we proposed that when adenine (A) and tyrosine (T) bases are in the context of AM (M stands for adenine or cytosine) or TA motif, A or T base has lower mutation frequency. Furthermore, we hypothesized that translation efficiency can affect the mutation frequency of the third position of the codon by the selection, which explains why SARS-CoV-2 prefers AT3 codons usage. In addition, we found a host-specific asymmetric dinucleotide mutation frequency in the SARS-CoV-2 genome, which provides a new basis for determining the origin of the SARS-CoV-2. Finally, we summarize all possible factors affecting mutation frequency and provide insights into the mutation characteristics and evolutionary trends of SARS-CoV-2. © 2022 The Authors. mLife published by John Wiley & Sons Australia, Ltd. on behalf of Institute of Microbiology, Chinese Academy of Sciences.

Older Chinese and Korean migrants' experiences of the first COVID-19 lockdown in Aotearoa New Zealand: A qualitative study

Later-life migrants, as older people living away from their home nations, occupy multiply-precarious positions in relation to national COVID-19 pandemic responses. Concern has particularly centred on this group's increased risk of social and linguistic exclusion. We explore the perspectives of later-life older Chinese and Koreans living in New Zealand during the nation's COVID-19 lockdown of 2020. This paper presents a sub-analysis of culturally-matched interviews conducted with 3 Korean and 5 Chinese later-life migrants. These participants are a sub-sample of a larger qualitative interview study comprising 44 interviews. A social capital approach has been used to aid conceptualisation of participants' experiences and a reflexive thematic approach guided analysis. Despite their underrepresentation in national response efforts, Chinese and Korean later-life migrants resourcefully participated in ethnically-specific pandemic initiatives. Three themes identified were: (1) taking it seriously (2) already digitally literate (3) challenges and difficulties. Older Asian migrants engaged in a range of creative strategies to stay connected during COVID-19 lockdowns which drew heavily on pre-existing social capital. Future pandemic responses should seek to improve connectedness between the national government COVID-19 response and older Korean and Chinese later-life migrants. © 2022 The Authors. Asia Pacific Viewpoint published by Victoria University of Wellington and John Wiley & Sons Australia, Ltd.

Intertextuality and ideology: Social actor's representation in handling of COVID-19 from China daily

As one of the major venues for articulating and disseminating national agendas and opinion discourse, national newspapers play a critical role in promulgating ideology. Underpinned by Intertextuality and Social Actor Theory, this study explores intertextual aspects of China Daily's reporting of COVID-19 to unearth hidden ideology behind texts. The analysis reveals diversified voices from multiple actors around the globe, with China's official leaders appearing most frequently. In the portrayal of social actors, some strategies like impersonalisation, and genericisation are utilised to add impersonal authority or power to an actor's activity, actant's engagement, and increase the trustworthiness of news. These reprsentational strategies belies a transformation in Chinese media discourse with a softer approach is used in wielding ideological intentions through journalistic practices of intertextuality. Our findings help to unravel how news texts draw on, echo, and bring together multiple intertextual resources realised in the forms of discourses. The circulations, dissemination and incorporation of these intertextual relations and practices construct specific understandings of ideology consolidation and public relations within the context of China and its response to the COVID-19 pandemic. © The Author(s) 2023.