Adapting parent‐focused interventions for diverse caregivers of children with intellectual and developmental disabilities: Lessons learned during global crises

Parent‐focused interventions have been designed to provide training and support to caregivers who are essential in achieving positive outcomes for children with intellectual and developmental disabilities (IDD). In 2020, significant crises, including the COVID‐19 pandemic and continued racial tensions, profoundly impacted the livelihood of children with IDD and their families. Many ongoing efforts to address disparities among this population were halted temporarily and required further adaptations. Researchers adapted interventions and support to address the disparities impacting children with IDD and their families with limited guidance. We provide a descriptive case analysis of four parent‐focused interventions that responded to the global crises to continue serving children with IDD and their families. The four distinct programs were based on applied behavior analysis and naturalistic, developmental‐behavioral paradigms that were culturally adapted for families of young children with IDD from diverse cultural and socioeconomic backgrounds. We present the qualitative reports on the challenges and benefits that arose with adapting the four parent‐focused interventions for telehealth implementation. We focused specifically on adaptations made in recruitment and retention, instrumentation and measurement, research staff training, and intervention delivery. We synthesize our experience with challenges and solutions in adapting parent‐focused interventions for racially/ethnically and socioeconomically diverse children with IDD and their families. We conclude with recommendations for researchers and practitioners on methods for adapting parent‐focused interventions to address the significant health disparities that impact racially, ethnically, and socioeconomically diverse children with IDD and their families.

Analysis on the physiological changes of residents before and during the COVID-19 pandemic: A cross-sectional study.

People's lifestyles have changed dramatically during the coronavirus disease 2019 (COVID-19) pandemic, yet data on physical examinations in the Chinese population before and during the pandemic are rarely reported. The study was based on the data from the physical examination center of Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine. We collected the data of physical examinations information between January 2017 and March 2022. The data of participants before December 31, 2019 were classified as "before COVID-19 pandemic group," while data after December 31, 2019 were classified as "during COVID-19 pandemic group." We used t-test and χ2  test to compare the differences before and during COVID-19 pandemic. A total of 72 257 individuals participated in the physical examinations, and finally retained 65 629 individuals for analysis. During the COVID-19 pandemic, body mass index (BMI), high-density lipoprotein, total cholesterol levels, as well as pulmonary nodule and thyroid nodule proportion of participants were higher than those before the pandemic, and the levels of systolic blood pressure and diastolic blood pressure of participants were lower than those before the pandemic. Ongoing assessment and surveillance are necessary to assess whether lifestyle changes caused by the COVID-19 pandemic are likely to increase chronic disease risk in the future.

Assessment of basic reproductive number for COVID-19 at global level: A meta-analysis.

BACKGROUND: There are large knowledge gaps regarding how transmission of 2019 novel coronavirus disease (COVID-19) occurred in different settings across the world. This study aims to summarize basic reproduction number (R0) data and provide clues for designing prevention and control measures. METHODS: Several databases and preprint platforms were retrieved for literature reporting R0 values of COVID-19. The analysis was stratified by the prespecified modeling method to make the R0 values comparable, and by country/region to explore whether R0 estimates differed across the world. The average R0 values were pooled using a random-effects model. RESULTS: We identified 185 unique articles, yielding 43 articles for analysis. The selected studies covered 5 countries from Asia, 5 countries from Europe, 12 countries from Africa, and 1 from North America, South America, and Australia each. Exponential growth rate model was most favored by researchers. The pooled global R0 was 4.08 (95% CI, 3.09-5.39). The R0 estimates for new and shifting epicenters were comparable or even higher than that for the original epicenter Wuhan, China. CONCLUSIONS: The high R0 values suggest that an extraordinary combination of control measures is needed for halting COVID-19.

Identification and characterization of virus-encoded circular RNAs in host cells.

Emerging evidence has identified viral circular RNAs (circRNAs) in human cells infected by viruses, interfering with the immune system and inducing diseases including human cancer. However, the biogenesis and regulatory mechanisms of virus-encoded circRNAs in host cells remain unknown. In this study, we used the circRNA detection tool CIRI2 to systematically determine the virus-encoded circRNAs in virus-infected cancer cell lines and cancer patients, by analysing RNA-Seq datasets derived from RNase R-treated samples. Based on the thousands of viral circRNAs we identified, the biological characteristics and potential roles of viral circRNAs in regulating host cell function were determined. In addition, we developed a Viral-circRNA Database (http://www.hywanglab.cn/vcRNAdb/), which is open to all users to search, browse and download information on circRNAs encoded by viruses upon infection.

Does health literacy promote COVID-19 awareness? Evidence from Zhejiang, China.

Background: Health literacy (HL) is considered a crucial determinant of disease prevention and control. However, the role of HL in the Coronavirus Disease 2019 (COVID-19) pandemic has not been studied using provincial representative data among Chinese residents. This study aimed to assess the association between HL and COVID-19 awareness among Zhejiang residents based on the 2020 China Health Literacy Survey (CHLS). Methods: The study was conducted among 5,596 residents aged 15-69 in Zhejiang using multistage, stratified, and probability proportional to size sampling. COVID-19 awareness and HL were assessed using the "Chinese Citizen Health Literacy Questionnaire (2020)" in Zhejiang. The covariates were divided into predisposing factors, enabling factors, and need factors according to Anderson's model. Data were analyzed by the chi-square test and logistic regression. Results: The study showed that HL and COVID-19 awareness levels of residents were 24.84% and 8.06%, respectively, in Zhejiang in 2020. After adjusting for covariates, residents with adequate HL were more likely to have better COVID-19 awareness (odds ratio [OR] = 5.22, 95% CI = 4.13-6.59, p < 0.001). Three dimensions of HL (knowledge and attitudes, behavior and lifestyle, and health-related skills) were associated with COVID-19 awareness. Additionally, COVID-19 awareness was associated with age, occupation, family size, annual household income, and chronic conditions. Conclusion: COVID-19 awareness is significantly associated with HL, suggesting that promoting HL is an important component of health education, disease prevention, and health promotion in response to the COVID-19 pandemic and even possible public health emergencies in the future.

Adapting parent-focused interventions for diverse caregivers of children with intellectual and developmental disabilities: Lessons learned during global crises.

Parent-focused interventions have been designed to provide training and support to caregivers who are essential in achieving positive outcomes for children with intellectual and developmental disabilities (IDD). In 2020, significant crises, including the COVID-19 pandemic and continued racial tensions, profoundly impacted the livelihood of children with IDD and their families. Many ongoing efforts to address disparities among this population were halted temporarily and required further adaptations. Researchers adapted interventions and support to address the disparities impacting children with IDD and their families with limited guidance. We provide a descriptive case analysis of four parent-focused interventions that responded to the global crises to continue serving children with IDD and their families. The four distinct programs were based on applied behavior analysis and naturalistic, developmental-behavioral paradigms that were culturally adapted for families of young children with IDD from diverse cultural and socioeconomic backgrounds. We present the qualitative reports on the challenges and benefits that arose with adapting the four parent-focused interventions for telehealth implementation. We focused specifically on adaptations made in recruitment and retention, instrumentation and measurement, research staff training, and intervention delivery. We synthesize our experience with challenges and solutions in adapting parent-focused interventions for racially/ethnically and socioeconomically diverse children with IDD and their families. We conclude with recommendations for researchers and practitioners on methods for adapting parent-focused interventions to address the significant health disparities that impact racially, ethnically, and socioeconomically diverse children with IDD and their families.

Factors Associated With Protective Mask-Wearing Behavior to Avoid COVID-19 Infection in China: Internet-Based Cross-sectional Study.

BACKGROUND: The novel coronavirus disease COVID-19 is likely to spread from person to person in close-contact settings. The Chinese Center for Disease Control and Prevention released a handbook on COVID-19, which introduced health information to the public, specifically related to wearing masks correctly and adopting preventive measures to avoid COVID-19 infection. OBJECTIVE: The aim of this study was to assess the level of mask knowledge, behavior related to mask usage, and major information channels used for obtaining mask- and COVID-19-related information in China. METHODS: An internet-based survey was conducted primarily using DingXiang Doctor WeChat public accounts. The data about mask knowledge and behavior were collected and analyzed. In addition to descriptive statistics, logistic regression was used to analyze significant risk factors contributing to protective mask behavior. RESULTS: Data were collected from a total of 10,304 respondents to the survey. More than half of the respondents were under 30 years old and nearly three-quarters were women. Over 80% of participants had a bachelor's degree or higher, and the largest proportion of respondents (n=4204, 40.80%) were employed as business/service workers. Over half of the study participants were married (n=5302, 51.46%). The findings revealed that 67.49% (6954/10,304) of the participants practiced protective mask behavior; 97.93% (10,091/10,304) believed that wearing masks is an effective protective measure against COVID-19; 96.85% (9979/10,304) chose a mask that has two or more layers of washable, breathable fabric; and 70.57% (7272/10,304) wore the masks correctly. Gender, age, occupation, and education level had significant effects on behavior, whereas marital status and the infection status of family members were not significantly related to mask-wearing behavior. In addition, WeChat public accounts (9227/10,304, 89.55%) were the most prominent source of obtaining health information for Chinese netizens after the outbreak of COVID-19. CONCLUSIONS: This study elucidated that Chinese netizens' protective mask behavior is far lower than their mask-related knowledge. Improved information channels and adequate information on wearing masks are necessary to improve the public's protective mask behavior, particularly among men, the elderly, and people with less education.

Incidence, causes and risk factors of vision loss in rural Southern China: 6-year follow-up of the Yangxi Eye Study.

PURPOSE: To report the 6-year incidence, causes and risk factors for vision loss (visual impairment (VI) and blindness), among elderly adults in rural southern China. METHODS: Population-based, cohort study. Initiated in 2014, the study recruited participants aged 50 and older using random cluster sampling from Yangxi County. All eligible participants were invited to attend interviews and comprehensive eye examinations at the 6-year follow-up between November 2020 and March 2021. The WHO categories of vision loss were used to define incident cases of VI (3/60≤VA <6/12), moderate-to-severe VI (MSVI) (3/60≤VA<6/18) and blindness (VA <3/60) in the better-seeing eye. RESULTS: Among the 5825 baseline participants, 3187 (64.4%) of 4946 surviving subjects participated in the 6-year follow-up. Based on presenting and best-corrected VA, respectively, the crude incidence rate of blindness was 0.8% (95% CI 0.5% to 1.1%) vs 0.3% (95% CI 0.1% to 0.5%), for MSVI 6.7% (95% CI 5.7% to 7.6%) vs 4.6% (95% CI 3.8% to 5.4%) and for any VI 16.1% (95% CI 14.5% to 17.6%) vs 12.9% (95% CI 11.6% to 14.1%). Cataract (48.3%) and refractive errors (44.4%) were the most common causes of vision loss. Factors significantly associated with greater incident vision loss were older age, female sex, less education, living alone and longer axial length (all p<0.05). CONCLUSIONS: Substantial work is still required to reduce avoidable vision loss in rural China. Screening outreach and efforts to improve awareness which target the poorer and less educated are urgently needed to reduce the growing unmet need for eye care due to ageing.

Mitoxantrone modulates a heparan sulfate-spike complex to inhibit SARS-CoV-2 infection.

Spike-mediated entry of SARS-CoV-2 into human airway epithelial cells is an attractive therapeutic target for COVID-19. In addition to protein receptors, the SARS-CoV-2 spike (S) protein also interacts with heparan sulfate, a negatively charged glycosaminoglycan (GAG) attached to certain membrane proteins on the cell surface. This interaction facilitates the engagement of spike with a downstream receptor to promote viral entry. Here, we show that Mitoxantrone, an FDA-approved topoisomerase inhibitor, targets a heparan sulfate-spike complex to compromise the fusogenic function of spike in viral entry. As a single agent, Mitoxantrone inhibits the infection of an authentic SARS-CoV-2 strain in a cell-based model and in human lung EpiAirway 3D tissues. Gene expression profiling supports the plasma membrane as a major target of Mitoxantrone but also underscores an undesired activity targeting nucleosome dynamics. We propose that Mitoxantrone analogs bearing similar heparan sulfate-binding activities but with reduced affinity for DNA topoisomerases may offer an alternative therapy to overcome breakthrough infections in the post-vaccine era.

Assessment on Pedestrian-level Wind Around a Pocket Park with and Without Vegetation Inside Street Canyons

Creating a good local microclimate can alleviate urban heat islands and poor urban ventilation. During the COVID-19 epidemic, citizens' cross-city and cross-regional activities were restricted, and most activities were conducted in open/semi-open areas next to residential areas, and local pedestrians were also quantitatively explored. The new characteristics of the microclimate bring difficulties. The RNG k-ε model in the Reynolds time-average method is used to simulate and analyze the wind environment of a typical street valley with a pocket park in a hot summer and a cold winter, and explore whether there are plants in the pocket park. The results show that the results obtained by the used turbulence model, initial edge conditions and numerical method are in good agreement with the selected verification experimental results, which meet the needs of the wind environment simulation of the pocket park. Only under the action of the pocket park, the pedestrian area is dimensionless. The difference in wind speed can reach 0.5 compared to the time when there is no park. When the plants in the park are added, the average wind speed in the pedestrian area of ​​the surrounding street valley is less affected by the plants, and the dimensionless wind speed is only reduced by 0.1 in the core area of ​​the park. Pocket parks can significantly improve the low wind speed in pedestrian areas, and the research results can provide reference for the design of low-carbon livable blocks and microclimate simulation during the epidemic period.

Health-Promoting Behaviors, Risk Perceptions, and Attention to COVID-19-Related Information: Comparing People's Responses to the COVID-19 Pandemic Across Times of Chinese New Year and Summer 2020 in Hong Kong.

Background: Since the start of the COVID-19 pandemic, individuals have been encouraged to engage in health-promoting behaviors, namely actions taken to prevent infection and keep themselves healthy, such as maintaining social distancing. However, other factors, such as risk perception and feelings of fear, also might influence whether an individual takes such measures. This study compared people's responses to the pandemic in terms of their adoption of COVID-19 health-promoting behaviors, COVID-19 risk perceptions, and attention to COVID-19-related information during two periods: the 2020 Chinese New Year (CNY) in Hong Kong (HK), i.e., the very beginning of the COVID-19 outbreak (Time 1, T1), and summer 2020, i.e., before and during the third wave of COVID-19 infections in HK (Time 2, T2). Methods: Data were extracted from 180 HK participants, who were asked to recall and report their health-promoting behaviors, emotional and cognitive COVID-19 risk perceptions, and attention to COVID-19-related information during T1 and T2. A repeated-measures ANOVA series was conducted to investigate differences in public responses between the two aforementioned time points. Main Findings: After controlling for the effects from gender, age, and education levels, the participants reported practicing more infection-prevention behaviors, experiencing a lower level of fear as a psychological response, and paying less attention to COVID-19-related information during T2 than T1. Conclusions: This study addressed the need to monitor public responses to the COVID-19 pandemic, including changes in people's behaviors and psychological responses across time. The results also suggest that the HK public was steered toward striking a balance between strengthening their infection-prevention behaviors and reducing their fear of COVID-19 infection.

Early predictors and screening tool developing for severe patients with COVID-19.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a declared global pandemic, causing a lot of death. How to quickly screen risk population for severe patients is essential for decreasing the mortality. Many of the predictors might not be available in all hospitals, so it is necessary to develop a simpler screening tool with predictors which can be easily obtained for wide wise. METHODS: This retrospective study included all the 813 confirmed cases diagnosed with COVID-19 before March 2nd, 2020 in a city of Hubei Province in China. Data of the COVID-19 patients including clinical and epidemiological features were collected through Chinese Disease Control and Prevention Information System. Predictors were selected by logistic regression, and then categorized to four different level risk factors. A screening tool for severe patient with COVID-19 was developed and tested by ROC curve. RESULTS: Seven early predictors for severe patients with COVID-19 were selected, including chronic kidney disease (OR 14.7), age above 60 (OR 5.6), lymphocyte count less than < 0.8 × 109 per L (OR 2.5), Neutrophil to Lymphocyte Ratio larger than 4.7 (OR 2.2), high fever with temperature ≥ 38.5℃ (OR 2.2), male (OR 2.2), cardiovascular related diseases (OR 2.0). The Area Under the ROC Curve of the screening tool developed by above seven predictors was 0.798 (95% CI 0.747-0.849), and its best cut-off value is > 4.5, with sensitivity 72.0% and specificity 75.3%. CONCLUSIONS: This newly developed screening tool can be a good choice for early prediction and alert for severe case especially in the condition of overload health service.

Surface water quality in the upstream-most megacity of the Yangtze River Basin (Chengdu): 2000-2019 trends, the COVID-19 lockdown effects, and water governance implications

Water is essential for a sustainable economic prosperity, but rapid economic growth and intensive agricultural activities usually cause water pollution. The middle and lower reaches of China’s Yangtze River Basin were urbanized and industrialized much earlier than the upper reach and have been suffering from water pollution. In the past two decades, economic growth accelerated in the upper reach due to several national economic initiatives. Based on analyzing water quality changes from 2000 to 2019 and during the COVID-19 lockdown in 2020 for Chengdu in the upper reach, we hope to provide some water governance suggestions. In 2019, water at 66% of 93 sites in Chengdu did not achieve the national III standards using measurements of 23 water quality parameters. The top two pollutants were total nitrogen (TN) and fecal coliform (FC). From 2000 to 2019, water quality was not significantly improved at the non-background sites of Chengdu's Min Basin, and the pollution in this basin was mainly from local pollutants release. During the same period, water quality deteriorated in Chengdu’s Tuo Basin, where pollution was the result of pollutant discharges in Chengdu in addition to inter-city pollutant transport. During the COVID-19 lockdown, water quality generally improved in the Min Basin but not in the Tuo Basin. A further investigation on which pollution sources were shut down or not during the lockdown can help make pollution reduction targets. Based on the results, we provide suggestions to strengthen inter-jurisdictional and inter-institutional cooperation, water quality monitoring and evaluation, and ecological engineering application.

ECMO combined with prone positioning strategies in COVID-19 respiratory distress syndrome.

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has already become a global pandemic as a public health emergency of international concern. Previous evidence from similar patient populations proved that carefully selected patients with severe ARDS who did not benefit from conventional treatment might be successfully supported with Veno-Venous extracorporeal membrane oxygenation (V-V ECMO). We now share the case reports of COVID-19 patients with ECMO combined prone position strategies.

Global Carbon Budget 2020

Accurate assessment of anthropogenic carbon dioxide (CO2) emissions and their redistribution among the atmosphere, ocean, and terrestrial biosphere in a changing climate – the “global carbon budget” – is important to better understand the global carbon cycle, support the development of climate policies, and project future climate change. Here we describe and synthesize data sets and methodology to quantify the five major components of the global carbon budget and their uncertainties. Fossil CO2 emissions (EFOS) are based on energy statistics and cement production data, while emissions from land-use change (ELUC), mainly deforestation, are based on land use and land-use change data and bookkeeping models. Atmospheric CO2 concentration is measured directly and its growth rate (GATM) is computed from the annual changes in concentration. The ocean CO2 sink (SOCEAN) and terrestrial CO2 sink (SLAND) are estimated with global process models constrained by observations. The resulting carbon budget imbalance (BIM), the difference between the estimated total emissions and the estimated changes in the atmosphere, ocean, and terrestrial biosphere, is a measure of imperfect data and understanding of the contemporary carbon cycle. All uncertainties are reported as ±1σ. For the last decade available (2010–2019), EFOS was 9.6 ± 0.5 GtC yr-1 excluding the cement carbonation sink (9.4 ± 0.5 GtC yr-1 when the cement carbonation sink is included), andELUC was 1.6 ± 0.7 GtC yr-1. For the same decade, GATM was 5.1 ± 0.02 GtC yr-1 (2.4 ± 0.01 ppm yr-1), SOCEAN 2.5 ± 0.6 GtC yr-1, and SLAND 3.4 ± 0.9 GtC yr-1, with a budget imbalance BIM of -0.1 GtC yr-1 indicating a near balance between estimated sources and sinks over the last decade. For the year 2019 alone, the growth in EFOS was only about 0.1 % with fossil emissions increasing to 9.9 ± 0.5 GtC yr-1 excluding the cement carbonation sink (9.7 ± 0.5 GtC yr-1 when cement carbonation sink is included), and ELUC was 1.8 ± 0.7 GtC yr-1, for total anthropogenic CO2 emissions of 11.5 ± 0.9 GtC yr-1 (42.2 ± 3.3 GtCO2). Also for 2019, GATM was 5.4 ± 0.2 GtC yr-1 (2.5 ± 0.1 ppm yr-1), SOCEAN was 2.6 ± 0.6 GtC yr-1, and SLAND was 3.1 ± 1.2 GtC yr-1, with a BIM of 0.3 GtC. The global atmospheric CO2 concentration reached 409.85 ± 0.1 ppm averaged over 2019. Preliminary data for 2020, accounting for the COVID-19-induced changes in emissions, suggest a decrease in EFOS relative to 2019 of about -7 % (median estimate) based on individual estimates from four studies of -6 %, -7 %,-7 % (-3 % to -11 %), and -13 %. Overall, the mean and trend in the components of the global carbon budget are consistently estimated over the period 1959–2019, but discrepancies of up to 1 GtC yr-1 persist for the representation of semi-decadal variability in CO2 fluxes. Comparison of estimates from diverse approaches and observations shows (1) no consensus in the mean and trend in land-use change emissions over the last decade, (2) a persistent low agreement between the different methods on the magnitude of the land CO2 flux in the northern extra-tropics, and (3) an apparent discrepancy between the different methods for the ocean sink outside the tropics, particularly in the Southern Ocean. This living data update documents changes in the methods and data sets used in this new global carbon budget and the progress in understanding of the global carbon cycle compared with previous publications of this data set (Friedlingstein et al., 2019;Le Quéré et al., 2018b, a, 2016, 2015b, a, 2014, 2013). The data presented in this work are available at 10.18160/gcp-2020 (Friedlingstein et al., 2020).

Concerns About Information Regarding COVID-19 on the Internet: Cross-Sectional Study.

BACKGROUND: Since the outbreak of COVID-19, the Chinese government and the Chinese Center for Disease Control and Prevention have released COVID-19-related information to the public through various channels to raise their concern level of the pandemic, increase their knowledge of disease prevention, and ensure the uptake of proper preventive practices. OBJECTIVE: Our objectives were to determine Chinese netizens' concerns related to COVID-19 and the relationship between their concerns and information on the internet. We also aimed to elucidate the association between individuals' levels of concern, knowledge, and behaviors related to COVID-19. METHODS: The questionnaire, which consisted of 15 closed-ended questions, was designed to investigate Chinese netizens' knowledge about COVID-19. The self-selection online survey method of nonprobability sampling was used to recruit participants through Dingxiangyisheng WeChat (a public, medical, and health service platform in China) accounts. Standard descriptive statistics and multivariate logistic regression analyses were conducted to analyze the data. RESULTS: In total, 10,304 respondents were surveyed on the internet (response rate=1.75%; 10,304/590,000). Nearly all (n=9803, 95.30%) participants were concerned about "confirmed cases" of COVID-19, and 87.70% (n=9036) received information about the outbreak through social media websites. There were significant differences in participants' concerns by sex (P=.02), age (P<.001), educational attainment (P=.001), and occupation (P<.001). All knowledge questions and preventive practices were associated with concerns about COVID-19. The results of the multivariate logistic regression indicated that participants' sex, educational attainment, occupation and employment status, knowledge acquisition, and concern level were significantly associated with the practice of proper preventive behaviors. CONCLUSIONS: This study elucidated Chinese netizens' concerns, information sources, and preventive behaviors related to the COVID-19 pandemic. Sex, educational attainment, occupation and employment status, knowledge acquisition, and level of concern were key factors associated with proper preventive behaviors. This offers a theoretical basis for the government to provide targeted disease prevention and control information to the public.

Heparan sulfate assists SARS-CoV-2 in cell entry and can be targeted by approved drugs in vitro.

The cell entry of SARS-CoV-2 has emerged as an attractive drug repurposing target for COVID-19. Here we combine genetics and chemical perturbation to demonstrate that ACE2-mediated entry of SARS-Cov and CoV-2 requires the cell surface heparan sulfate (HS) as an assisting cofactor: ablation of genes involved in HS biosynthesis or incubating cells with a HS mimetic both inhibit Spike-mediated viral entry. We show that heparin/HS binds to Spike directly, and facilitates the attachment of Spike-bearing viral particles to the cell surface to promote viral entry. We screened approved drugs and identified two classes of inhibitors that act via distinct mechanisms to target this entry pathway. Among the drugs characterized, Mitoxantrone is a potent HS inhibitor, while Sunitinib and BNTX disrupt the actin network to indirectly abrogate HS-assisted viral entry. We further show that drugs of the two classes can be combined to generate a synergized activity against SARS-CoV-2-induced cytopathic effect. Altogether, our study establishes HS as an attachment factor that assists SARS coronavirus cell entry and reveals drugs capable of targeting this important step in the viral life cycle.

Measures Undertaken in China to Avoid COVID-19 Infection: Internet-Based, Cross-Sectional Survey Study.

BACKGROUND: In early 2020, over 80,000 cases of coronavirus disease (COVID-19) were confirmed in China. Public prevention and control measures, along with efforts from all sectors of society, were undertaken to control and eliminate disease transmission. OBJECTIVE: This paper describes Chinese citizens' response to the epidemic, the preventive measures they implemented to avoid being infected, and the public strategies that were carried out by the government, health workers, etc. We also discuss the efficacy of these measures in controlling the epidemic in China. METHODS: Information on the responses and behaviors of Chinese citizens were collected through a cross-sectional, internet-based survey using Dingxiang Doctor's public account on WeChat. Information on public strategies implemented by all sectors of society to control the epidemic and data on new COVID-19 cases were collected from the internet, mainly from government websites. Standard descriptive statistics and multivariate logistic regression analyses were conducted to analyze the data. RESULTS: A total of 10,304 participants responded to the survey, with 10,198 valid responses; 74.1% (n=7557) were female and 25.9% (n=2641) were male. Overall, 98.2% (n=10,013) of participants paid high or very high attention to the epidemic, with WeChat being their main information source (n=9400, 92.2%). Over half the participants (n=5878, 57.7%) were confident that the epidemic could be curbed in China; 92.4% (n=9427) opened windows for ventilation more frequently than usual; 97.9% (n=9986) used masks in public; 95.7% (n=9759) avoided large crowds and stayed at home as much as possible; and 97.9% (n=9988) washed their hands more often than usual. Women were more likely to practice these behaviors than men (P<.001). With a series of strict public control measures, like nationwide health education campaigns, holiday extensions, the Examine and Approve Policy on the resumption of work, close management of working and living quarters, a health QR (Quick Response) code system, community screening, and social distancing policies, the number of new cases have decreased dramatically since February 12, 2020. CONCLUSIONS: The methods employed by Chinese citizens and authorities have effectively curtailed the spread of COVID-19, demonstrating that this pandemic can be brought under control as long as the right measures are taken.

COVID-19 causes record decline in global CO2 emissions (preprint)

The considerable cessation of human activities during the COVID-19 pandemic has affected global energy use and CO2 emissions. Here we show the unprecedented decrease in global fossil CO2 emissions from January to April 2020 was of 7.8% (938 Mt CO2 with a +6.8% of 2-{\sigma} uncertainty) when compared with the period last year. In addition other emerging estimates of COVID impacts based on monthly energy supply or estimated parameters, this study contributes to another step that constructed the near-real-time daily CO2 emission inventories based on activity from power generation (for 29 countries), industry (for 73 countries), road transportation (for 406 cities), aviation and maritime transportation and commercial and residential sectors emissions (for 206 countries). The estimates distinguished the decline of CO2 due to COVID-19 from the daily, weekly and seasonal variations as well as the holiday events. The COVID-related decreases in CO2 emissions in road transportation (340.4 Mt CO2, -15.5%), power (292.5 Mt CO2, -6.4% compared to 2019), industry (136.2 Mt CO2, -4.4%), aviation (92.8 Mt CO2, -28.9%), residential (43.4 Mt CO2, -2.7%), and international shipping (35.9Mt CO2, -15%). Regionally, decreases in China were the largest and earliest (234.5 Mt CO2,-6.9%), followed by Europe (EU-27 & UK) (138.3 Mt CO2, -12.0%) and the U.S. (162.4 Mt CO2, -9.5%). The declines of CO2 are consistent with regional nitrogen oxides concentrations observed by satellites and ground-based networks, but the calculated signal of emissions decreases (about 1Gt CO2) will have little impacts (less than 0.13ppm by April 30, 2020) on the overserved global CO2 concertation. However, with observed fast CO2 recovery in China and partial re-opening globally, our findings suggest the longer-term effects on CO2 emissions are unknown and should be carefully monitored using multiple measures.