Assessing COVID-19 Vaccine Booster Hesitancy Using the Modified 5C Scale in Zhejiang Province, China: A Cross-Sectional Study.

Following the rollout of a booster campaign to promote immunity against COVID-19 in China, this study aimed to assess booster hesitancy among adults who were fully vaccinated with primary doses across Zhejiang Province. Firstly, the modified 5C scale developed by a German research team was assessed for reliability and validity via a pre-survey in Zhejiang Province. Then, a 30-item questionnaire was established to conduct online and offline surveys during 10 November to 15 December 2021. Demographic characteristics and information on previous vaccination experience, vaccine type of primary doses, attitudes towards booster doses and awareness of SARS-CoV-2 infection were collected. Chi-square tests, pairwise comparison and multivariate logistic regression were performed in data analysis. In total, 4039 valid questionnaires were analyzed, with booster hesitancy of 14.81%. Dissatisfaction with previous vaccination experience of primary doses (ORs = 1.771~8.025), less confidence in COVID-19 vaccines (OR = 3.511, 95%CI: 2.874~4.310), younger age compared to the elderly aged 51-60 years old (2.382, 1.274~4.545), lower education level (ORs = 1.707~2.100), weaker awareness of social responsibility of prevention and control of COVID-19 (1.587, 1.353~1.859), inconvenience of booster vaccination (1.539, 1.302~1.821), complacency regarding vaccine efficacy as well as self-health status (1.224, 1.056~1.415) and excessive trade-offs before vaccination (1.184, 1.005~1.398) were positively associated with booster hesitancy. Therefore, intelligent means should be strengthened to optimize vaccination services. More influential experts and other significant figures should be supported to promote timely evidence-based information via various media platforms to reduce public hesitancy and increase booster uptake.

The SARS-CoV-2 accessory protein Orf3a is not an ion channel, but does interact with trafficking proteins.

The severe acute respiratory syndrome associated coronavirus 2 (SARS-CoV-2) and SARS-CoV-1 accessory protein Orf3a colocalizes with markers of the plasma membrane, endocytic pathway, and Golgi apparatus. Some reports have led to annotation of both Orf3a proteins as viroporins. Here, we show that neither SARS-CoV-2 nor SARS-CoV-1 Orf3a form functional ion conducting pores and that the conductances measured are common contaminants in overexpression and with high levels of protein in reconstitution studies. Cryo-EM structures of both SARS-CoV-2 and SARS-CoV-1 Orf3a display a narrow constriction and the presence of a positively charged aqueous vestibule, which would not favor cation permeation. We observe enrichment of the late endosomal marker Rab7 upon SARS-CoV-2 Orf3a overexpression, and co-immunoprecipitation with VPS39. Interestingly, SARS-CoV-1 Orf3a does not cause the same cellular phenotype as SARS-CoV-2 Orf3a and does not interact with VPS39. To explain this difference, we find that a divergent, unstructured loop of SARS-CoV-2 Orf3a facilitates its binding with VPS39, a HOPS complex tethering protein involved in late endosome and autophagosome fusion with lysosomes. We suggest that the added loop enhances SARS-CoV-2 Orf3a's ability to co-opt host cellular trafficking mechanisms for viral exit or host immune evasion.

The decline in immunity and circulation of pertussis among Chinese population during the COVID-19 pandemic: A cross-sectional sero-epidemiological study.

BACKGROUND: In recent years, the resurgence of pertussis has posed a public health challenge in many countries. This study aimed to evaluate the immunity levels against pertussis among populations of different ages in China. METHODS: We conducted a cross-sectional serological survey in Zhejiang Province, China in 2020. Serum IgG antibodies against pertussis toxin (anti-PT), filamentous hemagglutinin (anti-FHA), and pertactin (anti-PRN) were quantitatively measured. The geometric mean concentration (GMC) of three antibodies was calculated. An anti-PT level < 5 IU/mL was considered undetectable, ≥20 IU/mL as seropositive and ≥80 IU/mL as an indicator of recent infection. Mathematical models were fitted for anti-PT concentrations over time in children after four doses of the pertussis vaccination. RESULTS: A total of 4459 participants aged 0-59 years were included in the analyses. The overall positivity rate of anti-PT was 29.80% with the highest (81.44%) rate in the 1-2 years old and the lowest (4.72%) in 10-14 years old. The GMCs of anti-PT, anti-FHA and anti-PRN for the whole participants were 9.67 (95%CI: 9.25-10.10),18.93 (18.24-19.67), and 8.99 (8.61-9.38) IU/mL, respectively. Over 50% of subjects aged ≥ 7 years had undetectable anti-PT IgG antibodies (<5IU/mL). The proportions of the populations with anti-PT IgG ≥ 80 IU/mL were approximately 0.9%, 0.3% and 1.1% among the 10-14, 15-29, and 40-59 years old groups, respectively. The power regression equation of the attenuation model after last dose of pertussis vaccine was y = 41.088x-1.238 (R2 = 0.935, p < 0.001). The fitted anti-PT concentrations was only 5.60 IU/mL at 5 years following the last vaccination dose. CONCLUSION: The prevalence of pertussis decreased during the study period in the COVID-19 pandemic; however, there was still a certain proportion of adolescents and adults with evidence of recent infection. The decline in antibody levels after pertussis vaccination was observed, and booster doses are in urgent need in China.

Qualitative Research on the Training Experiences and Needs of Intensive Care Unit General Nurses Against the Background of Regular Coronavirus Disease 2019 Prevention and Control.

Objective: This study aimed to investigate the training experiences and needs of intensive care unit (ICU) general nurses against a background of regular Coronavirus disease (COVID-19) prevention and control. Methods: Using the phenomenological method of qualitative research, semi-structured interviews were conducted with 10 ICU nurses. The interview data were analyzed, sorted, summarized, and refined using the content analysis method. Results: The following five themes were extracted from the interviews, based on the training experiences of the nurses: 1) broadening their thinking; 2) discovering their personal shortcomings; 3) gaining self-confidence; 4) calmly facing frontline work; 5) experiencing high assessment pressure. The training needs of the nurses could be summarized into the following four themes: 1) increased training time; 2) improving the assessment mechanism; 3) establishing a normal rotating-shift training system; 4) balancing the teaching levels. Conclusion: Against a background of regular epidemic prevention and control, ICU training for general nurses is of high practical significance and value. Thus, active exploration and research should be conducted to establish perfect training and assessment mechanisms for these nurses. Additionally, training methods that are suitable for clinical needs should be formulated and training systematization and standardization must be promoted.

Mediation effect of perceived social support and resilience between physical disability and depression in acute stroke patients in China: A cross-sectional survey.

BACKGROUND: Physical disability is a cause of depression among acute stroke patients. Although previous studies have shown that physical disability, perceived social support, mental resilience, and post-stroke depression are significantly related, the interaction mechanism remains unclear. METHODS: Convenience sampling was used to recruit participants from a tertiary hospital in Daqing City, Heilongjiang Province, China from October 2020 to May 2021. Participants completed the Barthel Index Rating Scale, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and Zung Self-Rating Depression Scale. We used the PROCESS macro for SPSS to determine the mediating effect of perceived social support and resilience between disability and depression. RESULT: A total of 259 acute stroke patients participated in this study and completed the questionnaire survey. Stroke patients' BI scores was positively correlated with perceived social support (r = 0.26, P < 0.01) and resilience (r = 0.25, P < 0.01), and negatively correlated with depression (r = -0.47, P < 0.01). Perceived social support was positively correlated with resilience (r = 0.55, P < 0.01) and negatively correlated with depression (r = -0.41, P < 0.01). Resilience was negatively correlated with depression (r = -0.43, P < 0.01). Perceived social support and resilience played a mediating role of 10.27% and 5.74% of the total effects of disability and post-stroke depression, respectively. Meanwhile, the chain mediating effect of perceived social support and resilience (7%) was also significant. LIMITATIONS: The cross-sectional study design limited the inference of causal relationships between variables. This study used convenience sampling to select research participants from a single hospital, they were all acute stroke patients from the same region of China. Participants in our study were in high BI status, and thirty of them had a low level of education, which may contribute to the possibility of selection bias. Meanwhile, the low level of education and the poor eye-sight of old people prevents them from completing the questionnaire by themselves. So we collected data in the form of "researcher reading questionnaire items and recording participant responses" for the majority of participants (257 subjects), and only 2 participants completed it independently. Furthermore, the findings of this study may not apply to stroke survivors from other backgrounds. CONCLUSION: This study found that disability can directly predict post-stroke depression, and indirectly predict post-stroke depression through the mediating effect of perceived social support and resilience, and the chain mediating effect of perceived social support-resilience. Therefore, reducing the degree of disability of acute stroke patients and improving their perceived social support and resilience may help prevent post-stroke depression.

The platform development, adherence and efficacy to a digital Brief therapy for insomnia (dBTI) during the COVID-19 pandemic.

Brief therapy for insomnia (BTI) is a short-term cognitive behavioral therapy for insomnia. At present, there is no study combining BTI with digital technology. However, in the context of the outbreak of coronavirus disease 2019 (COVID-19), patients with acute insomnia may need an online treatment which can quickly improve insomnia symptoms. Our team built a digital BTI (dBTI) platform based on the WeChat mini program. This research provides a framework design and a course design of dBTI, and evaluates the system via recruiting participants suffering from acute insomnia in pandemic. What's more, it explores patients' adherence, the efficiency of the system and their relationship. As the result demonstrates, 68% of participants have completed more than half of the course with medium to high adherence. Gender, pre-sleep arousal scale (PSAS) somatic score and insomnia severity index (ISI) score have affected participants' adherence, and higher adherence has led to better improvement in the severity of insomnia and somatic pre-sleep arousal. It is proved that the platform we built is effective, which not only offers an entry point for the study of how to set up a dBTI platform, but also provides theoretical basis for its clinical application.

Epidemiology and Comparative Analyses of the S Gene on Feline Coronavirus in Central China.

Feline coronavirus (FCoV) infections present as one of two forms: a mild or symptom-less enteric infection (FEC) and a fatal systemic disease termed feline infectious peritonitis (FIP). The lack of epidemiology of FCoV in central China and the reason why different symptoms are caused by viruses of the same serotype have motivated this investigation. Clinical data of 81 suspected FIP cases, 116 diarrhea cases and 174 healthy cases were collected from veterinary hospitals using body cavity effusion or fecal samples. Risk factors, sequence comparison and phylogenetic studies were performed. The results indicated that FIPV was distinguished from FECV in the average hydrophobicity of amino acids among the cleavage sites of furin, as well as the mutation sites 23,531 and 23,537. FIPV included a higher minimal R-X-X-R recognition motif of furin (41.94%) than did FECV (9.1%). The serotype of FCoV was insignificantly correlated with FIP, and the clade 1 and clade 2 strains that appeared were unique to central China. Thus, it is hypothesized that this, along with the latent variables of an antigenic epitope at positions 1058 and 1060, as well as mutations at the S1/S2 sites, are important factors affecting FCoV transmission and pathogenicity.