Review on two-dimensional material-based field-effect transistor biosensors: accomplishments, mechanisms, and perspectives.

Field-effect transistor (FET) is regarded as the most promising candidate for the next-generation biosensor, benefiting from the advantages of label-free, easy operation, low cost, easy integration, and direct detection of biomarkers in liquid environments. With the burgeoning advances in nanotechnology and biotechnology, researchers are trying to improve the sensitivity of FET biosensors and broaden their application scenarios from multiple strategies. In order to enable researchers to understand and apply FET biosensors deeply, focusing on the multidisciplinary technical details, the iteration and evolution of FET biosensors are reviewed from exploring the sensing mechanism in detecting biomolecules (research direction 1), the response signal type (research direction 2), the sensing performance optimization (research direction 3), and the integration strategy (research direction 4). Aiming at each research direction, forward perspectives and dialectical evaluations are summarized to enlighten rewarding investigations.

Evaluation of a digital game for teaching behavioral aspects of clinical communication in dentistry.

INTRODUCTION: Traditionally, dental students learn the skills for dentist-patient interaction and communication via on-site contact with patients, when they start clinical training. However, preclinical students (who have not started clinical practice) have fewer chances to realize the context of dentist-patient interaction. It has remained unclear if a gamification approach via digital media, i.e., a computer role-playing game, can help to learn clinical communication skills. The intervention-based study investigates the effectiveness of the clinical dentist-patient communication (CDPC) game on students' motivation, beliefs, and self-efficacy to learn behavioral issues of clinical communication. METHODS: Fifty-two dental students (Preclinical group) and 18 dental interns and dentists (Clinical group) played the CDPC game, which consists of 16 scenes of clinical context about dentist-patient communication (less than 40 min for playing), via web browsers. Pre-test and post-test questionnaires were used to assess their motivation, beliefs, and self-efficacy to learn behavioral issues of clinical communication. The effectiveness was examined by comparing pre-test and post-test scores within-subject and between-group difference was compared between Preclinical and Clinical groups, via non-parametric statistical tests. RESULTS: (A) In the Preclinical group, participants showed a significant increase in motivation and self-efficacy in learning after playing the CDPC game (p < 0.05, adjusted of multiple comparison). (B) In contrast, the Clinical group did not show a significant difference before vs. after playing the game. (C) After playing the game, the Preclinical group showed a significant association between motivation and beliefs (p = 0.024) and between motivation and self-efficacy (p = 0.001); the Clinical group showed a significant association between motivation and beliefs (p = 0.033). CONCLUSIONS: The current evidence suggests that gamification of learning helps preclinical students to understand the context of clinical dentist-patient interaction and increase their motivation and self-efficacy to learn behavioral issues of clinical communication.

Inhibitory activities of alginate phosphate and sulfate derivatives against SARS-CoV-2 in vitro.

Alginate derivatives have been demonstrated remarkable antiviral activities. Here we firstly identified polymannuronate phosphate (PMP) as a highly potential anti-SARS-CoV-2 agent. The structure-activity relationship showed polymannuronate monophosphate (PMPD, Mw: 5.8 kDa, P%: 8.7 %) was the most effective component to block the interaction of spike to ACE2 with an IC50 of 85.5 nM. Surface plasmon resonance study indicated that PMPD could bind to spike receptor binding domain (RBD) with the KD value of 78.59 nM. Molecular docking further suggested that the probable binding site of PMPD to spike RBD protein is the interaction interface between spike and ACE2. PMPD has the potential to inhibit the SARS-CoV-2 infection in an independent manner of heparan sulfate proteoglycans. In addition, polyguluronate sulfate (PGS) and propylene glycol alginate sodium sulfate (PSS) unexpectedly showed 3CLpro inhibition with an IC50 of 1.20 µM and 1.42 µM respectively. The polyguluronate backbone and sulfate group played pivotal roles in the 3CLpro inhibition. Overall, this study revealed the potential of PMPD as a novel agent against SARS-CoV-2. It also provided a theoretical basis for further study on the role of PGS and PSS as 3CLpro inhibitors.

A computational framework for transmission risk assessment of aerosolized particles in classrooms.

Infectious airborne diseases like the recent COVID-19 pandemic render confined spaces high-risk areas. However, in-person activities like teaching in classroom settings and government services are often expected to continue or restart quickly. It becomes important to evaluate the risk of airborne disease transmission while accounting for the physical presence of humans, furniture, and electronic equipment, as well as ventilation. Here, we present a computational framework and study based on detailed flow physics simulations that allow straightforward evaluation of various seating and operating scenarios to identify risk factors and assess the effectiveness of various mitigation strategies. These scenarios include seating arrangement changes, presence/absence of computer screens, ventilation rate changes, and presence/absence of mask-wearing. This approach democratizes risk assessment by automating a key bottleneck in simulation-based analysis-creating an adequately refined mesh around multiple complex geometries. Not surprisingly, we find that wearing masks (with at least 74% inward protection efficiency) significantly reduced transmission risk against unmasked and infected individuals. While the use of face masks is known to reduce the risk of transmission, we perform a systematic computational study of the transmission risk due to variations in room occupancy, seating layout and air change rates. In addition, our findings on the efficacy of face masks further support use of face masks. The availability of such an analysis approach will allow education administrators, government officials (courthouses, police stations), and hospital administrators to make informed decisions on seating arrangements and operating procedures. Supplementary Information: The online version contains supplementary material available at 10.1007/s00366-022-01773-9.

High-intensity vector signals for detecting SARS-CoV-2 RNA using CRISPR/Cas13a couple with stabilized graphene field-effect transistor.

False detection of SARS-CoV-2 is detrimental to epidemic prevention and control. The scalar nature of the detected signal and the imperfect target recognition property of developed methods are the root causes of generating false signals. Here, we reported a collaborative system of CRISPR-Cas13a coupling with the stabilized graphene field-effect transistor, providing high-intensity vector signals for detecting SARS-CoV-2. In this collaborative system, SARS-CoV-2 RNA generates a "big subtraction" signal with a right-shifted feature, whereas any untargets cause the left-shifted characteristic signal. Thus, the false detection of SARS-CoV-2 is eliminated. High sensitivity with 0.15 copies/µL was obtained. In addition, the wide concerned instability of the graphene field-effect transistor for biosensing in solution environment was solved by the hydrophobic treatment to its substrate, which should be a milestone in advancing it's engineering application. This collaborative system characterized by the high-intensity vector signal and amazing stability significantly advances the accurate SARS-CoV-2 detection from the aspect of signal nature.

A computational framework for transmission risk assessment of aerosolized particles in classrooms

Infectious airborne diseases like the recent COVID-19 pandemic render confined spaces high-risk areas. However, in-person activities like teaching in classroom settings and government services are often expected to continue or restart quickly. It becomes important to evaluate the risk of airborne disease transmission while accounting for the physical presence of humans, furniture, and electronic equipment, as well as ventilation. Here, we present a computational framework and study based on detailed flow physics simulations that allow straightforward evaluation of various seating and operating scenarios to identify risk factors and assess the effectiveness of various mitigation strategies. These scenarios include seating arrangement changes, presence/absence of computer screens, ventilation rate changes, and presence/absence of mask-wearing. This approach democratizes risk assessment by automating a key bottleneck in simulation-based analysis—creating an adequately refined mesh around multiple complex geometries. Not surprisingly, we find that wearing masks (with at least 74% inward protection efficiency) significantly reduced transmission risk against unmasked and infected individuals. While the use of face masks is known to reduce the risk of transmission, we perform a systematic computational study of the transmission risk due to variations in room occupancy, seating layout and air change rates. In addition, our findings on the efficacy of face masks further support use of face masks. The availability of such an analysis approach will allow education administrators, government officials (courthouses, police stations), and hospital administrators to make informed decisions on seating arrangements and operating procedures. Supplementary Information The online version contains supplementary material available at 10.1007/s00366-022-01773-9.

Investigating the effectiveness of online interactive courses on loneliness and quality of life of older adults in the community during the COVID-19 pandemic: A pilot study and a randomized controlled trial.

BACKGROUND: The early stage of the COVID-19 pandemic was a critical time for increasing loneliness, especially for older people. However, there is insufficient existing research on associated interventions and their effectiveness. AIM: This study aimed to investigate the effectiveness of an 8-week online interactive course on the loneliness, depression, social support, and quality of life (QOL) of older adults in the community during the COVID-19 pandemic. METHODS: A single-blind randomized controlled trial was conducted to collect data from a community in Taiwan. Eighty-nine participants recruited from long-term care institutions were randomly divided into an experimental group (n = 44) and a control group (n = 45). Participants in the experimental group received an 8-week (Monday to Friday) intensive online interactive course, whereas those in the control group watched 8 weeks (Monday to Friday) of unidirectional online video programs. RESULTS: Significant differences were observed in the UCLA Loneliness Scale and in both the psychological health and social relationship domains of the WHO Quality of Life-BREF Scale. In other words, compared with those in the control group, participants in the experimental group experienced more significant improvements in the state of their loneliness as well as QOL in the psychological health and social relationship domains (without the physical health/environment domains) after taking the online interactive course. CONCLUSIONS: The results of this study showed that the 8-week online interactive course could effectively improve the loneliness, the psychological health domain, and the social relationship domain of the QOL of the older adults of a particular community during the ongoing pandemic. Geriatr Gerontol Int 2023; 23: 91-97.

Correction: Lee et al. The Synergistic Inhibition of Coronavirus Replication and Induced Cytokine Production by Ciclesonide and the Tylophorine-Based Compound Dbq33b. Pharmaceutics 2022, 14, 1511.

In the original publication [...].

Research on the Impact of Regular Exercise Behavior of College Students on Academic Stress and Sleep Quality during the COVID-19 Pandemic.

When college students face the COVID-19 pandemic and new learning challenges simultaneously, how to reduce or alleviate their own academic stress has become a topic of concern to students and their parents. The psychological and physiological benefits of regular exercise have been confirmed by related studies. This study aimed to explore the impact of college students' regular exercise behavior on academic stress and sleep quality during the COVID-19 pandemic. This study used a purposive sampling method to collect data through online questionnaires posted to relevant college student groups in northern, central, southern, and eastern Taiwan and the outlying islands. A total of 320 questionnaires were collected, with a response rate of 91.4%; based on 304 valid questionnaires. The validity rate was 95%. The obtained data were entered in SPSS 24.0 statistical software, and the correlation between variables was analyzed with AMOS 24.0 statistical software. The results show that hypothesis 1 is established, that is, regular exercise behavior of college students during the COVID-19 pandemic has a significant negative impact on academic stress, meaning that during the COVID-19 pandemic, if college students can use their spare time to make exercise part of their life, such a regular schedule will help reduce their academic stress. In addition, the empirical results show that hypothesis 2 is established, that is, regular exercise behavior of college students during the COVID-19 pandemic has a significant positive impact on sleep quality. A possible reason is that under the COVID-19 pandemic, the efficiency of the body to absorb oxygen is increased through regular exercise, which reduces pressure and improves sleep quality. Hypothesis 3 is also confirmed, that is, the academic stress of college students during the COVID-19 pandemic has a significant negative impact on sleep quality. The reason may be that many leisure and social activities have been suspended during the COVID-19 pandemic, and thus college students exercised and studied during the time they originally intended for leisure and social activities, which reduced their academic stress, stabilized their mood, and improved their sleep quality.

Inhibitory activities of alginate phosphate and sulfate derivatives against SARS-CoV-2 in vitro

Alginate derivatives have been demonstrated remarkable antiviral activities. Here we firstly identified polymannuronate phosphate (PMP) as a highly potential anti-SARS-CoV-2 agent. The structure-activity relationship showed polymannuronate monophosphate (PMPD, Mw: 5.8 kDa, P%: 8.7 %) was the most effective component to block the interaction of spike to ACE2 with an IC50 of 85.5 nM. Surface plasmon resonance study indicated that PMPD could bind to spike receptor binding domain (RBD) with the KD value of 78.59 nM. Molecular docking further suggested that the probable binding site of PMPD to spike RBD protein is the interaction interface between spike and ACE2. PMPD has the potential to inhibit the SARS-CoV-2 infection in an independent manner of heparan sulfate proteoglycans. In addition, polyguluronate sulfate (PGS) and propylene glycol alginate sodium sulfate (PSS) unexpectedly showed 3CLpro inhibition with an IC50 of 1.20 μM and 1.42 μM respectively. The polyguluronate backbone and sulfate group played pivotal roles in the 3CLpro inhibition. Overall, this study revealed the potential of PMPD as a novel agent against SARS-CoV-2. It also provided a theoretical basis for further study on the role of PGS and PSS as 3CLpro inhibitors. Graphical Unlabelled Image

High-intensity vector signals for detecting SARS-CoV-2 RNA using CRISPR/Cas13a couple with stabilized graphene field-effect transistor

False detection of SARS-CoV-2 is detrimental to epidemic prevention and control. The scalar nature of the detected signal and the imperfect target recognition property of developed methods are the root causes of generating false signals. Here, we reported a collaborative system of CRISPR-Cas13a coupling with the stabilized graphene field-effect transistor, providing high-intensity vector signals for detecting SARS-CoV-2. In this collaborative system, SARS-CoV-2 RNA generates a “big subtraction” signal with a right-shifted feature, whereas any untargets cause the left-shifted characteristic signal. Thus, the false detection of SARS-CoV-2 is eliminated. High sensitivity with 0.15 copies/μL was obtained. In addition, the wide concerned instability of the graphene field-effect transistor for biosensing in solution environment was solved by the hydrophobic treatment to its substrate, which should be a milestone in advancing it's engineering application. This collaborative system characterized by the high-intensity vector signal and amazing stability significantly advances the accurate SARS-CoV-2 detection from the aspect of signal nature.

Psychological impact, coping behaviors, and traumatic stress among healthcare workers during COVID-19 in Taiwan: An early stage experience.

OBJECTIVE: This study investigated the psychological impact on, coping behaviors of, and traumatic stress experienced by healthcare workers during the early stage of the COVID-19 pandemic and formulated effective support strategies that can be implemented by hospitals and government policymakers to help healthcare staff overcome the pandemic. METHODS: This cross-sectional study recruited clinical healthcare workers at a regional hospital in Nantou County, Taiwan. The questionnaire collected personal characteristics, data on the impact and coping behaviors of the pandemic, and Impact of Event Scale-Revised (IES-R). A total of 354 valid questionnaires were collected. The statistical methods employed were univariate and multivariate stepwise regression, and logistic regression. RESULTS: Perceived impact and coping behaviors were found to be moderate in degree, and traumatic stress was lower than that in other countries. However, our data identified the following subgroups that require special attention: those with young age, those living with minor children, nurses, those with self-rated poor mental health, and those with insufficient COVID-19-related training. CONCLUSION: Managers should pay particular attention to helping healthcare workers in high-risk groups, strengthen COVID-19 training, provide adequate protective equipment and shelter, and offer psychological counseling.

Newly-diagnosed immunoglobulin A nephropathy with increased plasma galactose-deficient-IgA1 antibody associated with mRNA COVID-19 vaccination: a case report.

Newly-diagnosed or relapses of immunoglobulin A nephropathy (IgAN) have been associated with COVID-19 vaccination in the literature. Most reported cases were mild clinical diseases characterized by microscopic haematuria and do not require dialysis treatment. This current case report describes a 55-year-old male patient that presented to the emergency department with acute kidney injury after receiving the first dose of the mRNA-1273 COVID-19 vaccine. After admission, his renal function deteriorated rapidly, and then he developed uraemic encephalopathy. He underwent emergency haemodialysis with a rapid improvement in his mental status. Renal biopsy showed newly-diagnosed IgA nephropathy along with markedly elevated plasma level of galactose-deficient-IgA1 (Gd-IgA1) antibody. The patient did not receive immunosuppressive treatment and is now dialysis-free. Immune activation is considered an essential factor in developing or exacerbating IgAN following COVID-19 vaccination. This current case report demonstrates that elevated Gd-IgA1 antibody may be the potential mechanistic link between COVID-19 vaccination and IgAN.

The Anti-Obesity Compound Asperuloside Reduces Inflammation in the Liver and Hypothalamus of High-Fat-Fed Mice

Obesity produces a systemic low-grade inflammation associated with many adverse health conditions and, as we recently learned, with complications of COVID-19. Functional studies in animal models have demonstrated that asperuloside, an iridoid glycoside found in many medicinal plants, has produced promising anti-obesity results. However, the safety profile and the anti-inflammatory properties of asperuloside remain unknown. Here, we confirmed the previously reported anti-obesity properties of asperuloside, and, importantly, we performed toxicity studies assessing cell viability providing a dose reference for future animal experiments. Asperuloside significantly reduced blood levels of leptin and the mRNA levels of orexigenic peptides, such as NPY and AgRP in mice consuming HFD, with no effect on mice eating a standard chow diet. In addition, our results indicate that ASP reduced both hypothalamic and hepatic mRNA levels of pro-inflammatory cytokines such as IL-1, IL-6 and TNF-αas well as the blood levels of plasminogen activator inhibitor-1 (PAI-1), which are known to play a major role in the development of insulin resistance and cardiovascular complications. Collectively, our findings suggest that asperuloside is a safe compound for long-term use in animal models and that it reduces the elevated levels of pro-inflammatory cytokines occurring in obesity.

Early Warning of Infectious Diseases in Hospitals Based on Multi-Self-Regression Deep Neural Network.

Objective: Infectious diseases usually spread rapidly. This study aims to develop a model that can provide fine-grained early warnings of infectious diseases using real hospital data combined with disease transmission characteristics, weather, and other multi-source data. Methods: Based on daily data reported for infectious diseases collected from several large general hospitals in China between 2012 and 2020, seven common infectious diseases in medical institutions were screened and a multi self-regression deep (MSRD) neural network was constructed. Using a recurrent neural network as the basic structure, the model can effectively model the epidemiological trend of infectious diseases by considering the current influencing conditions while taking into account the historical development characteristics in time-series data. The fitting and prediction accuracy of the model were evaluated using mean absolute error (MAE) and root mean squared error. Results: The proposed approach is significantly better than the existing infectious disease dynamics model, susceptible-exposed-infected-removed (SEIR), as it addresses the concerns of difficult-to-obtain quantitative data such as latent population, overfitting of long time series, and considering only a single series of the number of sick people without considering the epidemiological characteristics of infectious diseases. We also compare certain machine learning methods in this study. Experimental results demonstrate that the proposed approach achieves an MAE of 0.6928 and 1.3782 for hand, foot, and mouth disease and influenza, respectively. Conclusion: The MRSD-based infectious disease prediction model proposed in this paper can provide daily and instantaneous updates and accurate predictions for epidemic trends.

Tyrphostin AG1024 Suppresses Coronaviral Replication by Downregulating JAK1 via an IR/IGF-1R Independent Proteolysis Mediated by Ndfip1/2_NEDD4-like E3 Ligase Itch.

JAK1 depletion or downregulation was previously reported to account for coronavirus inhibition. Here, we found that AG1024, an IR (insulin receptor) and IGF-1R (insulin-like growth factor 1 receptor) inhibitor, diminishes JAK1 protein levels and exerts anti-coronaviral activities with EC50 values of 5.2 ± 0.3 µM against transmissible gastroenteritis coronavirus (TGEV) and 4.3 ± 0.3 µM against human flu coronavirus OC43. However, although the IR and IGF-1R signaling pathways are activated by insulin or IGF-1 in swine testis cells, they are not triggered upon TGEV infection. AG1024, therefore, inhibits coronaviral replication and downregulates JAK1 protein levels independently of IR and IGF-1R. Moreover, JAK1 proteolysis caused by AG1024 was found through activation of upstream Ndfip1/2 and its effector NEDD4-like E3 ligase Itch. In addition, ouabain, which was reported to mediate JAK1 proteolysis causing anti-coronaviral activity by activation of Ndfip1/2 and NEDD4 E3 ligase, additively inhibited anti-coronaviral activity and JAK1 diminishment in combination with AG1024. This study provides novel insights into the pharmacological effects of AG1024 and Itch E3 ligase mediated JAK1 proteolysis and identified Ndfip1/2 as a cognate effector for JAK1 proteolysis via the diversified E3 ligases NEDD4 and NEDD4-like Itch. These findings are expected to provide valued information for the future development of anti-viral agents.

The Synergistic Inhibition of Coronavirus Replication and Induced Cytokine Production by Ciclesonide and the Tylophorine-Based Compound Dbq33b.

Ciclesonide is an inhaled corticosteroid used to treat asthma and has been repurposed as a treatment for mildly ill COVID-19 patients, but its precise mechanism of action is unclear. Herein, we report that ciclesonide blocks the coronavirus-induced production of the cytokines IL-6, IL-8, and MCP-1 by increasing IκBα protein levels and significantly decreasing p65 nuclear translocation. Furthermore, we found that the combination of ciclesonide and dbq33b, a potent tylophorine-based coronavirus inhibitor that affects coronavirus-induced NF-κB activation a little, additively and synergistically decreased coronavirus-induced IL-6, IL-8, and MCP-1 cytokine levels, and synergistically inhibited the replication of both HCoV-OC43 and SARS-CoV-2. Collectively, the combination of ciclesonide and dbq33b merits consideration as a treatment for COVID-19 patients who may otherwise be overwhelmed by high viral loads and an NF-κB-mediated cytokine storm.

Changes of COVID-19 Knowledge, Attitudes, Practices and Vaccination Willingness Among Residents in Jinan, China.

Background: Vaccine hesitancy is responsible for low vaccine coverage and increased risk of epidemics. The purpose of this study was to assess whether public knowledge, attitudes, practices, and willingness to vaccinate against COVID-19 have changed over time and at different stages of vaccination. Methods: Two consecutive surveys were conducted among residents of the Leshan Community in Jinan from May to June, 2021 (n = 423) (basic dose vaccination phase) and from December, 2021 to January, 2022 (n = 470) (booster vaccination phase). Randomly sampling was used in residents to complete an anonymous questionnaire. Chi-square test was used to compare the changes in knowledge, attitudes and practices of the subjects in different survey stages. Multivariable logistic regression analysis was used to explore factors related to vaccination hesitancy. Results: In the booster vaccination phase, protective behaviors (89.9%) of residents increased significantly compared with the basic vaccination phase (74.5%). Residents were more hesitant to receive booster doses than basal doses of COVID-19 vaccine (OR: 18.334, 95% CI: 9.021-37.262). Residents with other marital statuses (OR: 2.719, 95% CI: 1.632-4.528), negative attitudes toward government measures were more hesitant to get vaccinated (OR: 2.576, 95% CI: 1.612-4.118). People who thought their physical condition was very good or good were more likely to be vaccinated than those who thought they were in fair or poor health (OR: 0.516, 95% CI: 0.288-0.925; OR: 0.513, 95% CI: 0.295-0.893). Young people inclined to use new media (such as WeChat and microblog) to obtain information, while the elderly inclined to use traditional methods (such as television). Government propaganda, residents' perception of the importance of vaccines and the risk of disease were the main reasons for accelerating residents to vaccinate. The main reasons affecting residents' lack of vaccination were contraindications to the vaccine or inconvenient time for vaccination. Conclusions: Vaccine hesitancy increased significantly with change in vaccination stage. Strategies should be adopted to increase vaccination coverage such as improving the convenience of vaccination, promoting through multiple channels.

Discussing the Effect of Students' Crisis Awareness on Emotion During the COVID-19 Pandemic From the Perspective of Trust

The effects of crises vary among individuals, societies, and nations. Governments' crisis management is quite different from that of non-governmental organizations, especially in terms of “publicity,” since it involves bureaucracy to address people's accountability concerns. The purpose of this study is to investigate the relationship between students' crisis awareness, trust, and emotions in the event of a major public health emergency. A questionnaire survey was conducted for this study. A total of 500 copies of questionnaires were distributed to the college students in Jiangxi. Among those, 437 valid copies were retrieved, with a retrieval rate of 87%. A structural equation model (SEM) was used to conduct the statistical analyses. The research results were summarized as follows: (1) At the stage of epidemic spread, people can easily fall into the negative emotion. (2) The society with a good trust relationship considers schools less responsible for critical incidents and more helpful for crisis communication. (3) Reducing the negative emotions of the public after the occurrence of critical incidents can effectively reduce the damage of critical incidents to the organization. Avoiding a loss of student confidence and increasing anger, protecting the school's reputation, having a good communication effect, and minimizing the impact of the crisis can help the students develop better trust toward the school. When a crisis occurs on campus, this can reduce the possibility of students' showing negative emotions and spreading rumors. It is considered that the findings provide guidance on how to optimize the management of public health crisis situations and improve students' mental health.

Infection control operations of a large hospital in Taiwan to prevent nosocomial outbreaks during COVID-19 pandemic.

BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) is highly contagious, with a potential to cause large nosocomial outbreaks in the hospital setting. We report the advance deployment of comprehensive, multi-level infection control measures in a 3,700-bed large hospital to prevent nosocomial outbreaks of COVID-19 during the pandemic. METHODS: We implemented a series of dynamic infection control policies during the pandemic. A confirmed COVID-19 case was defined by positive real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay. All healthcare worker (HCW) having symptoms or close contact with the confirmed case received the RT-PCR test. RESULTS: A total of 5,722 patients were tested in our hospital from January to May 2020. Twenty-five patients were confirmed COVID-19, including two inpatients. A cluster of 4 HCWs with COVID-19 associated with the 2nd inpatient was identified in the early stage of epidemic. Our enhanced traffic control bundling, mask wearing, hand hygiene and environmental cleaning were reinforced after the outbreak. All other confirmed cases were identified at our outdoor quarantine station or epidemic clinic afterwards, and the results of testing for 146 symptomatic HCWs were all negative. CONCLUSIONS: Integrated teamwork, advance deployment of infection control measures and efficient diagnostic testing and response protected HCW and facilities from large SARS-CoV-2 outbreaks and preserved the capacity and function of the health care system during the pandemic.