Virtual student mobility on Zoom: digital platforms and differentiated experiences of international education and (im)mobilities in a time of pandemic

Against the backdrop of growing prevalence of digital platforms in higher education, strong considerations are being made for the potential of virtual student mobility in the aftermath of the pandemic. While extant literature on digital education platforms has shed light on the relationships between platform interfaces and wider political economies, less is known about students' experiences of virtually mediated mobility and immobility. This article draws upon research that examines how students and universities are responding to the COVID-19 pandemic and its subsequent impact on border control and international travel. First, it discusses how the socio-technical platform of Zoom extends and stabilises students' imagined, communicative, and aspirational mobilities in a context of stalled physical mobility. Second, it underlines the crevices and moorings of digital platforms in the mediation of students' experiences of mobility and immobility. Third, it examines how students refashion their (im)mobile subjectivities in and through digital spaces vis-a-vis a negotiation of co-presences in a renewed context of virtual interaction. In doing so, we argue the role of corporeal mobility, social interaction, and inhabiting tangible places remain a core aspect of student mobility experiences and aspirations.

[Latent period and incubation period with associated factors of COVID-19 caused by Omicron variant].

Objective: To estimate the latent period and incubation period of Omicron variant infections and analyze associated factors. Methods: From January 1 to June 30, 2022, 467 infections and 335 symptomatic infections in five local Omicron variant outbreaks in China were selected as the study subjects. The latent period and incubation period were estimated by using log-normal distribution and gamma distribution models, and the associated factors were analyzed by using the accelerated failure time model (AFT). Results: The median (Q1, Q3) age of 467 Omicron infections including 253 males (54.18%) was 26 (20, 39) years old. There were 132 asymptomatic infections (28.27%) and 335 (71.73%) symptomatic infections. The mean latent period of 467 Omicron infections was 2.65 (95%CI: 2.53-2.78) days, and 98% of infections were positive for nucleic acid test within 6.37 (95%CI: 5.86-6.82) days after infection. The mean incubation period of 335 symptomatic infections was 3.40 (95%CI: 3.25-3.57) days, and 97% of them developed clinical symptoms within 6.80 (95%CI: 6.34-7.22) days after infection. The results of the AFT model analysis showed that compared with the group aged 18-49 years old, the latent period [exp(ß)=1.36 (95%CI: 1.16-1.60), P<0.001] and incubation period [exp(ß)=1.24 (95%CI: 1.07-1.45), P=0.006] of infections aged 0-17 years old were prolonged. The latent period [exp(ß)=1.38 (95%CI: 1.17-1.63), P<0.001] and the incubation period [exp(ß)=1.26 (95%CI: 1.06-1.48), P=0.007] of infections aged 50 years old and above were also prolonged. Conclusion: The latent period and incubation period of most Omicron infections are within 7 days, and age may be a influencing factor of the latent period and incubation period.

Difference of Clinical Characteristics in Patients with Omicron and Delta Variants of SARS-CoV-2 in Beijing, China

Background Delta and Omicron are two main variants that have been prevalent since 2021. However, the Omicron variant of severe acute respiratory syndrome coronavirus 2 shows a less severe clinical presentation and high transmissibility. Therefore, we carried out this retrospective study to evaluate Omicron severity compared with the Delta variant and further comprehend the differences in clinical characteristics in patients with the Omicron variant. Methods We extracted clinical data and compared clinical severity, symptoms, vaccination status, laboratory parameters, viral shedding time, and computed tomography (CT) imaging between the two groups of patients, which included 109 COVID-19 cases with the Delta variant and 183 cases with the Omicron variant, from January 19 to April 1, 2022, in Beijing Ditan Hospital. In addition, the Beijing Center for Disease Prevention and Control conducted whole-genome sequencing. Results We obtained 94 strains of variants of concern/Delta and 110 strains of variants of concern/Omicron. For the 110 Omicron strains, three were assigned as BA.1.1, 53 as BA.2, and 54 as BA.2.2. Among patients with the Delta variant, 54% (59/109) were moderate, which was significantly higher than that of patients with the Omicron variant (7% (12/183), P < 0.001). The number of patients with mild symptoms in the Omicron group was significantly higher than in the Delta group (80% vs. 35%, P < 0.001). Compared with the Omicron group, patients with underlying diseases or obesity, 60 years or older, or unvaccinated in the Delta group had more severe disease, and there was a significant difference between the two groups. The viral shedding time in the Omicron group was shorter than in the Delta group ((11.9 ± 5.9) vs. (14.0 ± 5.8) days, P = 0.003). Among the 183 patients in the Omicron group, 104 (57%) had dry or sore throat symptoms, more than those in the Delta group (34% (37/109);P < 0.001). In the Delta group, patients in the moderate group had more fever and cough symptoms than those in the mild group. The remission time of CT imaging in the Omicron group was shorter than in the Delta group ((9.0 ± 5.2) vs. (13.2 ± 4.2) days, P = 0.018). Conclusions Patients with Delta variants are more likely to have pneumonia, mainly with fever and cough symptoms, while patients with the Omicron variant are mostly mild, with more prominent dry or sore throat symptoms. In addition, patients with the Omicron variant have a short viral shedding time and rapid absorption of pneumonia. © Wolters Kluwer Health, Inc. All rights reserved.

[Analysis on infection sources and transmission chains of three outbreaks caused by 2019-nCoV Omicron variant in Beijing, China].

Objective: To investigate the infection sources and the transmission chains of three outbreaks caused by 2019-nCoV Omicron variant possibly spread through cross-border logistics in Beijing. Methods: Epidemiological investigation and big data were used to identify the exposure points of the cases. Close contacts were traced from the exposure points, and the cases' and environmental samples were collected for nucleic acid tests. Positive samples were analyzed by gene sequencing. Results: The Omicron variant causing 3 outbreaks in Beijing from January to April, 2022 belonged to BA.1, BA.1.1 and BA.2. The outbreaks lasted for 8, 12 and 8 days respectively, and 6, 42 and 32 cases infected with 2019-nCoV were reported respectively. International mail might be the infection source for 1 outbreak, and imported clothes might be the infection sources for another 2 outbreaks. The interval between the shipment start time of the imported goods and the infection time of the index case was 3-4 days. The mean incubation period (Q1, Q3) was 3 (2,4) days and the mean serial interval (Q1, Q3) was 3 (2,4)days. Conclusions: The 3 outbreaks highlighted the risk of infection by Omicron variant from international logistics-related imported goods at normal temperature. Omicron variant has stronger transmissibility, indicating that rapid epidemiological investigation and strict management are needed.

Immunologic Mechanisms and Advances in Clinical Research for The mRNA Cancer Vaccine

Messenger RNA (mRNA) therapy is a novel anticancer treatment strategy based on in vitro transcription (IVT) mRNA, with promising potential for the treatment of malignant tumors. The outbreak of the COVID-19 pandemic in the early 21st century has greatly promoted the application of mRNA technologies in SARS-CoV-2 vaccines. Meanwhile, the research and development of the mRNA cancer vaccine has become a priority. A number of key technologies, including mRNA production strategies, delivery systems, anti-tumor immune strategies, etc., have made dramatic improvements and modifications. These technologies accelerated the research progress and clinical applications of mRNA therapy, thereby greatly overcoming the bottleneck problem, such as the instability, inefficient deliveries, and weak immunogenicity of the mRNA vaccines in the past. This review provides a detailed overview of the production, delivery systems, immunological mechanisms, and antitumor immune response strategies for mRNA cancer vaccines. We list some mRNA cancer vaccines that have been used as candidates for cancer treatment and the clinical trials in the field of tumor immunotherapy. In addition, we discuss about the immunological mechanism of the mRNA vaccines to destroy tumors, as well as the challenges and prospects for the future. © 2022 Institute of Biophysics,Chinese Academy of Sciences. All rights reserved.

Liver injury caused by antiviral agents for COVID-19.

Antiviral therapy is important for COVID-19. Currently, the anti-2019-nCoV drugs in clinical trials include broad-spectrum antiviral drugs (alpha interferon and ribavirin), hemagglutinin inhibitors (arbidol), human immunodeficiency virus protease inhibitors (lopinavir/ritonavir and darunavir/cobicistat), nucleoside analogues (favipiravir and remdesivir) and antimalarial drug (chloroquine);while liver damage may occur in some patients with the medication. This article reviews the research on liver damage associated with anti-2019-nCoV drugs, aiming at promoting the safe and effective antiviral therapy for COVID-19 patients.Copyright © 2020 by the Chinese Medical Association.

Liver injury caused by antiviral agents for COVID-19.

Antiviral therapy is important for COVID-19. Currently, the anti-2019-nCoV drugs in clinical trials include broad-spectrum antiviral drugs (alpha interferon and ribavirin), hemagglutinin inhibitors (arbidol), human immunodeficiency virus protease inhibitors (lopinavir/ritonavir and darunavir/cobicistat), nucleoside analogues (favipiravir and remdesivir) and antimalarial drug (chloroquine);while liver damage may occur in some patients with the medication. This article reviews the research on liver damage associated with anti-2019-nCoV drugs, aiming at promoting the safe and effective antiviral therapy for COVID-19 patients.Copyright © 2020 by the Chinese Medical Association.

International Student Mobility in a Deglobalizing and Post-Pandemic World: Resilience, Reconfiguration, Renewal

Writing about international student mobility (ISM) at such a juncture, there is a certain temptation to go with hyperbolic statements about how the ISM landscape has shifted dramatically in a world characterized by deglobalizing momentum (Irwin, 2020) or how the COVID pandemic was a "game-changer” (Yang & Lu, 2022, p. 133). Undoubtedly, the past several years have been volatile for international students and all those involved in various aspects of ISM. The unsynced trajectories of the pandemic in different regions/countries of the world, aggravated by the pandemic's multifarious global repercussions – social, economic, geo-political, etc. – have created a cacophony of experiences for international students, about which scholarship is rapidly emerging, both in this journal (to mention just a few: Sustarsic & Zhang, 2021;Thorson et al., 2021;Zabin, 2022) and elsewhere (e.g., Gomes, 2022;Xu & Tran, 2022;Yang, 2022b). © The Author(s) 2015. All Rights Reserved.

An Analysis of Public Service Satisfaction of Tourists at Scenic Spots: The Case of Xiamen City

The outbreak of the COVID-19 epidemic has greatly hindered the development of the tourism industry. It is urgent for the city to improve the quality of public service in scenic spots, so as to attract more tourists and achieve sustainable development. With a literature review and reference to some guidance, the evaluation indicator system of public service satisfaction of scenic spots was constructed based on the analytic hierarchy process. Then, we distributed two questionnaires to complete the study. The first is the expert questionnaire for the evaluation indicator system. We used YAAHP software to process the questionnaire data and calculated the weight of each indicator, which provided a basis for the following analysis. The second is the questionnaire distributed to tourists of Xiamen. Then, we used the fuzzy comprehensive evaluation method to analyze the satisfaction of public services in scenic spots. The outcomes show that tourists are overall satisfied with the public services of scenic spots in Xiamen. However, there are still some problems, such as lagging information service, inadequate security, and supervision in the scenic spot. Therefore, the city and scenic spots should improve the level of smart tourism service, strengthen the construction of hardware and software facilities, and focus on the protection of tourists' rights and interests. © 2023 by the authors.

Immunologic Mechanisms and Advances in Clinical Research for The mRNA Cancer Vaccine

Messenger RNA (mRNA) therapy is a novel anticancer treatment strategy based on in vitro transcription (IVT) mRNA, with promising potential for the treatment of malignant tumors. The outbreak of the COVID-19 pandemic in the early 21st century has greatly promoted the application of mRNA technologies in SARS-CoV-2 vaccines. Meanwhile, the research and development of the mRNA cancer vaccine has become a priority. A nwnber of key technologies, including mRNA production strategies, delivery systems, anti-tumor immune strategies, etc., have made dramatic improvements and modifications. These technologies accelerated the research progress and clinical applications of mRNA therapy, thereby greatly overcoming the bottleneck problem, such as the instability, inefficient deliveries, and weak immunogenicity of the mRNA vaccines in the past. This review provides a detailed overview of the production, delivery systems, immunological mechanisms, and antitumor immune response strategies for mRNA cancer vaccines. We list some mRNA cancer vaccines that have been used as candidates for cancer treatment and the clinical trials in the field of tumor immunotherapy. In addition, we discuss about the immunological mechanism of the mRNA vaccines to destroy tumors, as well as the challenges and prospects for the future.

Trends in Lipid-Lowering Prescriptions by Statin Intensity - United States, 2017-202

Introduction: Almost 30% of US adults have elevated low-density lipid cholesterol (LDL-C) increasing their risk of atherosclerotic cardiovascular disease (ASCVD). The 2018 American College of Cardiology/American Heart Association Multisociety Cholesterol Guideline recommends maximally tolerated statin for those at increased ASCVD risk and add-on therapies (ezetimibe and PCSK9 inhibitors) for those at very high risk with LDL-C>=70 mg/dl, but prescription fill trends are unknown. Method(s): Using the IQVIA Total Patient Tracker database (covering ~93% of outpatient retail prescriptions in the US) from Q1 2017-Q1 2022, we determined counts of patients who filled low-, moderate-, or high-intensity statins alone and with ezetimibe or PCSK9 inhibitors. Overall percent change and joinpoint regression were used to assess trends. Result(s): From Q1 2017-Q1 2022, patients filling any statin intensity increased 25% with the greatest increase in high-intensity statins (64.1%). Concurrent fills of high-intensity statin and ezetimibe rose 210%, with an increase in slope by Q2 2019 for all statin intensities (p<0.001, Figure A). Patients filling a PCSK9 inhibitor and all statin intensities increased over the study period (2124% for high-intensity), with increases in slope in Q2 2019 and continued increase in fills but less sharp rise in Q1 2020 (p<0.001, Figure B). Conclusion(s): Increasing prescription fills of high-intensity statins and add-on ezetimibe and PCSK9 inhibitors indicate uptake of guideline-concordant lipid-lowering therapies for cardiovascular disease prevention. There is need for continuity of PCSK9 inhibitor therapy which may have been disrupted during COVID-19. (Figure Presented).

Predictors of High-Flow Nasal Cannula Failure in Covid-19

INTRODUCTION: Severe coronavirus disease-19 (COVID-19) is characterized by progressive hypoxemia and patients may require advanced oxygen therapy, including high-flow nasal cannula (HFNC) therapy and mechanical ventilation. Previous data has suggested that the ROX index, IL-6 levels, thrombocytopenia, and kidney injury may predict failure of high-flow nasal cannula therapy. Our study aims to evaluate risk factors that predict HFNC failure in our patient population. METHOD(S): Retrospective cohort study of patients treated for COVID-19 across 4 hospitals in Atlanta, Georgia between February 2020 and February 2021. Patients placed on high-flow nasal cannula within the first 24 hours of admission and who remained on high-flow nasal cannula for at least 6 consecutive hours were identified. Patients that met our cohort criteria were followed for the first seven days of admission and transition across oxygen therapy modalities were examined. Demographic and comorbidity data of patients who failed high-flow nasal cannula therapy within the first 7 days, defined as need for mechanical ventilation or death, were compared to patients who did not fail. RESULT(S): There were 1205 patients placed on high-flow nasal cannula oxygen therapy in our hospitals between February 2020 and February 2021. In total, 465 patients met inclusion criteria. Of the cohort, 35.9% remained on highflow, 32.0 % transitioned to low-flow or room air, and 31.6% failed high-flow nasal cannula therapy within the first week of hospitalization (26.2% failed due to requiring intubation and 5.4% failed due to death). When comparing demographics and comorbidities, patients who failed were older (median age 67.5 vs 62 years, p=0.01) and more frequently had renal disease (28.8% vs 18.5%, p=0.02). There were no significant differences in sex, race, congestive heart failure, pulmonary disease, hypertension, diabetes mellitus, liver disease, or metastatic cancer. CONCLUSION(S): In our patient population, 31.6% of patients failed high-flow nasal cannula therapy within the first week of admission due to mechanical ventilation or death. Age and renal disease were significant risk factors for highflow nasal cannula therapy failure in COVID-19 patients.

Attribute Analysis and Diagnosis of LUNG CT Images of COVID-19

Computed Tomography (CT) is an authoritative verification standard for patients with Corona Virus Disease 2019 (COVID-19). Automatic detection of lung infection through CT is of great significance for epidemic prevention and control and prevention of cross-infection. The accuracy of existing lung CT image segmentation methods is not high, and due to the privacy protection measures of hospitals, the number of COVID-19 lung CT data sets is too small, which is prone to over-fitting during training. In this paper, we propose a qualitative mapping model for the diagnosis and localization of COVID-19 lesions. The binary image processed by U-net network is used as input, and lung CT is segmented as four attributes, and attribute diagnosis is carried out with the help of correlation matrix and transformation degree function. Experiments show that this method not only avoids the over-fitting risk of data sets, but also increases the robustness of data. Experiments also prove that this design has higher accuracy than the simple neural network learning. © 2022 IEEE.

Impact of delay to definitive surgical management in colorectal cancer patients during the covid pandemic: A single unit experience

Aim: The Covid-19 pandemic has caused significant strain on the UK national healthcare system. Consequently, there has been a delay in elective colorectal cancer (CRC) resections performed across the UK. We aim to assess how a delay in surgical resection of CRC patients due to covid influences may influence tumour histology and post-operative outcomes compared to pre-pandemic period Method: Retrospective review of timing of CRC resection since diagnosis, tumour histology and post-surgical outcomes of all patients undergoing elective non-metastatic CRC resection during March to June 2020 (covid group) with that during March to June 2019 (pre-covid group) Results: 82 new CRCs were diagnosed in covid group compared to 73 in pre-covid group. In pre-covid group, 61.5% patients underwent resection <4 weeks since diagnosis, 20.2% in 4 to <8 weeks, and 13.7% in >=8 weeks. Comparatively, in covid group, 17.7% patients underwent resection <4 weeks (p = 0.019), 24.4% in 4 to <8 weeks, and 53.3% in >=8 weeks (p = 0.034). Rectal cancer resection had more notable delay >=8 weeks in covid group compared to pre-covid. 25.6% patients had confirmed T4 histology in covid group, compared to 12.3% (p = 0.035) in pre-covid. 14.9% patients received adjuvant therapy following CRC resection in pre-covid group, compared to 29.8% in covid group (p = 0.042). Surgical delays >8 weeks during pandemic were significantly associated with high tumour grade (p = 0.032). Surgical delays, however, were not statistically significantly associated with need for adjuvant therapy post-resection, 1 year disease free survival rates, or palliation rates (p > 0.1). Conclusion(s): Covid pandemic has led to significant delays in elective CRC resections. Delayed CRC resections due to covid influence were associated with advanced tumour histology, but not with worsening short-term oncological outcomes. A longer study period is required to assess whether advanced tumour histology during pandemic leads to higher rates of localised or distant recurrence.

Management and outcomes of colorectal cancer during the covid-19 era: A single unit experience

Aim: Covid-19 pandemic has caused significant disruption of investigations and management of colorectal cancers (CRC) across the UK. We aim to assess the management and outcomes of new CRCs diagnosed during the covid first wave at our unit. Method(s): Retrospective study comparing management and outcomes of all patients newly diagnosed with CRC during March to June 2020 (covid group) with that during March to June 2019 (pre-covid group). Result(s): 82 new CRCs were diagnosed in covid group compared to 73 in pre-covid group. Median age at referral was 75 and 72 years in covid and pre-covid groups respectively. 28/82(34.1%) presented as an emergency in covid group, compared to 20/73(27.4%) in pre-covid (p = 0.061). 29/82(35.4%) received neo-adjuvant chemotherapy in covid group, compared to 9/73(12.5%) in pre-covid (p = 0.022). 55/82(67%) proceeded to CRC resection in covid group, compared to 51/73(69.8%) in pre-covid (p = 0.087). Difference in R0 resections were not statistically significant (p = 0.076). 41.5% resections were laparoscopic in covid group, compared to 39.7% in pre-covid. 32/82(39%) patients in covid group had stoma formation during surgical resection, 44% of these were unplanned. Comparatively, 21/73(28.7%) in pre-covid group had stoma formation (p = 0.043), 42% were unplanned. No patients had stoma reversal in covid group, compared to 19% in pre-covid group. 33% were palliated and died within 3 years following CRC diagnosis in covid group, compared to 36.6% in pre-covid (p = 0.081). Conclusion(s): There was no statistically significant difference in emergency presentations of new CRC, in total number of R0 resections performed, as well as in CRC palliation rates during the covid first-wave. It is important that we protect and maintain our services to minimise impact of the ongoing pandemic on CRC patient care, and to consolidate benefits of earlier diagnosis to our patients.

[Survey on infection source of a cold-chain product associated COVID-19 epidemic caused by 2019-nCoV Delta variant in Beijing].

Objective: To investigate the source and the transmission chain of a cold-chain product associated COVID-19 epidemic caused by 2019-nCoV Delta variant in Beijing. Methods: Epidemiological investigation were used to verify the exposure points of the cases. Close contacts were traced from the exposure points, and human and environmental samples were collected for nucleic acid tests. Positive samples were analyzed by gene sequencing. Results: A total of 112 cases of COVID-19 were reported in the epidemic from January 18 to February 6, 2022 in Beijing. Except for 1 case was uncertain, there were epidemiological links among 111 cases. The source of infection was the packages of imported cold-chain products from Southeast Asia, which were harvested and stored in a local cold-storage in January 2021, and packaged and sent to the cold-storage A in A district in June 2021, and then sold in batches in cold-storage B in B district from January 2022. The first case was infected in the handling of positive frozen products, and then 77 cases occurred due to working, eating and living together with the index case in the cold-storage B, cold-storage C and restaurant D. Besides the cold-storage B, C and the restaurant D, there were 16 sub-transmission chains, resulting in additional 35 cases. Conclusion: The epidemic indicated that the risk of 2019-nCoV infection from imported cold-chain products contaminated by package and highlighted the importance to strengthen the management of cold-chain industry in future.

Prospective Evaluation of Serial Protein Biomarker Measurements in Sepsis-Induced Acute Respiratory Distress Syndrome

RATIONALE: Protein biomarkers including soluble receptor for advanced glycation end-products (sRAGE), angiopoietin-2 (Ang- 2), and surfactant protein-D (SP-D) have been studied for diagnosis or prognostication in acute respiratory distress syndrome (ARDS). However, prior studies of ARDS biomarkers often included heterogeneous populations, and rarely examined serial measurements. Our aim was to determine the association between serially measured sRAGE, Ang-2, and SP-D levels and ARDS development in patients with sepsis. METHODS: Adult patients admitted to the medical ICU at Grady Memorial Hospital within 72 hours of sepsis diagnosis were enrolled into this prospective observational cohort study within 48 hours of ICU admission. Patients who already had ARDS at the time of screening were excluded. After obtaining informed consent, serial plasma samples were collected on day 1, 2, and 3 of enrollment, and were analyzed for sRAGE, Ang-2, and SP-D levels using ELISA. The patients were followed for up to 28 days for relevant clinical characteristics and outcomes. The primary outcome was ARDS development according to the Berlin Definition. The secondary outcome was mortality. Pulmonary sepsis was defined as the primary infection being pneumonia (including COVID19) or aspiration pneumonia. The biomarker levels and their changes from day 1 to days 2/3 were compared between those who developed ARDS versus those who did not. RESULTS: Among 80 patients with sepsis enrolled between September 1, 2020 and June 22, 2021, 15 patients (18.8%) developed ARDS and 65 patients (81.3%) did not. ARDS patients had higher proportions of pulmonary sepsis (14/15 [93.3%] vs. 30/65 [46.2%], p=0.001) and COVID19 (7/15 [46.7%] vs. 7/65 [10.8%], p=0.003) compared to non-ARDS patients. ARDS patients had higher SP-D levels on days 1 and 2, and had a greater increase in sRAGE levels from day 1 to day 3, compared to non-ARDS patients (Figure 1A- 1B). Within the ARDS group, those who died had higher sRAGE levels on day 1 compared to those who survived (Figure 1C). CONCLUSIONS: In this analysis, ARDS patients had higher SP-D and a greater increase in sRAGE over time compared to non- ARDS patients. Non-survivors of ARDS also had higher sRAGE compared to survivors. Our findings suggest that early serial biomarker measurements may be useful for identifying sepsis patients at risk of developing ARDS and adverse clinical outcomes, and for risk stratifying sepsis patients in ARDS clinical trials focused on early therapeutics and prevention. Larger studies are needed for more detailed analyses and confirmation of these findings.