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Through a case study of Kunshan, China, this paper shows how a local state utilised place-based leadership to enhance regional economic resilience under the COVID-19 pandemic crisis. It unpacks how Kunshan effectively mitigated early economic disturbances induced by the COVID-19 pandemic, by two ways of leadership actions, namely, enacting jurisdictional power (that is formal leadership), and mobilising wide official and interpersonal networks (that is network leadership). Four specific local-state-led adaptive resilience processes or strategies are identified: stabilising labour supply, mitigating supply-chain disruptions, alleviating financial strains and reconfiguring market orientations. Through these proactive endeavours, the local state played an enabling role in aligning diverse stakeholders and resources across places, scales and sectors, thereby allaying economic shocks and enhancing regional economic resilience. This study contributes to the resilience literature by developing an agency-centric perspective to understanding regional economic resilience during the COVID-19 pandemic.
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Background: The Coronavirus Disease 2019 (COVID-19) pandemic has changed the delivery of cancer care and may have impacted the treatment outcomes. This study described the preliminary outcomes in non-metastatic breast cancer (BC) patients before and during the COVID-19 pandemic. Methods: This retrospective study included adult patients newly diagnosed with non-metastatic BC at two community cancer centers in southeast Texas. Patients diagnosed from 1/2018-10/2018 were included in the control group. Patients diagnosed from 4/2020-1/2021 were included in the COVID-19 group. The key outcomes were progression free survival (PFS), overall survival (OS), breast conserving surgery (BCS) rate, pathological complete response (PCR) rate, and time to treatment initiation (TTI). Results: The study included 74 patients (Table). The proportion of patients with self-detected BC was numerically higher in the COVID-19 group (55%) compared to the control group (36%), although this was not statistically significant (P = 0.09). The median follow-up periods were 38 (IQR: 36-43) months in the control group and 15 (IQR: 13-17) months in the COVID-19 group. No significant difference was observed in PFS (P = 0.74), with 1-year PFS of 93% (95%CI: 80%-98%) in the control group and 100% in the COVID-19 group. No significant difference was observed in OS (p = 0.22), with 1-year OS of 98% (95%CI 85%-100%) in the control group and 100% in the COVID-19 group. No significant difference was observed in TTI between control (51 days) and COVID-19 groups (52 days) (95%CI: -14 to 13;P = 0.91). Among patients who received neoadjuvant systemic therapy and surgery, BCS rates were 29% (5/17) in the control group and 50% (5/10) in the COVID-19 group (P = 0.42). Among patients who had triple negative or HER2 positive BC and received neoadjuvant systemic therapy and surgery, PCR rates were 57% (4/7) in the control group and 33% (1/3) in the COVID-19 group. Conclusions: Although total patient volume decreased during the COVID-19 pandemic, no significant difference was observed in clinical outcomes when comparing patients diagnosed with non-metastatic BC during and prior to the pandemic. Ongoing monitoring with a larger study population and longer followup period will help to elucidate the long-term impact of COVID-19 on BC treatment.
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Among the coronaviruses that cause pneumonia, Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) are highly infectious and harmful to human beings, which have attracted wide attention. In this paper, the above two coronaviruses were taken as examples to explore the etiology, infection route and molecular basis of the disease, to provide a reference for the prevention and control of coronavirus-related diseases. © 2022 Author(s).
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Snake soup continues to be an iconic tradition in Cantonese culture. Yet little is known about the relationship between snake soup consumption in Hong Kong, wild snake populations, and the communities depending on this tradition for their livelihoods. We applied an interdisciplinary approach including interviews with shopkeepers and genetic analyses of snake meat samples to determine the species consumed in Hong Kong, their source locations, and shopkeepers' views on the future of the industry. We genetically identified the common rat snake Ptyas mucosa, widely distributed throughout East and Southeast Asia, and the Javan spitting cobra Naja sputatrix, endemic to Indonesia, as the species most commonly consumed, which was consistent with interview responses. According to interviews, snakes had mostly been imported from mainland China in the past, but now tend to be sourced from Southeast Asia, particularly Indonesia. Interviews also revealed a pessimistic outlook on the continuation of this tradition because of various factors, including a lasting yet misinformed association of snakes with the 2002-2003 outbreak of severe acute respiratory syndrome. Given the COVID-19 pandemic and China's ensuing ban on the consumption of terrestrial wildlife, Hong Kong's snake soup industry will probably continue to rely on Southeast Asian sources to persist. Given the cultural and conservation issues surrounding this tradition, further research on the economic, ecological and social consequences of snake consumption is needed to examine the broader implications of snake soup and similar industries in the region.
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Due to the continuing impact of COVID-19, people spend an increasing amount of time on working or studying from home. The indoor light environment became quite important since it can affect people's physical and mental health. In order to reduce human fatigue resulting from continuous indoor working or studying and to improve work efficiency, and also hope to contribute to the research of indoor light environment design, this paper explores the correlation between indoor light environments and fatigue. Through laboratory simulation of indoor light environment. Participants are asked to complete the task stimulation test and filled in the subjective fatigue questionnaire with three different illumination levels. Their EEG (ElectroEncephaloGraphy), eye movement, and other physiological data are also monitored at the same time. The participants’ fatigue degree is statistically analyzed under the 300 lx, 570 lx, and 870 lx illumination. The results showed that the lighting environment has a strong correlation with human fatigue. Fatigue degree varies the most from 570 to 870 lx. There is a largest error rate gap of task test up to 20% under 300 lx and 870 lx illumination. As the illuminance increases, the fatigue degree has a visible trend of increase as well, and it is the most obvious under the 870 lx illumination. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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In this study, we describe the development and use of a biological-behavior-intervention computational informatics framework that combines disease modelling for infectious virus with stratifications for social behavior and employment, and resource logistics. The framework incorporates heterogeneous group behavior and interaction dynamics, and optimizes intervention and resources for effective containment. We demonstrate its usage by analyzing and optimizing containment strategies for the 2014-2016 West Africa Ebola outbreak, and its implementation for responses to the 2020 COVID-19 pandemic in the United States. Our analysis shows that timely action within 1.5 months from the onset of confirmed cases can cut down 90% of overall infections and bring rapid containment within 6-8 months. The additional medical resources required are minor and would ensure proper treatment and quarantine of patients while reducing the risk of infections among healthcare workers. The benefit (in infection / death control) would be reduced by 10 to over 100 fold and time to containment would increase by 2-4 fold when intervention and medical resources are injected within 5 months. In contrast, the additional resources needed to bring down the overall infection in a delayed intervention are significant, with inferior results. The disease module can be tailored for different pathogens. It expands the well-used SEIR model to include social and intervention activities, asymptomatic and post-recovery transmission, hospitalization, outcome of recovery, and funeral events. The model also examines the transmission rate of health care workers and allows for heterogenous infection factors among different groups. It also captures time-variant human behavior during the horizon of the outbreak. The framework optimizes the intervention timeline and resource allocation during an infectious disease outbreak and offers insights on how resource availability in time and quantity can affect the disease trends and containment significantly. This can inform policy, disease management and resource allocation. While focusing on bed availability for quarantine and treatment appears to be simplistic, their necessity for Ebola responses cannot be overemphasized. We link these insights to a web-based tool to provide quick and intuitive observations for decision making and investigation of the disease outbreak situation. Subsequent use of the system to determine the optimal timing and effectiveness and tradeoffs analysis of various non-pharmaceutical intervention strategies for COVID-19 provide a foundation for policy makers to execute the first-step response. These results have been implemented on the ground since March 2020. The web-based tool pinpoints accurately the import of disease from global travels and associated disease spread and health burdens. This prospectively affirms the importance of such a real-time computational system, and its availability before onset of a pandemic.
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The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the biggest challenge in public health worldwide. Similarities among viral receptors predict that there are several animal species that could function as reservoirs for the virus. Recent studies have reported that felid animals, including wild and domestic cats, are highly susceptible to SARS-CoV-2 infection. These findings cause great concerns on the potential for human-to-animal and animal-to-human transmission, along with the virus mutations that appear as the virus goes back and forth between species. It is urgently needed to develop novel reagents for control of viral infection and preventing interspecies transmission. In this chapter, we described protocols for generation of a mouse-feline chimeric neutralizing antibody against SARS-CoV-2. This chimeric antibody has potential to be developed as a diagnostic tool and therapeutic agent against SARS-CoV-2 infections in cats.
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Purpose: This study aimed to identify probable cases of nosocomial Coronavirus Disease 2019 (COVID-19) among hospitalized solid organ transplant (SOT) recipients. Methods: All hospitalized SOT recipients diagnosed with COVID-19 by polymerase chain reaction (PCR) from March 11, 2020 to August 24, 2020 were evaluated. Potential nosocomial cases included admissions where the first positive PCR occurred on hospital day 3 or later (intra-admission) or within 14 days of a previous hospital discharge (inter-admission). Two infectious disease specialists independently adjudicated all potential cases into four categories (definitely community-acquired, likely community-acquired, likely hospital-acquired, and definitely hospital-acquired) using systematic chart review of symptom onset, radiographic findings, and community risk factors. Discrepancies were resolved by a third investigator. Results: Of 132 hospitalized SOT recipients diagnosed with COVID-19, nosocomial infections were apparent in 19 (14%;Figure 1). Intra-admission cases (n=11, 4 likely hospital-acquired and 7 definitely hospital-acquired) were diagnosed a median (IQR) of 43 (8 to 53) days after admission. Inter-admission cases (n=8, all likely hospitalacquired) had 5 (3 to 10) days of hospital care in the 14 days preceding diagnosis. The proportion of COVID-19 infections classified as nosocomial varied by time from most recent transplant until diagnosis (P<0.001) and transplant type (P<0.001;Table 1). Probable nosocomial infections peaked in June and gradually declined. Conclusions: Despite infection control measures to sequester SOT recipients and their nurses on dedicated transplant floors and provide patients and healthcare workers with screening, COVID-19 may have been acquired during healthcare interactions in 14% of hospitalized SOT recipients diagnosed with COVID-19. Vaccination against COVID-19 for front-line healthcare workers is important for protection of SOT recipients.
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To provide new ideas for clinical diagnosis and treatment of coronavirus disease 2019 (COVID-19), this study explore the expression level and prognostic value of platelet parameters in mild, moderate and severe COVID-19. This is a retrospective analysis. From January to May 2020, a total of 69 patients who were diagnosed with COVID-19 in the Third Central Hospital and the Jinnan Hospital (both situated in Tianjin) were enrolled in the disease group. According to the severity, these patients were divided into mild group (15 cases), moderate group (46 cases), and severe group (8 cases). In the same period, 70 non-infected patients were enrolled in control group. The level of white blood cell count (WBC), absolute neutrophil count (NEU#), absolute lymphocyte count (LY#), neutrophil-lymphocyte ratio (NLR), red blood cell count (RBC), hemoglobin (Hb), platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large contrast ratio (P-LCR) before and after treatment were analyzed. Binary logistic regression analysis is used to establish a mathematical model of the relationship between these indexes and the outcome of severe COVID-19 patients. The receiver operating characteristic(ROC) curve is used to further explore the prognosis value of MPV, P-LCR, NLR separately and jointly in COVID-19 patients. Compare to the control group, WBC and NE# increase (Z=-5.63, P<0.01;Z=-9.19,P<0.01) and LY# decrease (Z=-9.34, P<0.01) in the severe group; NLR increase with the aggravation of the disease, there is significant difference between groups (Z=17.61, P<0.01); PLT, PDW, MPV and P-LCR decrease with the aggravation of the disease, there is significant difference between groups (Z=9.47, P<0.01; Z=11.41, P<0.01; Z =16.76, P<0.01; Z=13.97, P<0.01). Binary logistic regression analysis shows MPV, P-LCR and NLR have predictive value for severe COVID-19 patients. There is a negative correlation between MPV, P-LCR and severe COVID-19 patients (OR=1.004, P=0.034; OR=1.097, P=0.046). There is a positive correlation between NLR and severe COVID-19 patients (OR=1.052, P=0.016). MPV and P-LCR of patients with good prognosis after treatment were significantly higher than those before treatment (Z=-6.47, P<0.01; Z=-5.36, P<0.01). NLR was significantly lower than that before treatment (Z=-8.13, P<0.01). MPV and P-LCR in poor prognosis group were significantly lower than those before treatment (Z=-9.46, P<0.01; Z=-6.81, P<0.01). NLR was significantly higher than that before treatment (Z=-3.24, P<0.01). There were significant differences between good and poor prognosis groups before and after treatment in MPV, P-LCR and NLR (P<0.01). Combination of these three indexes, ROC shows the AUC is 0.931, the sensitivity is 91.5%, the specificity is 94.1%, the positive predictive value is 88.9%, and the negative predictive value is 87.4%, which is better than any of these indexes separately. Changes in these parameters are closely related to clinical stage of COVID-19 patients. MPV, P-LCR and NLR are of great value in the prediction and prognosis of severe COVID-19 patients.
Subject(s)
COVID-19 , Mean Platelet Volume , Humans , Lymphocytes , Neutrophils , ROC Curve , Retrospective Studies , SARS-CoV-2ABSTRACT
Since the outbreak of Corona Virus Disease 2019 (COVID-19) in December 2019, more than 26 million people have been infected. Urban and rural communities are the first line of defense for epidemic prevention and control. As an effective means of disease prevention and control at the community level, health management is of great significance in how to give full play to the professional advantages of health managers at present, and in combination with the current urgent situation of lack of specific drugs and vaccines, to maintain the health and social stability of the community population to the maximum extent. By assessing and intervening the health risk factors of COVID-19, the health manager can help the community effectively control the source of covid-19 infection, cut off the transmission route of COVID-19, effectively protect the vulnerable population in the community, and thus delay the spread and spread of COVID-19. © The Authors, published by EDP Sciences, 2021.
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OBJECTIVES: This study explored the factors influencing health behaviours during the coronavirus disease 2019 (COVID-19) outbreak in China. The impact of perceived stress and positive perception of interventions on health behaviours in China were assessed using the extended information-motivation-behaviour skills (IMB) model. STUDY DESIGN: Cross-sectional survey. METHODS: The Questionstar online survey tool was used to construct a structured questionnaire based on the IMB model. Between 14 and 22 February 2020, during the peak of COVID-19 epidemic in China, 2449 participants were recruited by snowball sampling on WeChat and Tencent QQ social media platforms in China. Data were collected through an online questionnaire, and structural equation modelling was performed to evaluate the extended IMB model. RESULTS: Health behaviours were assessed using a scoring system (total score range: 8-40); the average health behaviour score in this study was 34.62 ± 4.44. The term 'health risk stress' refers to the impact that perceived stress has on health, and this was experienced by 39.9% of participants. Only 35.9% of participants answered all seven questions on COVID-19 information correctly. The final model showed that information, motivation, behavioural skills, heath risk stress and positive perception of interventions had significant direct effects on health behaviours. Health behaviours were positively associated with the positive perception of interventions but negatively associated with health risk stress. Behavioural skills had the greatest impact on health behaviours. CONCLUSIONS: In the face of public health emergencies, the extended IMB model has been used as a theoretical framework to construct more effective interventions. The government should pay attention to publicity and guidance, strengthen positive interactions with the public and disclose relevant information in a timely manner to gain trust and to maintain the positive public perception of the interventions. In terms of health education, the government should focus on behavioural skills, promptly rectify ineffective prevention information and raise awareness about the disease to relieve stress and anxiety in the population.