Residents' participation in rural tourism and interpersonal trust in tourists: The mediating role of residents' perceptions of tourism impacts

Interpersonal trust is a critical psychological factor that reveals the quality of resident-tourist relationship in tourism destinations. However, residents' positive attitudes toward tourists are gradually taken for granted, with research on residents' psychological tendency (i.e., interpersonal trust) in providing tourism services and creating mutually beneficial resident-tourist interaction lagging behind. Based on interpersonal relationship theory and social exchange theory, this study employed a sequential mixed-methods design to examine the formation of interpersonal trust in tourists during resident participation in rural tourism. The dimensions of resident participation (i.e., decision-making, economic, and social participation) and the conceptual model were first identified through qualitative analysis. Subsequently, through the PLS-based structural equation modeling using a sample of 469 residents from Jiuzhai Valley, China, the study suggested that economic and social participation were instrumental in shaping residents' cognitive and affective trust in tourists both directly and indirectly through residents' perceived benefits of tourism. This study offers implications for academia and destination management to promote sustainable tourism development and social harmony against the crisis of trust between residents and tourists caused by the COVID-19 pandemic.

Perceived stress and its impact on the health behavior of Chinese residents during the COVID-19 epidemic: An Internet-based cross-sectional survey.

Background and Aims: The novel coronavirus disease 2019 (COVID-19) causes severe respiratory illnesses, following exposure to air-borne droplets or direct contact, posing a great threat to human life. This study aimed to investigate perceived stress and its correlation with the health behaviors of Chinese residents during the COVID-19 epidemic. Methods: An Internet survey was conducted among 2449 residents in 20 provinces of China on residents' perceived stress, perception of COVID-19, and health behaviors. SAS 9.4 was used to analyze the relationship between health behaviors and perceived stress, and logistic regression was used to explore the factors influencing health risk stress. Results: The participants' perceived stress score was 22.25 ± 7.2 (total 56), and the incidence of health risk stress was 39.89% (977/2449). Females, students, and medical staff were at high risk. Health risk stress refers to a level of stress that is hazardous to health (score over 25). Perceived stress increased, while the frequency of health behaviors decreased. Age, perception of susceptibility to COVID-19, life-threatening level of COVID-19, perception of the importance of home isolation, and perception of the difference between a common cold and COVID-19 were positively related to the occurrence of health risk stress. Conclusions: A negative correlation was found between health behaviors and perceived stress. Therefore, it is of great significance to provide psychological interventions for those who are experiencing health risk stress and to promote their health behaviors.

Perceived stress and its impact on the health behavior of Chinese residents during the COVID‐19 epidemic: An Internet‐based cross‐sectional survey

Background and Aims The novel coronavirus disease 2019 (COVID‐19) causes severe respiratory illnesses, following exposure to air‐borne droplets or direct contact, posing a great threat to human life. This study aimed to investigate perceived stress and its correlation with the health behaviors of Chinese residents during the COVID‐19 epidemic. Methods An Internet survey was conducted among 2449 residents in 20 provinces of China on residents' perceived stress, perception of COVID‐19, and health behaviors. SAS 9.4 was used to analyze the relationship between health behaviors and perceived stress, and logistic regression was used to explore the factors influencing health risk stress. Results The participants' perceived stress score was 22.25 ± 7.2 (total 56), and the incidence of health risk stress was 39.89% (977/2449). Females, students, and medical staff were at high risk. Health risk stress refers to a level of stress that is hazardous to health (score over 25). Perceived stress increased, while the frequency of health behaviors decreased. Age, perception of susceptibility to COVID‐19, life‐threatening level of COVID‐19, perception of the importance of home isolation, and perception of the difference between a common cold and COVID‐19 were positively related to the occurrence of health risk stress. Conclusions A negative correlation was found between health behaviors and perceived stress. Therefore, it is of great significance to provide psychological interventions for those who are experiencing health risk stress and to promote their health behaviors.

Research on the Mechanism of Influence of Game Competition Mode on Online Learning Performance.

With the rapid development of information technology and the influence of the COVID-19 pandemic, online learning has become an important supplement to the teaching organization form of basic education and higher education. In order to increase user stickiness and improve learning performance, gamification elements are widely introduced into online learning situations. However, scholars have drawn different conclusions on the impact of game-based competition on online learning performance. This study is based on field theory and constructivist learning theory. Taking the online interaction of the curriculum platform as the situation, psychological capital as the intermediary variable and connected classroom atmosphere as the adjustment variable, this paper constructs an interaction model between game competition and online learning performance and discusses in depth the intermediary effect of psychological capital and the adjustment effect of a connected classroom atmosphere. The results show that game-based competition has a significant positive effect on learning performance, and the effect of direct competition is better than that of indirect competition; the self-efficacy dimension of psychological capital plays an intermediary role between direct competition and learning performance, and the resilience dimension plays an intermediary role between competition and learning performance; and a connected classroom atmosphere plays a regulating role in the dimensions of game competition, knowledge mastery and knowledge innovation.

Corticosteroids Utilization in the Management of Critically Ill Coronavirus Disease-2019 Pneumonia

Background: There are controversies regarding corticosteroids using in coronavirus disease-2019 (COVID-19) pneumonia in the current pandemic. Objectives: This study investigates the efficacy and safety profiles of corticosteroids therapy in COVID-19 patients. Methods: Retrospective, multicenter study case series of consecutive patients with confirmed COVID-19 infection at the whole hospital from January 1 to March 1, 2020, were enrolled. Demographic, clinical, radiological, laboratory, and treatment data were collected and analyzed. The effect of corticosteroids therapy on death and organ-failure complications of pneumonia were analyzed by logistic regression. Results: A total of 470 COVID-19 patients at the whole hospital were enrolled. According to the time of corticosteroids initiation and severity of illness, there were 159 patients stratified into critical ill group and 64% (102 of 159) patients received corticosteroids treatments. Ninety-four percent (166 of 176) of corticosteroids were methylprednisolone. The median cumulative corticosteroids dosage was 300 mg equivalent of methylprednisolone over a median duration of 6 days. Multivariate regression analysis showed that corticosteroids use did not affect the mortality. However, corticosteroids therapy at moderate cumulative doses (total exposure 480 mg to 1200 mg) was associated with deceased occurrence of organ-failure complications in critically ill COVID-19. Conclusions: Corticosteroids have no effect to mortality in COVID-19 patients. The moderate cumulative doses of corticosteroids might decrease organ-failure complications in critically ill COVID-19. Further large-scale randomized controlled trials are warranted to confirm our findings, until then use of corticosteroids should be used with caution COVID-19 patients.

On thinking of power: A research on mindset about power and well-being among business leaders in china high-tech industry

Power, as the capability to achieve an individual's goals and influence others, has long been studied by scholars in various fields, yet there is a lack of understanding about the relationship between power and well-being. Mindset is the basic beliefs of an individual for constructing the reality and re-orienting their expectations and behaviors. There is also a lack of research on the mindsets of leaders to better understand the behavior of leaders. A leader's belief, affection, and motive about power, offers interesting insights on what mindset about power is and its relationship to the well-being of powerholders. Extant research showed contradictory findings about how the belief about power of a powerholder correlates with their well-being. Using both qualitative and quantitative approaches, this empirical research found that business leaders from China's high-tech industry believed that power is not just about control of resources, power is defined as a combination of positional authority, responsibility, and an integrative process. Business leaders believed that it is critical to keep the equilibrium among positional authority, responsibility, and reward from power. This research also found that the belief about power, no matter individualistic or relational, correlated with powerholders' well-being, both positively and negatively. First, these beliefs served as a psychological state of power and directly correlated with factors of well-being, such as affection, relationship with others, accomplishment, stress, and physical health. Second, these beliefs also functioned as a lens interpreting the effects of power on powerholders' well-being through re-orienting their ways of thinking and using power. There were cultural factors in the business leaders' belief about power, such as the meaning of the word "Power" () in Chinese, and "Lao Da" (), an iconic leadership figure in organizations). This research also found that female business leaders believed that their beliefs about power had no significant difference from their male counterparts, yet they were more considerate in using power than male leaders. Finally, this research found that business leaders believed that COVID-19 pandemic had little impact on their beliefs about power. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Should people with chronic liver diseases be vaccinated against COVID-19?

Hepatic impairment in coronavirus disease 2019 (COVID-19) may derive from cholangiocyte damage in the beginning, but not from direct infection of hepatocytes. Chronic liver disease patients co-infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exhibited overexpression of angiotensin-converting enzyme 2 receptors and overwhelming cytokine storm. Consensus has been reached that we should encourage as many people as possible to be vaccinated in order to achieve herd immunity. SARS-CoV-2 vaccines can prevent or alleviate severe infection and cytokine storm. It is recommended that all adult patients with chronic liver diseases and liver transplant recipients should receive COVID-19 vaccines using the standard dose and schedule. Data is not yet sufficient to compare the efficacy of different types of vaccines used in chronic liver disease patients.

Amygdala connectivity as a predisposing neural feature of stress-induced behaviour during the COVID-2019 outbreak in Hubei (preprint)

The amygdala plays an important role in the regulation of stress and anxiety. However, little is known about the relationship between amygdala connectivity and subsequent stress-induced behavior. The current study investigated whether amygdala connectivity measured before experiencing stress is a predisposing neural feature of subsequent stress-induced behavior while individuals face an emergent and unexpected event like the COVID-19 outbreak. Using an fMRI cohort established before the pandemic in Wuhan, Hubei, we found that resting-state functional connectivity (rsFC) of the right amygdala with the dorsomedial prefrontal cortex (dmPFC) was negatively correlated with the stress-induced behavior of these volunteers during the COVID-2019 outbreak in Hubei. Furthermore, the self-connection of the right amygdala, inferred using dynamic causal modeling, was negatively correlated with stress-induced behavior in this cohort. A significant correlation between the right amygdala-dmPFC rsFC and self-connection of the right amygdala was found. Additionally, after three months of the COVID-19 outbreak in Hubei when the stressor weakened - and in another cohort collected in regions outside Hubei where the individuals experienced a lower level of stress - the relationship between the amygdala-dmPFC rsFC and the stress-induced behavior disappeared. Our findings support that amygdala connectivity is a predisposing neural feature of stress-induced behavior in the COVID-19 outbreak in Hubei, suggesting the amygdala connectivity before stress predicts subsequent behavior while facing an emergent and unexpected event. And thus our findings provide an avenue for identifying individuals vulnerable to stress using intrinsic brain function before stress as an indicator.

Clinical utility of a computed tomography-based receiver operating characteristic curve model for the diagnosis of COVID-19.

BACKGROUND: The outbreak of COVID-19 poses a major and urgent threat to global public health. CT findings associated with COVID-19 pneumonia from initial diagnosis until patient recovery. This study aimed to retrospectively analyze abnormal lung changes following initial computed tomography (CT) among patients with coronavirus disease 2019 (COVID-19) in Yunnan, and to evaluate the effectiveness of a chest CT-based model for the diagnosis of COVID-19. METHODS: One hundred and nine patients with COVID-19 pneumonia confirmed with the positive new coronavirus nucleic acid antibody who exhibited abnormal findings on initial CT were retrospectively analyzed. Thereafter, changes in the number, distribution, shape, and density of the lesions were observed. Further, the epidemiological, clinical, and CT imaging findings (+/-) were correlated. Following univariate and multivariate logistic regression analysis, receiver operating characteristic (ROC) curves were generated for significant factors, and models were established to evaluate the diagnostic ability of CT for COVID-19. RESULTS: Our results showed significant differences between patients with COVID-19 in epidemiological history (first, second, and third generation), clinical type (moderate, severe, and critical), and abnormal CT imaging characteristics (+/-) (P<0.05). Moreover, significant differences in abnormal CT imaging characteristics, including region, extent, and focus, were observed between the first generation and the other generations (P<0.05). For the diagnosis of COVID-19, the areas under the ROC curves for logistic regression models 1, 2, and 3 were 0.8016 (95% CI: 0.6759-0.9274), 0.9132 (95% CI: 0.8571-0.9693), and 0.9758 (95% CI: 0.9466-1), respectively. CONCLUSIONS: The ROC curve regression model based on chest CT signs displayed a high diagnostic value for COVID-19.

Dynamic changes in chest CT findings of patients with coronavirus disease 2019 (COVID-19) in different disease stages: a multicenter study.

BACKGROUND: To investigate the dynamic changes in high-resolution computed tomography (HRCT) findings of coronavirus disease 2019 (COVID-19) patients with different severities in different disease stages. METHODS: We retrospectively collected the clinical and imaging data of 96 patients in Yunnan Province, China, who were diagnosed with COVID-19 between January 22 and March 15, 2020. Based on disease severity, the COVID-19 patients were classified into four types: mild (n=15), moderate (n=59), severe (n=19), and critical (n=3). Based on hospital stay and number of computed tomography (CT) scans, the clinical/disease course was divided into four stages, including stage 1 (days 0-4), stage 2 (days 5-9), stage 3 (days 10-14), and stage 4 (days 15-19). The HRCT findings, CT value, and lesion volume were analyzed for each stage and compared among the four stages of COVID-19 patients. RESULTS: CT findings were negative over the four stages for all mild COVID-19 patients. More lesions were found in the peripheral lung fields than in peripheral + central fields (P<0.05), and the number of negative patients in stage 4 were more than those in stages 1-3 (P<0.05). The left and right lower lobe were the most frequently affected lobes (P<0.05). In moderate patients, round ground glass opacities (GGOs) decreased from stage 1 to stage 4; partial consolidation peaked in stage 2 and then decreased in stages 3-4; fibrous stripes and subpleural lines increased from stage 1 and peaked in stage 4. Partial consolidation and consolidation were more common in severe patients than in moderate patients over the disease course (P<0.05). Critical patients showed significant partial consolidation and consolidation; The CT value, lesion volume and lesion volume percentage significantly decreased from stages 1-2 to stage 4 (all P<0.05). CONCLUSIONS: The dynamic changes in lung HRCT images are clinically related to the disease course of COVID-19.

Comparison of initial high-resolution computed tomography (HRCT) features of coronavirus disease 2019 (COVID-19) pneumonia and other viral pneumonias.

BACKGROUND: Multicenter retrospective comparison of the first high-resolution computed tomography (HRCT) findings of coronavirus disease 2019 (COVID-19) and other viral pneumonias. METHODS: We retrospectively collected clinical and imaging data from 262 cases of confirmed viral pneumonia in 20 hospitals in Yunnan Province, China, from March 1, 2015 to March 15, 2020. According to the virus responsible for the pneumonia, the pneumonias were divided into non-COVID-19 (141 cases) and COVID-19 (121 cases). The non-COVID-19 pneumonias comprised cytomegalovirus (CMV) (31 cases), influenza A virus (82 cases), and influenza B virus (20 cases). The differences in the basic clinical characteristics, lesion distribution, location and imaging signs among the four viral pneumonias were analyzed and compared. RESULTS: Fever and cough were the most common clinical symptoms of the four viral pneumonias. Compared with the COVID-19 patients, the non-COVID-19 patients had higher proportions of fatigue, sore throat, expectorant and chest tightness (all P<0.000). In addition, in the CMV pneumonia patients, the proportions of acquired immunodeficiency syndrome (AIDS) and leukopenia were high (all PP<0.000). Comparison of the imaging findings of the four viral pneumonias showed that the pulmonary lesions of COVID-19 were more likely to occur in the peripheral and lower lobes of both lungs, whereas those of CMV pneumonia were diffusely distributed. Compared with the non-COVID-19 pneumonias, COVID-19 pneumonia was more likely to present as ground-glass opacity, intralobular interstitial thickening, vascular thickening and halo sign (all PP<0.05). In addition, in the early stage of COVID-19, extensive consolidation, fibrous stripes, subpleural lines, crazy-paving pattern, tree-in-bud, mediastinal lymphadenectasis, pleural thickening and pleural effusion were rare (all PP<0.05). CONCLUSIONS: The HRCT findings of COVID-19 pneumonia and other viral pneumonias overlapped significantly, but many important differential imaging features could still be observed.

Impacts of the COVID-19 pandemic on the dairy industry: Lessons from China and the United States and policy implications

The purposes of this study are to assess the COVID-19 pandemic's impacts on the dairy industries in China and the United States and to derive policy recommendations for enhancing the diary industries' resilience to pandemics and other market shocks. Specifically, data from the two nations are used to analyze and compare the mechanisms through which the pandemic has affected their dairy industries and to discuss potential lessons from their experiences. The findings suggest that this pandemic has heavily affected the dairy industries in both China and the United States through similar mechanisms, such as decreased farmgate milk prices, disruption and difficulties of moving milk within the supply chains, worker shortages, increased production costs, and lack of operating capital. There were also significant differences in the affecting mechanisms between the two nations, including transportation difficulties from widespread road closures and significant reduction in holiday sales of dairy products in China, and the shutdown of many dairy processors in the United States due to the closing of schools, restaurants, and hotels. While government financial reliefs are highly needed to help many dairy farms and processors survive this pandemic in the short term, the dairy industries and governments need to work together to develop long-term strategies and policies to balance the industries' efficiency and flexibility, product specialization and diversification, supply chain integration and local food systems, and market mechanisms and policy regulations and interventions.

Urban and Rural Disparities of Personal Health Behaviors and the Influencing Factors During the COVID-19 Outbreak in China: Based on an Extended IMB Model.

OBJECTIVE: Health behavior was conducive to control the coronavirus disease (COVID-19) epidemic. This study aimed to determine the differences in health behaviors and related factors among rural and urban residents in China. METHODS: From February 14 to 22, 2020, during the peak of the COVID-19 epidemic in China, a total of 2449 participants (1783 (72.81%) urban residents and 666 (27.19%) rural residents) were recruited by snowball sampling on WeChat and QQ social platforms, both owned by Tencent. Data were collected through the Web-questionnaire guided by an information-motivation-behavioral skills model. The multiple-group structural equation model was applied to analyze the factors. RESULTS: Rural residents had lower health behavior scores than urban residents, even after adjusting demographic characteristics (33.86 vs 34.29, P = 0.042; total score was 40). Motivational, behavioral skills, and stress had direct positive and negative influences on health behaviors of urban and rural residents. Information and positive perception of interventions had direct effects on health behaviors in rural residents, but not in urban residents. All the factors were mediated by behavioral skills in rural and urban residents. CONCLUSIONS: This study suggests that the government should pay attention to substantial rural and urban disparities and implement different COVID-19 prevention and intervention policies for health behaviors targeting rural and urban residents.

Clinical characteristics and chest computed tomography findings of severe and critical coronavirus disease 2019 in Shanghai, China

Objective To sum up the clinical characteristics and chest computed tomography (CT) findings of severe and critical coronavirus disease 2019 (COVID-19) patients, and to explore the factors affecting the outcomes, so as to provide experience for the clinical diagnosis and treatment of severe and critical COVID-19. Methods The data of 25 severe and critical COVID-19 patients, who were treated in our hospital from Jan. 23, 2020 to Mar. 5, 2020, were collected. The clinical characteristics were retrospectively analyzed, and the clinical and laboratory indexes were compared between cured patients and uncured patients. The laboratory indicators of cured patients were further compared between the progressive and recovery stages. The chest CT findings of the patients were observed, and the lesion volume was quantified to assess the evolution of lung lesions using the CT image-based intelligent pneumonia lesion quantitative analysis software. Results There were 19 male and six female COVID-19 patients, and there were three deaths. The median age of 25 patients was 65 (63, 75) years old, and the body mass index (BMI) was 25.60 (23.51, 28.65) kg/m2. Twenty-two patients had a clear epidemiological history. Fever (22 cases) and cough (14 cases) were the most common first symptoms, and 18 patients had underlying diseases. Twelve patients were cured and discharged (median hospital stay was 25.5 d), and 13 patients were not cured, including three deaths and 10 cases with hospital stay>25 d with no remission. Compared with the uncured patients, the cured patients had significantly lower BMI, longer time from onset to progression to severe or critical illness, and higher CD4 +T lymphocyte counts (all P<0.05). Multivariate logistic regression analysis showed that high CD4 +T lymphocyte count was an independent protective factor for the cure and discharge of severe and critical COVID-19 patients (P=0.031). Compared with those in the progressive stage, the lymphocyte count and CD4 +T lymphocyte count of 12 cured patients were significantly higher in the progression stage, and the C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR) and procalcitonin level were significantly lower (all P<0.01). Twenty-one patients received chest CT examination in the progressive stage;and all of them had multiple ground-glass opacities and consolidation shadows of the multiple-lobe lateral band and the dorsal side of bilateral lungs, 20 cases had pleural thickening, 9 cases had a small amount of bilateral pleural effusion, and 8 cases had mediastinal lymphadenopathy. The 12 cured patients received CT examination during the recovery period, and their lesions were all improved to different extents;some patients had irregular fiber grid shadows and stripe shadows;and the pleural thickening and pleural effusion were reduced to different extents. The quantitative analysis curves showed that lesion volume in the 12 cured patients obviously increased in the progressive stage and reduced in the absorption stage, showing an inverted V shape;and lesion volume in the uncured patients (nine cases received CT examination for two or more times) showed a rapid increase in the progressive stage. Conclusion Most severe and critical COVID-19 patients in Shanghai are older, with higher BMI and underlying diseases. Low BMI, slow disease progression, and high CD4 +T lymphocyte count are beneficial to the improvement of COVID-19. The main findings of chest CT include multiple ground-glass opacities and consolidation shadows, mainly distributing in the lateral band and the dorsal side of lungs and mostly involving the pleura. The laboratory indexes, including the lymphocyte, CRP, CD4 +T lymphocyte, ESR and procalcitonin, and chest CT examination play an important role in the diagnosis, disease monitoring and prognosis assessment of COVID-19

Network Pharmacology Approach to Investigate the Preventive Mechanism of Hunan Expert Group Recommended Chinese Medicine Prevention No. 2 Prescription Against COVID-19

OBJECTIVE: To explore the possible preventive mechanism of Hunan expert group recommended Chinese medicine prescription of No. 2 (Pre-No. 2) against coronavirus disease 2019 (COVID-19) by network pharmacology method. METHODS: The target proteins of effective components and active compounds in Pre-No. 2 were screened by searching the Tradi-tional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). A component-target-disease interac-tion network of Pre-No. 2 was constructed by Cytoscape 3.7.2, gene ontology (GO) analysis, and Kyoto encyclopedia of genes and genomes (KEGG) analysis of target protein pathway by DAVID. RESULTS: A total of 163 compounds and 278 target protein targets in Pre-No. 2 were collected from the TCMSP database. Kaempferol, wogonin, 7-methoxy-2-methyl isoflavone, formononetin, isorhamnetin, and licochalcone A were the most frequent targets in the regulatory network. GO enrichment analysis showed that Pre-No. 2 regulated response to virus, viral processes, humoral immune responses, defense responses to virus and viral entry into host cells. KEGG enrichment analysis showed that the formula regulated the NF-κB signaling pathway, B cell receptor signaling pathway, viral carcinogenesis, T cell signaling pathway and FcγR-mediated phagocytosis signaling pathway. CONCLUSIONS: Pre-No. 2 may play a preventive role against COVID-19 through regulation of the Toll-like signaling, T cell signaling, B cell signaling and other signaling pathways. It may re-gulate the immune system to protect against anti-influenza virus.

Protective Factors and Risk Factors in Patients with COVID-19 Pneumonia and/or Infection (preprint)

This study examined 50 COVID-19 patients who have been cured in Anhui Province, China. The protective factors and risk factors for these patients were investigated. By comparing CT-negative and CT-positive patients, we found protective factors in blood: lymphocytes, eosinophils number and %, basophils%, reticulocyte%, high fluorescence reticulocyte ratio, and reticulocyte absolute value. Comparing patients with underlying disease and without underlying disease, we found protective factors in blood: lymphocytes%, basophils%, large platelets, and low-fluorescent reticulocyte ratio. Regarding the biochemistry indicators, albumin/globulin, apolipoprotein and prealbumin can be considered as protective factors for patients without lung symptoms. Urea, glucose, total bile aicd, creatinine and hypersensitivity CRP can be considered as risk factors for patients with underlying diseases. For patients with repeatedly negative and positive results in nucleic acid tests, they were at a medium level in terms of both protective and risk factors, explaining the mild symptoms and repeatedly results in nucleic acid tests.