Cationic Conjugated Microporous Polymers Coating for Dual-Modal Antimicrobial Inactivation with Self-Sterilization and Reusability Functions

COVID-19 pandemic outbreak poses a great threat to human health. Face masks have been considered as important personal protective equipment to prevent the COVID-19 transmission. However, pathogens can survive up to several days on the fabrics of commercial masks, which increases the risk of direct/indirect microbial transmission. Herein, new cationic conjugated microporous polymers (CCMPs)-based coating is developed, which possesses extended π-conjugated skeletons and massive quaternary ammonium salt (QAS) groups, exhibiting dual-modal antimicrobial inactivation, including sunlight-driven photodynamic sterilization through the generation of reactive oxygen species and contact sterilization through QAS groups. As a result, the CCMPs coatings can rapidly and efficiently eradicate 99% of model microbes, such as Escherichia coli and Staphylococcus aureus under solar illumination, and also ensure the great antimicrobial effect in the absence of light. More importantly, the CCMPs coatings exhibit excellent durability, reusability as well as antimicrobial stability in humid environment. Contributing to the outstanding processability and formability, CCMPs can be in situ synthesized and coated over fibers through a simple spray procedure. Taken together, the design provides a promising strategy for developing reusable and self-sterilizing antimicrobial fabrics, particularly for the application of face masks to tackle infectious pathogen and viruses in daily protection and medical applications. © 2023 Wiley-VCH GmbH.

The optimal anticoagulation strategy for COVID-19, prophylactic or therapeutic?: a meta-analysis, trial sequential analysis, and meta-regression of more than 27,000 participants

Background: Anticoagulants are promising regimens for treating coronavirus disease 2019 (COVID-19). However, whether prophylactic or intermediate-to-therapeutic dosage is optimal remains under active discussion. Methods: We comprehensively searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, ClinicalTrials, and MedRxiv databases on April 26, 2022. Two independent researchers conducted literature selection and data extraction separately according to predetermined criteria. Notably, this is the first meta-analysis on COVID-19, taking serious consideration regarding the dosage overlap between the 2 comparison groups of prophylactic anticoagulation (PA) and intermediate-to-therapeutic anticoagulation (I-TA). Results: We included 11 randomized controlled trials (RCTs) and 36 cohort studies with 27,051 COVID-19 patients. By analyzing all the RCTs, there was no significant difference in mortality between the PA and I-TA groups, which was further confirmed by trial sequential analysis (TSA) (odds ratio [OR]: 0.93;95% confidence interval [CI]: 0.71–1.22;P = 0.61;TSA adjusted CI: 0.71–1.26). The rate of major bleeding was remarkably higher in the I-TA group than in the PA group, despite adjusting for TSA (OR: 1.73;95% CI: 1.15–2.60;P = 0.009;TSA adjusted CI: 1.09–2.58). RCTs have supported the beneficial effect of I-TA in reducing thrombotic events. After including all studies, mortality in the I-TA group was significantly higher than in the PA group (OR: 1.38;95% CI: 1.15–1.66;P = 0.0005). The rate of major bleeding was similar to the analysis from RCTs (OR: 2.24;95% CI: 1.86–2.69;P < 0.00001). There was no distinct difference in the rate of thrombotic events between the 2 regimen groups. In addition, in both critical and noncritical subgroups, I-TA failed to reduce mortality but increased major bleeding rate compared with PA, as shown in meta-analysis of all studies, as well as RCTs only. Meta-regression of all studies suggested that there was no relationship between the treatment effect and the overall risk of mortality or major bleeding (P = 0.14, P = 0.09, respectively). Conclusion: I-TA is not superior to PA for treating COVID-19 because it fails to lower the mortality rate but increases the major bleeding rate in both critical and noncritical patients. Copyright © 2022 Shandong University, published by Wolters Kluwer, Inc.

Research on the Evolution of Global LNG Maritime Transportation Network and Trade Condition of China

With the proposal of "carbon peak" and "carbon neutralization", Liquefied Natural Gas (LNG) has gradually garnered the attention of energy market as a clean and low-carbon energy. In this context, it is of great significance to analyze the evolution mode of the LNG maritime transport network, so as to master the dynamic of global energy pattern and the status of China's import trade. In this paper, the evolution trend of the global LNG maritime transport network from 2018 to 2020 is explored based on the ship trajectory data and complex network theory. Meanwhile, according to China's trade status, LNG import sources, distribution of main import ports, and the inflow status of the top three import ports in China are analyzed. The results show that: (1) From 2018 to 2020, the global LNG maritime transport network expanded with a "scale-free" characteristic. The "breadth" and "depth" of node connections in the backbone network are increasing, and there is a risk that global LNG trade will become monopolistic;(2) The countries along the "Belt and Road Initiative" actively participated in trade. The numbers of import ports and import voyages in Central and North America, South and Southeast Asia have significantly increased, and in particular, Sabetta and Bonny ranked the top eight globally according to their export volume;(3) The average shortest path length of the network is increasing year by year from 2018 to 2020, and the new mode of "transshipment port" business is gradually emerging. By 2020, 21 transshipment ports have participated in LNG trade, and the United States occupies the dominant position in global transshipment;(4) In recent three years, China's LNG import scale has developed rapidly, and the flow direction of the maritime transport network tends to be diversified. However, Australia is still the main LNG source for China. In terms of import volume, the ports of Tianjin, Shenzhen, and Yung'an rank the top three in China, and the pressure to reduce carbon emissions has prompted the economically developed regions to build terminals and increase imports. © 2022, Science Press. All right reserved.

Design Suggestion of Epidemic Prevention System for Shared Car Based on Scenario and Data

Entering the post-epidemic era, the travel demand for shared cars is increasing day by day. In the normalized epidemic prevention and control, epidemic prevention in shared cars needs to be designed systematically. This paper analyzes the existing risk of COVID-19 propagation based on two perspectives: scenario and data, and discusses the existing means of protection. Then based on the existing measures, the design suggestions are given from two aspects: scenario-based and data-based. Based on the scenario, the layout design and disinfection is implemented in regard to various ways that COVID-19 is transmitted;based on data, travel data integration should be promoted to achieve macro-structural dynamic adjustment and integrated governance from the overall transportation system. In the context of the industries, the shared car industry should response to new trend immediately and implement innovative ideas to obtain a service that is better suited for individuals in the post-epidemic era. In the end, several major functions of design in terms of developing the urban transportation system are discussed. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Soluble Signals to Improve Endothelial Integrity in the Lung

Disorders in pulmonary vascular integrity are a prominent feature in many lung diseases, including acute respiratory distress syndrome (ARDS), capillary leak syndrome, and COVID19. Paracrine signals are enriched in the lung and are critically important in regulating the homeostasis of the functional pulmonary microvasculature. Here, we employed single-cell RNA-sequencing (scRNAseq) to study ligand and receptor interactions in the native human lung microvascular niche, and identified soluble factors that are critical in endothelial integrity. The scRNAseq data reveals a total of 47 cell populations consisting of five vascular endothelial subtypes in human lungs, including general capillary EC, aerocyte capillary EC (EC aCap), arterial EC, pulmonary venous EC, and systemic venous EC. Using EC aCap as a signal receiving core (Receptors) and the putative adjacent cell types (alveolar fibroblast, ATI, ATII, pericyte, plasma cell, etc.) in the EC aCap niche as senders (Ligands), we identified that SLIT2-ROBO4, ANGPT1-TIE1, ADM-RAMP2, VEGFD-KDR, and BMP5-BMPR2 are the top specific and abundant pairs in the niche. Immunostaining and ELISA assays confirmed their spatial information and secretion level. Furthermore, upon treatment with these ligands, real-time resistance recorded using an electric cell-substrate impedance sensing (ECIS) system revealed that VEGFD, ANGPT1 (angiopoietin 1), and ADM (adrenomedullin) could markedly increase the electrical resistance of human lung microvascular, arterial, and venous endothelial cells, suggesting their strong impact on the endothelial barrier function. Deciphering the cell-cell soluble signals that improve endothelial integrity in human lungs lays the foundation for uncovering the pathogenesis of pulmonary vascular disorders and the development of ex vivo functional lung vasculature.

Impact of ACEI/ARB on clinical outcomes in Chinese patients with COVID-19: a meta-analysis

Objective To systematically review the impact of ACEI/ARB (angiotensin converting enzyme inhibitor/angiotensin receptor antagonist) treatment on the clinical outcomes of Chinese patients with COVID-19 infections. Methods PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, WanFang Data, and VIP databases were electronically searched to collect cohort studies on the impact of the treatment with ACEI/ARB on the clinical outcomes of Chinese patients with COVID-19 infections from January 2020 to January 2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 17 cohort studies involving 4 912 subjects were included. The results of meta-analysis showed that patients who were prescribed ACEI/ARB had shorter hospital stays (SMD=-0.28, 95%CI -0.46 to -0.11, P=0.002) and a lower mortality rate (OR=0.47, 95%CI 0.36 to 0.62, P<0.000 01) than patients who did not take ACEI/ARB. Conclusion Current evidence shows that the use of ACEI/ARB drugs can improve the clinical prognosis of Chinese patients with COVID-19 infections. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.

Allocation changes and COVID effect on waiting time for liver transplantation

Purpose: On April 30, 2019 the National Liver Review Board (NLRB) was implemented and patients meeting criteria for hepatocellular carcinoma exception points received a score of the median MELD at transplant minus 3 (MMAT-3). On February 4, 2020 liver allocation changed to concentric circles. Approximately one month later the COVID pandemic altered liver transplantation in many regions for a period of time. It is unknown what effect these policy changes had on the wait-list time of patients for liver transplant. Methods: We conducted a retrospective cohort study based on data from the Organ Procurement and Transplantation Network from December 2017-June 2020. Mean waiting-time was calculated for the transplants performed each month. An interrupted time-series analysis was used to examine the trend of mean waiting-time for liver transplantation from December 2017 to April 2019 (Pre-NLRB), May 2019 to January 2020 (NLRB-Alone), and February 2020 to June 2020 (Post-Allocation + COVID). Results: In the Pre-NLRB era, the mean waiting time for liver transplantation was 240 days. For the NLRB-Alone era the mean waiting time was 209 days, and in the Post-Allocation + COVID era, the mean waiting time was 201 days (Figure 1). However, on interrupted time-series analysis, there was a significant trend in the mean waiting-time for transplant over time. The trend of the mean waiting-time increased in the NLRB-Alone era compared to the Pre-NLRB era (p<0.001). There was a decrease in the trend of mean waiting-time in the Post-Allocation + COVID era (p<0.0001) (Figure 2). Conclusions: The NLRB and allocation change for liver transplantation has impacted the waiting time. The trend of the waiting time increased after the NLRB and MMAT-3 policy was implemented. After the allocation change, the trend of the waiting time for liver transplant has had a decreasing trajectory. The allocation change coincided closely with the COVID pandemic, which may have temporarily impacted the waiting-time for transplantation. More data is needed about the long-term impact of allocation changes on wait-list time for liver transplantation. (Table Presented).

[Influence of SARS-CoV-2 vaccination on the epidemiological and clinical characteristics of imported COVID-19 cases in Chengdu].

Objective: To analyze the epidemiological and clinical characteristics of imported COVID-19 cases after SARS-CoV-2 vaccination and to provide evidence for the prevention and control of COVID-19. Methods: The imported COVID-19 cases in Chengdu as of April 15, 2021 were divided into the vaccinated group and unvaccinated group according to the history of SARS-CoV-2 vaccination. The epidemiological and clinical data of the cases were collected retrospectively, and the differences in epidemiological and clinical characteristics of the two groups were compared. Laboratory tests consisted of nucleic acid test, clinical index test, serum antibody test and lymphocyte test. Software WPS2019 was used for data management and software R 4.0.3 was used for statistical analysis. Results: A total of 75 COVID-19 cases were included in the analysis, in which 20 had received SARS-CoV-2 vaccination and only 4 with clinical symptoms, 55 patients did not receive SARS-CoV-2 vaccination, and 16 had clinical symptoms. In vaccinated group, the first injection time of vaccination ranged from July to November 2020, and 10 cases received two doses of vaccine simultaneously and 10 cases received two doses of vaccine at intervals of 14-57 days. The intervals between the completion of vaccination and the onset ranged from 87 days to 224 days. The differences in classification and clinical type between the two groups were significant. Significant differences were observed in case classification and clinical type between vaccinated group and unvaccinated group (P<0.05). The vaccinated group had a relatively high proportion of asymptomatic infections (40.00%, 8/20), while mild infections were mainly observed in the unvaccinated group(76.36%,42/55). The differences in Ct values (ORF1ab gene and N gene) at the diagnosis were not significant between vaccinated group and unvaccinated group (P>0.05), similar results were also observed in lymphocyte subtypes, procalcitonin and C-reactive protein level comparisons. Serum amyloid A level was higher in unvaccinated group than in vaccinated group (P<0.05). However, the SARS-CoV-2 related serum antibody of IgM, IgG and total antibody levels were significantly higher in vaccinated group (P<0.05). Conclusions: Risk of infection still exists with SARS-CoV-2 after vaccination, which can facilitate the production of specific serum antibody of IgM and IgG when people are exposed to the virus. It has a certain protective effect on SARS-CoV-2 infected persons. Vaccination can reduce the clinical symptoms and mitigate disease severity.

[Investigation of contamination of SARS-CoV-2 in imported frozen seafood from a foreign cargo ship and risk factors for infection in stevedores in Qingdao].

Objective: To investigate the contamination status of SARS-CoV-2 in imported frozen seafood from a Russia cargo ship in Qingdao and to analyze the risk factors for infection in local stevedores. Methods: The method of "two-stage, full coverage and mixed sampling" was used to collect the seafood packaging samples for the nucleic acid detection of SARS-CoV-2 by real-time fluorescent quantitative RT-PCR. A unified questionnaire was designed to investigate 71 stevedores in two shifts through telephone interview. The stevedores were divided into two groups, with 23 in the shit with two infections was group A and 48 in the shift without infection was group B. Software Epi Info7.2 was used to identify the risk factors for SARS-CoV-2 infections in the stevedores. Results: In the frozen seafood from a Russia cargo ship, the total positive rate of SARS-CoV-2 nucleic acid in the frozen seafood was 11.53% (106/919). The positive rate of SARS-CoV-2 nucleic acid in the frozen seafood unloaded by group A (14.29%,70/490) was significantly higher than that in the frozen seafood unloaded by group B (8.39%,36/429)(χ2=7.79,P=0.01) and the viral loads detected in the frozen seafood unloaded by group A were higher than those detected in the frozen seafood unloaded by group B. The scores of personal protection and behaviors in the stevedores in group A were significantly lower than those in group B (P<0.05), and toilet use, smoking and improper hand washing before meals were the risk factors for the infection. Conclusions: The imported frozen seafood was contaminated by SARS-CoV-2 and the contamination distribution was uneven. Supervision and management of personal occupational protection and behaviors of workers engaged in imported frozen food transportation should be strengthened. It is suggested that a closed-loop monitoring and management system for the whole process of "fishing-transport- loading/unloading" should be established by marine fishery authority.

FEASIBILITY, DELIVERY, AND IMPLEMENTATION OF A REMOTE CRITICAL CARE TRAINING PROGRAM IN CHINA: THE CERTAIN APPROACH

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: To describe the development, implementation, and learner engagement in a longitudinal international remote critical care continuing medical education program in China. METHODS: Based on the Mayo Clinic Checklist for Early Recognition and Treatment of Acute and Illness and iNjury (CERTAIN) program, we designed and delivered a longitudinal 40-week remote coaching program for a community-based teaching hospital in Shandong Province, China. Based on a mixed-methods needs assessment that included learner feedback using an exploratory sequential design and ICU process and outcomes data, we developed a curriculum that included asynchronous, online learning modules with multiple language captions and weekly remote education sessions using a blend of didactic presentations on common critical care syndromes, virtual simulation, journal club, and case-based discussions. Faculty included a diverse group of critical care experts and bilingual facilitators. The program also included clinical research and quality improvement workshops to facilitate implementation of key concepts identified during these activities. Participants completed a survey using a 5 point anchored Likert scale after each educational activity to provide feedback and guide course improvement. RESULTS: Twenty-two Chinese clinicians (18 physicians, 4 nurses) enrolled in this CERTAIN longitudinal program. Learners completed a total of 163 hours (mean 7.4 hr/learner) asynchronous online learning, and to date have completed 23 weekly education sessions (total 28 hours, including an extended virtual simulation experience). Survey response rate was 56%. Learners reported a high rate of overall satisfaction with the course (112, 61% Excellent;55 (30%) Very Good) and specific topic discussions (110,60% Excellent;57, 31% Very Good), with steady improvement over time. Perceived practice relevance was also high (110, 59% Excellent;55,30% Very Good), and this effort has informed ongoing local performance improvement initiatives. CONCLUSIONS: Remote delivery of longitudinal critical care continuing education program in China using asynchronous learning, case-based discussion, and virtual simulation is feasible, associated with a high rate of learner satisfaction, and increases engagement in quality improvement initiatives. This innovative global education initiative offers an important potential solution to strengthen critical care services in remote, resource-limited settings at low cost, especially during the ongoing COVID-19 pandemic. CLINICAL IMPLICATIONS: The World Health Organization has identified remote education programs as a priority to strengthen international critical care services and better meet growing global clinical demand. The best method to effectively deliver continuing medical education to international healthcare providers with unique cultural, organizational, and practice backgrounds is not well defined. DISCLOSURES: no disclosure on file for Wenjuan Cui;No relevant relationships by Yue Dong, source=Web Response Patent/IP rights for a licensed product relationship with Ambient Clinical Analytics Please note: From 2016 Added 05/23/2021 by Ognjen Gajic, source=Web Response, value=Royalty No relevant relationships by Heyi Li, source=Web Response No relevant relationships by Alexander Niven, source=Web Response no disclosure on file for Lujun Qiao;No relevant relationships by Yuqiang Sun, source=Web Response no disclosure on file for Qingzhong Yuan;

Clinical characteristics of twenty children with COVID⁃19

Objective: To investigate the characteristics of disease transmission, diagnosis, and treatment of COVID‑19 in children. Methods: We retrospectively studied 20 children with COVID‑19 from 4 medical centers in Hubei, China. Results: Among the 20 children, 18 (90.0%) were contaminated by close contact and characterized by family clustering. Seven cases (35.0%) had all family members infected, and 11 cases (55.0%) were confirmed by either of the parents infected. Twelve cases (60.0%) had fever, which was the primary symptom in 10 cases (50.0%). Only one child was in severe degree and combined with severe underlying disease (congenital heart disease). Seven cases (35.0%) presented typical ground‑glass opacity in CT. All patients were confirmed to be infected with SARS‑CoV‑2. Eleven cases (55.0%) had normal white blood cell counts, and one case (5.0%) with severe COVID‑19 showed a continuous decline in T cells subsets. Conclusion: COVID‑19 in children is transmitted by close contact and characterized by family clustering. Fever is the most common symptom or initial symptom. However, the sustained low levels of T cells and underlying diseases are risk factors for severe COVID‑19 children. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.

[Effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy for screening imported patients with COVID-19 in Xiamen].

Objective: To analysis effectiveness of the "14 plus 7 day quarantine" and "nucleic acid plus total antibody testing" strategy (combined screening strategy) for screenin the imported patients with COVID-19 in Xiamen. Methods: The study populations were overseas travelers arriving in Xiamen from March 17 to December 31, 2020, and overseas travelers who had quarantine outside Xiamen for less than 21 days from July 18 to December 31, 2020. Data were collected and analyzed on the timing of detection, pathways, and test results of the imported patients with COVID-19 after implementing combined screening strategy. Results: A total of 304 imported patients with COVID-19 were found from 174 628 overseas travelers and 943 overseas travelers from other cities. A total of 163 cases (53.6%) were diagnosed by multitime, multisite intensive nucleic acid testing after positive finding in total antibody testing. Among them, 27 (8.9%) were first positive for nucleic acid in 14 plus 7 day quarantine and 136 were first positive for nucleic acid in 14-day quarantine. Only 8 of these individuals were tested positive for nucleic acid after positive total antibody testing. The other 128 individuals were tested positive for nucleic acid after being negative for average 2.3 times (maximum of 6 times). Aditional 155 cases might be detected by using the combined "14 plus 7 day quarantine" and " nucleic acid plus total antibody testing" strategy compared with "14-day quarantine and nucleic acid testing" strategy, accounting for 51.0% of the total inbound infections. So the combined screening strategy doubled the detection rate for imported patients with COVID-19. No second-generation case caused by overseas travelers had been reported in Xiamen as of February 26, 2021. Conclusions: Xiamen's combined screening strategy can effectively screen the imported patients with COVID-19 who were first positive for nucleic acid after 14 day quarantine. Compared with "14 day quarantine and nucleic acid testing", the combined screening strategy improved detection rate and further reduced the risk of the secondary transmission caused by the imported patients with COVID-19.

Research on Support Services of MOOC-Based Online Teacher Professional Development During the COVID-19 Pandemic

During the COVID-19 Pandemic, the Ministry of Education of the People's Republic of China has noted that elementary and secondary schools in various regions should ensure "Undisrupted Learning with Disrupted Classes". Therefore, it is important to carry out online teacher professional development (PD) to ensure the quality of basic education. We adopt the literature research method, theoretical deduction method, investigation research method and evaluation research method. Guided by the fundamental principles of online teaching and the "Internet +" thinking, we follow the general online teacher PD process, which is building a community, defining PD issues, providing PD resources, organizing PD activities, generating PD outcomes, and evaluating the outcomes. The Chinese Universities MOOCs Platform is deployed to provide PD resources, organize and manage PD activities. Then we design and apply the MOOC-based online teacher PD support model. Empirical results have shown that this model effectively meets the online PD needs, and corrects the misconceptions of online teaching of first-line elementary and secondary school teachers during the pandemic. Moreover, this model can promote teachers' engagement in online PD. At the same time, we foster a batch of typical online teacher PD cases, which contributes to the online teaching practice to achieve "Undisrupted Learning with Disrupted Classes".

Convalescent plasma in the treatment of severe covid-19: A systematic review and meta-analysis

Background: COVID-19 is a public health emergency of international concern. Its incidence rates and mortality are very high;however, so far, an effective drug treatment remains unknown. Based on the role of convalescent plasma therapy in previously identified viral pneumonias, patients with severe COVID-19 have been given this therapy. This systematic review and meta-analysis aimed to summarize the clinical evidence regarding the efficacy and safety of convalescent plasma therapy in the treatment of severe COVID-19. Methods: PubMed, Embase, Ovid, China Knowledge Network, China Biomedical, VIP Chinese Sci-tech Journal, Wanfang Database, and the International Clinical Trials Registry Platform were searched up to 21 June 2020, to identify clinical studies and registered trials on the use of convalescent plasma in the treatment of critically ill patients with COVID-19. Stata 13.0 was used to perform Meta-analysis. All records were screened as per the protocol eligibility criteria. Results: Nineteen clinical reports regarding convalescent plasma in the treatment of severe COVID-19 were included. Through systematic analysis, convalescent plasma was found to yield some efficacy on severe COVID-19 and had almost no obvious adverse reactions. Conclusion: Convalescent plasma therapy seems to yield some efficacy among patients with severe COVID-19 and almost no obvious adverse reactions were found. However, at present, the clinical evidence is insufficient, and there is an urgent need for support from high-quality clinical trial data. © 2020, Iranian Journal of Public Health. All rights reserved.