Source investigation of a COVID-19 outbreak in the sea-land border city

Objective: To analyze the epidemiological characteristic and tracing process of an outbreak of COVID-19 in a sea-land border city (D city) of Guangxi in December 2021, and provide scientific data for for the emergency management and scientific traceability of similar outbreaks in the future. Methods Epidemiological investigation of cases was carried out under the guideline of the Novel Coronavirus Epidemiological Investigation Programme on Cases of Pneumonia (Edition 8). RT-PCR method was used for samples testing. Furthermore, positive samples were analyzed by whole-genome sequence and phylogenetic analysis. R software 4.1.3 version was used for data analysis. Results There were 20 cases in this outbreak which related 6 families. The average incubation period was (4.6..2.2) d. Compared with the Wuhan reference strain (NC_045512), the genome sequence analysis showed that there were 35-36 nucleotide mutation sites in the novel Coronavirus genome sequence of 19 local cases, which belonged to VOC/Delta variant strain (AY.57 evolutionary branch). The 11 amino acid mutation sites were the same in all the novel Coronavirus spikes (S) proteins, which were highly homologous to the 2 COVID-19 genome sequences uploaded from a neighboring country in the GISAID genome database. Conclusion This outbreak was caused by fishermen who were infected by contacting with persons of neighboring country in the public sea area and causing located community transmission. The management of border villagers and the monitoring of epidemic strains should be strengthened to detect and deal with the outbreak as early as possible in the future.

Green-Labelled Rice versus Conventional Rice: Perception and Emotion of Chinese Consumers Based on Review Mining.

The COVID-19 pandemic increased public health awareness, changing consumers' sensitivity and beliefs about food health. Food anxiety and health scares turn consumers toward safe and healthy foods to strengthen their immunity, which makes green food more popular. However, it remains unclear how to understand the gap between consumer intention to purchase green food and their actual purchasing behaviour. Taking rice as an object of study, comparing differences in consumer perceptions and emotions towards green-labelled rice and conventional rice is beneficial for understanding the components and psychological characteristics of consumer perceptions of green food. Therefore, we used topic modelling and sentiment analysis to explore consumers' focus of attention, attitudinal preferences, and sentiment tendencies based on the review (n = 77,429) from JD.com. The findings revealed that (1) consumers' concerns about green-labelled rice are increasing rapidly, and most have a positive attitude; (2) consumers of green-labelled rice are more concerned about origin, aroma, and taste than conventional rice; (3) consumers of conventional rice are more concerned about the cost-performance ratio, while consumers of green-labelled rice are also price-sensitive; (4) green label mistrust and packaging breakage during logistics are the leading causes of negative emotions among consumers of green-labelled rice. This study provides a comparative analysis of consumer perceptions and emotions between the two types of rice, thus revealing the main influencing factors of the intention-behaviour gap and providing valuable consumer insights for the promotion of green consumption and the sustainable development of the green food industry.

Analysis of Innovation Drivers of New and Old Kinetic Energy Conversion Using a Hybrid Multiple-Criteria Decision-Making Model in the Post-COVID-19 Era: A Chinese Case

To overcome the continuous decline in its gross domestic product growth rate, China has advocated new and old kinetic energy conversion (NOKEC) as a policy for sustainable economic development in the post-COVID-19 era. The innovation drivers of NOKEC are the key to promoting sustainable economic development. However, the innovation drivers have various orientations, and their selection requires multiple-criteria decision-making (MCDM). This study proposes a modified Delphi method combined with the best–worst method (BWM) as a research framework for selecting and ranking innovation drivers. Our results show the validity of this integrated research framework on a case based in China in the post-COVID-19 era. The results reveal 21 innovation-driven factors of NOKEC with varying levels of relative importance. These results may provide a basis for policymakers and researchers with a useful further understanding of the importance and prioritizing of innovation drivers. In this study, BWM uses 4% fewer pairwise comparisons than AHP, and the consistency ratio is in the range of 0.00 to 0.24.

A systematic review and Bayesian network meta-analysis for comparative safety assessment of favipiravir interventions in hospitalized COVID-19 patients.

INTRODUCTION: COVID-19 is a coronavirus-based infectious illness that was first detected at the end of 2019 in Wuhan, China. The novel virus induces severe acute respiratory syndrome (SARS-CoV-2) and has spread globally, resulting in an ongoing pandemic. There is still a lack of evidence for direct comparison of favipiravir therapy. Network meta-analysis (NMA), may incorporate direct and indirect comparisons in a pooled computation while depending on strong assumptions and premises. This study provides evidence-based recommendations on the safety of currently used clinical pharmacological treatments compared to favipiravir for COVID-19 patients. METHODOLOGY: We conducted a systematic review and Bayesian NMA. We searched the primary databases and clinical trials center for reports of short-term, randomized controlled trials (RCTs) of favipiravir for COVID-19 treatment. The primary endpoints here considered were any adverse events observed or reported during the treatment cycle with estimates of odds ratio (OR) and 95% confidence interval (CI), until November 6, 2021. RESULTS: Between January 2020 and July 2021, 908 individuals were randomly assigned to one of the seven active prescription medication regimens or placebo in this study, generating seven direct comparisons on 12 data points. The safety of favipiravir over the four clinically efficacious monotherapies or combinations including tocilizumab, arbidol, lopinavir + ritonavir, and chloroquine remained unknown due to the lack of a significant difference and the limited sample size. CONCLUSIONS: Overall, comparative rankings could assist doctors and guideline developers in decision-making. We have also concluded that the safety of favipiravir requires further attention.

Spatial-Temporal Pattern Evolution of Public Sentiment Responses to the COVID-19 Pandemic in Small Cities of China: A Case Study Based on Social Media Data Analysis.

The impact of the COVID-19 pandemic on public mental health has become increasingly prominent. Therefore, it is of great value to study the spatial-temporal characteristics of public sentiment responses to COVID-19 exposure to improve urban anti-pandemic decision-making and public health resilience. However, the majority of recent studies have focused on the macro scale or large cities, and there is a relative lack of adequate research on the small-city scale in China. To address this lack of research, we conducted a case study of Shaoxing city, proposed a spatial-based pandemic-cognition-sentiment (PCS) conceptual model, and collected microblog check-in data and information on the spatial-temporal trajectory of cases before and after a wave of the COVID-19 pandemic. The natural language algorithm of dictionary-based sentiment analysis (DSA) was used to calculate public sentiment strength. Additionally, local Moran's I, kernel-density analysis, Getis-Ord Gi* and standard deviation ellipse methods were applied to analyze the nonlinear evolution and clustering characteristics of public sentiment spatial-temporal patterns at the small-city scale concerning the pandemic. The results reveal that (1) the characteristics of pandemic spread show contagion diffusion at the micro level and hierarchical diffusion at the macro level, (2) the pandemic has a depressive effect on public sentiment in the center of the outbreak, and (3) the pandemic has a nonlinear gradient negative impact on mood in the surrounding areas. These findings could help propose targeted pandemic prevention policies applying spatial intervention to improve residents' mental health resilience in response to future pandemics.

mRNA Vaccines Against SARS‐CoV‐2 Variants Delivered by Lipid Nanoparticles Based on Novel Ionizable Lipids

SARS‐CoV‐2 variants are now still challenging all the approved vaccines, including mRNA vaccines. There is an urgent need to develop new generation mRNA vaccines with more powerful efficacy and better safety against SARS‐CoV‐2 variants. In this study, a new set of ionizable lipids named 4N4T are constructed and applied to form novel lipid nanoparticles called 4N4T‐LNPs. Leading 4N4T‐LNPs exhibit much higher mRNA translation efficiency than the approved SM‐102‐LNPs. To test the effectiveness of the novel delivery system, the DS mRNA encoding the full‐length S protein of the SARS‐CoV‐2 variant is synthesized and loaded in 4N4T‐LNPs. The obtained 4N4T‐DS mRNA vaccines successfully trigger robust and durable humoral immune responses against SARS‐CoV‐2 and its variants including Delta and Omicron. Importantly, the novel vaccines have higher RBD‐specific IgG titers and neutralizing antibody titers than SM‐102‐based DS mRNA vaccine. Besides, for the first time, the types of mRNA vaccine‐induced neutralizing antibodies are found to be influenced by the chemical structure of ionizable lipids. 4N4T‐DS mRNA vaccines also induce strong Th1‐skewed T cell responses and have good safety. This work provides a novel vehicle for mRNA delivery that is more effective than the approved LNPs and shows its application in vaccines against SARS‐CoV‐2 variants. In this study, mRNA vaccines against SARS‐CoV‐2 variants delivered by lipid nanoparticles based on 4N4T lipids are constructed, and successfully trigger robust and durable humoral immune responses against SARS‐CoV‐2 and its variants including Delta and Omicron. In addition, head‐to‐head comparison studies find that the novel 4N4T lipids have a higher mRNA delivery efficiency than SM‐102.

Use of Latent Dirichlet Allocation and Structural Equation Modeling in Determining the Factors for Continuance Intention of Knowledge Payment Platform

Knowledge payment is a new type of E-learning that has developed in the era of social media. With the influence of the COVID-19 epidemic, the knowledge payment market is developing rapidly. Exploring the influencing factors of users' continuance intention is beneficial for the sustainable development of knowledge payment platforms. Our study took 'Himalayan FM';as an example and included two studies: Study 1 used latent dirichlet allocation (LDA) to explore the main factors affecting the users' willingness to continue use, through mining user comment data on the knowledge payment platform;Study 2 constructed the conceptual model by integrating the technology acceptance model (TAM) and IS success model (IS) and carried out empirical analysis by SPSS and AMOS using the data that were collected through the questionnaire. The results show that: (1) perceived usefulness, user satisfaction, and spokesperson identity have a direct positive impact on users' willingness to continuous use, while perceived cost has a direct negative impact on users' willingness to continue use;(2) perceived ease of use, content quality, and system quality of knowledge payment platforms impacted user satisfaction directly, then affected users' willingness to continue use indirectly;(3) users' perceived enjoyment, membership experience, auditory experience, and other factors also directly impacted user satisfaction, affecting users' willingness to continue use indirectly. This study effectively expands the factors influencing knowledge payment users' willingness to continue use and provides a useful reference for the sustainable development of knowledge payment platforms.

Research on the Public Opinion Guidance Mechanism of Major Public Health Incidents

Public opinion guidance plays a crucial role in the management of major public health incidents, and thus, exploring its mechanism is conducive to the comprehensive governance of social security. This study conducts a case study on the anti-pandemic public opinion guidance and analyzes the public opinion representation and the internal mechanism of public opinion guidance in the context of the COVID-19 in China. The findings suggest that the public opinion on the COVID-19 manifested a three-stage progressive and stable tendency and witnessed the strength of China, specifically, benefiting from the systematic and complete integration and release mechanism for anti-pandemic information, the three-dimensional mechanism for the dissemination of knowledge related to pandemic prevention and health, the innovative disclosure mechanism for precise information, and diversified channels for international public opinion guidance. The guidance mechanism proposed in this study provides significant suggestions for the public opinion guidance of global major public health incidents in future.

The Relationship between Intimate Partner Violence and Online Help-Seeking: A Moderated Mediation Model of Emotion Dysregulation and Perceived Anonymity.

During the COVID-19 pandemic, lockdowns and isolation have limited the availability of face-to-face support services for victims of intimate partner violence (IPV). Despite the growing need for online help in supporting IPV victims, far less is known about the underlying mechanisms between IPV and online help-seeking. We studied the mediating role of emotion dysregulation (ED) and the moderating role of perceived anonymity (PA) on the internet to explain IPV victims' willingness of online help-seeking (WOHS). Through a PROCESS analysis of the questionnaire data (n = 510, 318 female, 192 male, Mage = 22.41 years), the results demonstrate that: (1) ED has been linked with the experience of IPV, and IPV significantly induces ED. (2) When IPV victims realize the symptoms of ED, they have a strong willingness to seek external intervention to support themselves. ED mediates the relationship between IPV and online help-seeking. (3) For youth growing up in the era of social networking sites (SNS), personal privacy protection is an important factor when seeking online help. The anonymity of the internet has a positive effect on victims who experience IPV and ED, and it increases WOHS. This study introduces a new perspective on the psychological mechanism behind IPV victims' help-seeking behaviors, and it suggests that the improvement of anonymity in online support can be an effective strategy for assisting IPV victims.

Public Attention and Sentiment toward Intimate Partner Violence Based on Weibo in China: A Text Mining Approach.

The mobile internet has resulted in intimate partner violence (IPV) events not being viewed as interpersonal and private issues. Such events become public events in the social network environment. IPV has become a public health issue of widespread concern. It is a challenge to obtain systematic and detailed data using questionnaires and interviews in traditional Chinese culture, because of face-saving and the victim's shame factors. However, online comments about specific IPV events on social media provide rich data in understanding the public's attitudes and emotions towards IPV. By applying text mining and sentiment analysis to the field of IPV, this study involved construction of a Chinese IPV sentiment dictionary and a complete research framework. We analyzed the trends of the Chinese public's emotional evolution concerning IPV events from the perspectives of a time series as well as geographic space and social media. The results show that the anonymity of social networks and the guiding role of opinion leaders result in traditional cultural factors such as face-saving and family shame for IPV events being no longer applicable, leading to the spiral of an anti-silence effect. Meanwhile, in the process of public emotional communication, anger often overwhelms reason, and the spiral of silence remains in effect in social media. In addition, there are offensive words used in the IPV event texts that indicate misogyny in emotional, sexual, economic and psychological abuse. Fortunately, mainstream media, as crucial opinion leaders in the social network, can have a positive role in guiding public opinion, improving people's ability to judge the validity of network information, and formulating people's rational behaviour.

A combination regimen by lopinave/litonawe, emtricitabine and tenofovir alafenamide fumarate for treatment of novel coronavirus pneumonia (TARCoV)

Objective: To explore the efficacy of a combination regimen by Lopinave/Litonawe (LPV/r), emtricitabine and tenofovir alafenamide fumarate (FTC/TAF) for the treatment of novel coronavirus pneumonia.

Gut, metabolism and nutritional Support for COVID-19: Experiences from China.

There is little research that focuses on the relationship between the gut, metabolism, nutritional support and COVID-19. As a group of Chinese physicians, nutritionists and scientists working on the frontline treating COVID-19 patients, we aim to integrate our experiences and the current clinical evidence to address this pressing issue in this article. Based on our clinical observations and available evidence, we recommend the following practice. Firstly, the Nutritional Risk Screening 2002 tool should be used routinely and periodically; for patients with a score ≥3, oral nutritional supplements should be given immediately. Secondly, for patients receiving the antiviral agents lopinavir/ritonavir, gastrointestinal side effects should be monitored for and timely intervention provided. Thirdly, for feeding, the enteral route should be the first choice. In patients undergoing mechanical ventilation, establishing a jejunal route as early as possible can guarantee the feeding target being achieved if gastric dilatation occurs. Fourthly, we suggest a permissive underfeeding strategy for severe/critical patients admitted to the intensive care unit during the first week of admission, with the energy target no more than 20 kcal/kg/day (for those on mechanical ventilation, this target may be lowered to 10-15 kcal/kg/day) and the protein target around 1.0-1.2 g/kg/day. If the inflammatory condition is significantly alleviated, the energy target may be gradually increased to 25-30 kcal/kg/day and the protein target to 1.2-1.5 g/kg/day. Fifthly, supplemental parenteral nutrition should be used with caution. Lastly, omega-3 fatty acids may be used as immunoregulators, intravenous administration of omega-3 fatty emulsion (10 g/day) at an early stage may help to reduce the inflammatory reaction.

[Retrospective Analysis of Neurological Symptoms of Severe/Critical COVID-19 Patients in Sichuan Province].

OBJECTIVE: To retrospectively analyze the symptoms and characteristics of nervous system damage in severe/critically severe patients with coronavirus disease 2019 (COVID-19) in Sichuan province, with a view to providing basic references for the prevention and treatment of COVID-19. METHODS: A total of 90 patients with severe/critically severe COVID-19 were included, who were diagnosed and treated in COVID-19 designated hospital of Sichuan province from 11 January 2020 to 20 March 2020. Clinical features, test results, treatment options and clinical outcomes were analyzed retrospectively. RESULTS: Of 90 patients, there were 54 males and 36 females, with an average age of (53.90±16.92) years. In addition to the classic symptoms such as fever and/or respiratory symptoms, 53 patients also had various degrees of neurologic manifestations, including 33 cases of fatigue, 21 muscle soreness, 12 dizziness, 8 headaches, 3 mental disorders, and 1 consciousness disorders and 1 case of neck pain. Compared with the patients without neurologic manifestations, those with neurologic manifestations took a longer time from admission to diagnosis of COVID-19 ( P<0.05), and received more antifungal treatment ( P<0.05). CONCLUSIONS: Neurological symptoms are not uncommon in severe/critically severe patients with COVID-19, and it's relatively difficult in the treatment. It should be paid attention in order to avoid misdiagnosis.

Epidemiological and clinical based study on four passages of COVID-19 patients: intervention at asymptomatic period contributes to early recovery.

BACKGROUND: With the worldwide spread of the 2019 novel coronavirus, scarce knowledge is available on the clinical features of more than two passages of patients. Further, in China, early intervention policy has been enacted since February. Whether early intervention contributes to swift recovery is still unknown. Hence, in this study, we focused on the patients from an isolated area, investigated the epidemiological and clinical characteristics of four serial passages of the virus. METHODS: From January 25 to February 29, 2020, all patient data on the SARS-CoV-2 passages in this isolated area were traced, and the patients were grouped according to the passaging of SARS-CoV-2. Clinical characteristics of patients, including laboratory, radiology, treatment and outcomes, were collected and analyzed. RESULTS: A total of 78 patients with four passages of virus transmission were included in this study. One patient transmitted SARS-CoV-2 to 8 patients (passage 2, P2), who next infected 23 patients (passage 3, P3), and then 46 patients (passage 4, P4). P2 received antiviral treatment when they had symptom, whereas P4 received antiviral treatment during their asymptomatic period. The incubation periods for P2, P3 and P4 patients were 7 days (IQR:2-12), 8 days (IQR:4-13) and 10 days (IQR:7-15), respectively. P2 patients showed lymphocytopenia (0.79 × 109/L), decreased lymphocyte percentages (12.15%), increased white blood cell count (6.51 × 109/L), increased total bilirubin levels (25% of P2 patients), increased C-reactive protein levels (100% of P2 patients) and abnormal liver function. By chest CT scans, all P2 patients (100%), 15 of P3 patients (65.22%) and 16 of P4 patients (34.78%) showed abnormality with typical feature of ground glass opacity. All of P2 patients (100%) received oxygen therapy, and in contrast, 19 of P4 patients (41.3%) received oxygen therapy. Further, significant decreased nucleic acid positive periods was found in P4 group (16 days, IQR: 10-23), compared with that of P2 group (22 days, IQR: 16-27). Moreover, the severity ratios were sharply decreased from 50% (P2 patients) to 4.35% (P4 patients), and the case fatality rate is zero. CONCLUSIONS: Judged from four passages of patients, early intervention contributes to the early recovery of COVID-19 patients.

Risk factors for severe cases of COVID-19: a retrospective cohort study.

BACKGROUND: SARS-CoV-2 has raged around the world since March, 2020. We aim to describe the clinical characteristics and risk factors of severe patients with COVID-19 in Guangzhou. RESULTS: The severity and mortality of COVID-19 was 10.4% and 0.3% respectively. And each 1-year increase in age (OR, 1.057; 95% CI, 1.018-1.098; P=0.004), Wuhan exposure history greater than 2 weeks (OR, 2.765; 95% CI, 1.040-7.355; P=0.042), diarrhea (OR, 24.349; 95% CI, 3.580-165.609; P=0.001), chronic kidney disease (OR, 6.966; 95% CI, 1.310-37.058; P = 0.023), myoglobin higher than 106 µg/L (OR, 8.910; 95% CI, 1.225-64.816; P=0.031), white blood cell higher than 10×109/L (OR, 5.776; 95% CI, 1.052-31.722; P=0.044), and C-reactive protein higher than 10 mg/L (OR, 5.362; 95% CI, 1.631-17.626; P=0.006) were risk factors for severe cases. CONCLUSION: Older age, Wuhan exposure history, diarrhea, chronic kidney disease, elevated myoglobin, elevated white blood cell and C-reactive protein were independent risk factors for severe patients with COVID-19 in Guangzhou. METHODS: We included 288 adult patients with COVID-19 and compared the data between severe and non-severe group. We used univariate and multivariate logistic regression methods to explore risk factors of severe cases.

Clinical features and risk factors for ICU admission in COVID-19 patients with cardiovascular diseases.

Previous studies on coronavirus disease 2019 (COVID-19) have focused on the general population. However, cardiovascular disease (CVD) is a common comorbidity that has rarely been investigated in detail. This study aims to describe clinical characteristics and determine risk factors for intensive care unit (ICU) admission of COVID-19 patients with CVD. In this retrospective cohort study, we included 288 adult patients with COVID-19 in Guangzhou Eighth People's Hospital from January 15, 2020 to March 10, 2020. Demographic characteristics, laboratory results, radiographic findings, complications, and treatments were recorded and compared between CVD and non-CVD groups. A binary logistic regression model was used to identify risk factors associated with ICU admission for infected patients with underlying CVD. COVID-19 patients in the CVD group were older and had higher levels of troponin I (TnI), C-reactive protein (CRP), and creatinine. They were also more prone to develop into severe or critically severe cases, receive ICU admission, and require respiratory support treatment. Multivariate regression analysis showed that the following were risk factors for ICU admission in COVID-19 patients with CVD: each 1-year increase in age (odds ratio (OR), 1.08; 95% confidence interval (CI), 1.02-1.17; p = 0.018); respiratory rate over 24 times per min (OR, 25.52; 95% CI, 5.48-118.87; p < 0.0001); CRP higher than 10 mg/L (OR, 8.12; 95% CI, 1.63-40.49; p = 0.011); and TnI higher than 0.03 µg/L (OR, 9.14; 95% CI, 2.66-31.43; p < 0.0001). Older age, CRP greater than 10 mg/L, TnI higher than 0.03 µg/L, and respiratory rate over 24 times per minute were associated with increasing odds of ICU admission in COVID-19 patients with CVD. Investigating and monitoring these factors could assist in the risk stratification of COVID-19 patients with CVD at an early stage.