Local travel behaviour under continuing COVID-19 waves- A proxy for pandemic fatigue?

COVID-19 continues to threaten the world. Relaxing local travel behaviours on preventing the spread of COVID-19, may increase the infection risk in subsequent waves of SARS-CoV-2 transmission. In this study, we analysed changes in the travel behaviour of different population groups (adult, child, student, elderly) during four pandemic waves in Hong Kong before January 2021, by 4-billion second-by-second smartcard records of subway. A significant continuous relaxation in human travel behaviour was observed during the four waves of SARS-CoV-2 transmission. Residents sharply reduced their local travel by 51.9%, 50.1%, 27.6%, and 20.5% from the first to fourth pandemic waves, respectively. The population flow in residential areas, workplaces, schools, shopping areas, amusement areas and border areas, decreased on average by 30.3%, 33.5%, 41.9%, 58.1%, 85.4% and 99.6%, respectively, during the pandemic weeks. We also found that many other cities around the world experienced a similar relaxation trend in local travel behaviour, by comparing traffic congestion data during the pandemic with data from the same period in 2019. The quantitative pandemic fatigue in local travel behaviour could help governments partially predicting personal protective behaviours, and thus to suggest more accurate interventions during subsequent waves, especially for highly infectious virus variants such as Omicron.

Student close contact behavior and COVID-19 transmission in China's classrooms.

Classrooms are high-risk indoor environments, so analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in classrooms is important for determining optimal interventions. Due to the absence of human behavior data, it is challenging to accurately determine virus exposure in classrooms. A wearable device for close contact behavior detection was developed, and we recorded >250,000 data points of close contact behaviors of students from grades 1 to 12. Combined with a survey on students' behaviors, we analyzed virus transmission in classrooms. Close contact rates for students were 37 ± 11% during classes and 48 ± 13% during breaks. Students in lower grades had higher close contact rates and virus transmission potential. The long-range airborne transmission route is dominant, accounting for 90 ± 3.6% and 75 ± 7.7% with and without mask wearing, respectively. During breaks, the short-range airborne route became more important, contributing 48 ± 3.1% in grades 1 to 9 (without wearing masks). Ventilation alone cannot always meet the demands of COVID-19 control; 30 m3/h/person is suggested as the threshold outdoor air ventilation rate in a classroom. This study provides scientific support for COVID-19 prevention and control in classrooms, and our proposed human behavior detection and analysis methods offer a powerful tool to understand virus transmission characteristics and can be employed in various indoor environments.

Rumour type matters: The effect of different types of rumours on coping, subjective well-being, and interpersonal trust during the COVID-19 pandemic.

Rumours circulated quickly online and offline during the COVID-19 pandemic, but empirical research on the subject is limited. Combining qualitative (Study 1, content analysis was conducted on 2344 actual rumours extracted from a rumour-refuting website) and quantitative methods (Study 2, a three-wave study with 10-day intervals), the current study suggests that (1) rumours during the pandemic can be categorised into three types, that is, wish, dread, and aggression rumours, and (2) exposure to different types of rumours is associated with coping consequences, subjective well-being (comprising positive affect, negative affect, and life satisfaction), and interpersonal trust in different ways. Generally, wish rumours seem benign, while dread and aggression rumours are malicious. Specifically, wish rumours are believed to assist coping and to be positively associated with positive affect and interpersonal trust. In contrast, dread rumours are believed not to assist coping and to be marginally significantly and positively associated with negative affect and negatively associated with interpersonal trust. Meanwhile, aggression rumours are believed not to assist coping and are marginally significantly and positively associated with negative affect. All other relationships are nonsignificant. The results of the current study will help national governments and international agencies design and evaluate rumour control strategies and policies.

Changes on local travel behaviors under travel reduction-related interventions during COVID-19 pandemic: a case study in Hong Kong

The emerging Omicron variant poses a serious threat to human health. Public transports play a critical role in infection spread. Based on the data of nearly 4 billion smartcard uses, between January 1, 2019 and January 31, 2021 from the Mass Transit Railway Corporation of Hong Kong, we analyzed the subway travel behavior of different population groups (adults, children, students and senior citizens) due to the COVID-19 pandemic and human travel behavior under different interventions (e.g. work suspension, school closure). Due to the pandemic, the number of MTR passengers (the daily number of passengers in close proximity in subway carriages) decreased by 37.4% (40.8%) for adults, 80.3% (78.5%) for children, 71.6% (71.6%) for students, and 33.5% (36.1%) for senior citizens. Due to work from home (school suspension), the number of contacted adults (students/children) in the same carriage during the rush hours decreased by 39.6% (38.6%/43.2%). If all workers, students, and children were encouraged to commute avoiding rush hours, the possible repeated contacts during rush hour of adults, children and students decreased by 73.3%, 77.9% and 79.5%, respectively. Since adults accounted for 87.3% of the total number of subway passengers during the pandemic, work from home and staggered shift pattern of workers can reduce the infection risk effectively. Our objective is to find the changes of local travel behavior due to the pandemic. From the perspective of public transports, the results provide a scientific support for COVID-19 prevention and control in cities. Supplementary Information The online version contains supplementary material available at 10.1007/s44213-023-00006-z.

Peripheral blood mononuclear cell tissue factor (F3 gene) transcript levels and circulating extracellular vesicles are elevated in severe coronavirus 2019 (COVID-19) disease.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with excessive coagulation, thrombosis, and mortality. OBJECTIVE: To provide insight into mechanisms that contribute to excessive coagulation in coronavirus 2019 (COVID-19) disease. PATIENTS/METHODS: Blood from COVID-19 patients was investigated for coagulation-related gene expression and functional activities. RESULTS: Single-cell RNA sequencing (scRNA-seq) of peripheral blood mononuclear cells from severe COVID-19 patients revealed a 5.2-fold increase in tissue factor (TF [F3 gene]) transcript expression levels (P < .05), the trigger of extrinsic coagulation; a 7.7-fold increase in C1-inhibitor (SERPING1 gene; P < .01) transcript expression levels, an inhibitor of intrinsic coagulation; and a 4.4-fold increase in anticoagulant thrombomodulin (TM [THBD gene]) transcript expression levels (P < .001). Bulk RNA-seq analysis of sorted CD14+ monocytes on an independent cohort of COVID-19 patients confirmed these findings (P < .05). Indicative of excessive coagulation, 41% of COVID-19 patients' plasma samples contained high D-dimer levels (P < .0001); of these, 19% demonstrated extracellular vesicle TF activity (P = .109). COVID-19 patients' ex vivo plasma-based thrombin generation correlated positively with D-dimer levels (P < .01). Plasma procoagulant extracellular vesicles were elevated ∼9-fold in COVID-19 patients (P < .01). Public scRNA-seq data sets from bronchoalveolar lung fluid and our peripheral blood mononuclear cell scRNA-seq data show CD14+ monocytes/macrophages TF transcript expression levels are elevated in severe but not mild or moderate COVID-19 patients. CONCLUSIONS: Beyond local lung injury, SARS-CoV-2 infection increases systemic TF (F3) transcript levels and elevates circulating extracellular vesicles that likely contribute to disease-associated coagulation, thrombosis, and related mortality.

Bibliometric and visual analysis of cardiovascular diseases and COVID-19 research.

Background: The global community has been affected by the coronavirus disease 2019 (COVID-19), which emerged in December 2019. Since then, many studies have been conducted on cardiovascular diseases (CVDs) and COVID-19. The aim of this study was to perform a bibliometric and visual analysis of the published relationship between CVDs and COVID-19. Methods: 1,890 publications were retrieved from the Web of Science Core Collection database on January 5, 2022. Microsoft Office Excel and CiteSpace were then used to carry out scientometric analysis on the relevant literature according to seven aspects: document type, countries/regions, institutions, authors, journals, references, and keywords. Results: The research on CVDs and COVID-19 is currently in a period of rapid development, with China, USA, England, and Italy leading the field. There is active cooperation between most countries and institutions. Harvard Medical School stands out among the many institutions not only for the largest number of publications, but also for their high quality. Banerjee A, Solomon SD and Narula J are three representative authors in this field. Frontiers in Cardiovascular Medicine was the journal with the highest number of published studies, and The Lancet was the most cited journal. Two documents with a high degree of significance in this field were identified. Popular research topics in this field are specific diseases, such as acute coronary syndrome and heart failure; pathogenesis related to ACE2, insulin resistance and pericyte; the specific therapeutic drug chloroquine; and clinical characteristics, physical activity, and mental health. ACE2 and NF-κB will be the focus of future research. Conclusions: This study provides useful information for the research of CVDs and COVID-19, including potential collaborators, popular research topics, and a reference for more extensive and in-depth research in the future.

Effects of occupant behavior and ventilation on exposure to respiratory droplets in the indoor environment

To quantify the risk of the transmission of respiratory infections in indoor environments, we systematically assessed exposure to talking- and breathing-generated respiratory droplets in a generic indoor environment using computational fluid dynamic (CFD) simulations. The flow field in the indoor environment was obtained with SST k-ω model and Lagrangian method was used to predict droplet trajectories, where droplet evaporation was considered. Droplets can be categorized into small droplets (initial size ≤30 μm or ≤10 μm as droplet nuclei), medium droplets (30–80 μm) and large droplets (>100 μm) according to the exposure characteristics. Droplets up to 100 μm, particular the small ones, can contribute to both short-range and long-range airborne routes. For the face-to-face talking scenario, the intake fraction and deposition fractions of droplets on the face and facial mucosa of the susceptible were up to 4.96%, 2.14%, and 0.12%, respectively, indicating inhalation is the dominant route. The exposure risk from a talking infector decreases monotonically with the interpersonal distance, while that of nasal-breathing generated droplets maintains a relatively stable level within 1.0 m. Keeping an angle of 15° or above with the expiratory flow is efficient to reduce intake fractions to <0.37% for small droplets. Adjusting the orientation from face-to-face to face-to-back can reduce exposure to small droplets by approximately 88.0% during talking and 66.2% during breathing. A higher ventilation rate can reduce the risk of exposure to small droplets but may increase the risk of transmission via medium droplets by enhancing their evaporation rate. This study would serve as a fundamental research for epidemiologist, healthcare workers and the public in the purpose of infection control.

Multiple Death Pathways of Neutrophils Regulate Alveolar Macrophage Proliferation.

Alveolar macrophage (AM) proliferation and self-renewal play an important role in the lung tissue microenvironment. However, the impact of immune cells, especially the neutrophils, on AM homeostasis or function is not well characterized. In this study, we induced in vivo migration of neutrophils into bronchoalveolar lavage (BAL) fluid and lung using CXCL1, and then co-cultured these with AMs in vitro. Neutrophils in the BAL (BAL-neutrophils), rather than neutrophils of bone marrow (BM-neutrophils), were found to inhibit AM proliferation. Analysis of publicly available data showed high heterogeneity of lung neutrophils with distinct molecular signatures of BM- and blood-neutrophils. Unexpectedly, BAL-neutrophils from influenza virus PR8-infected mice (PR8-neutrophils) did not inhibit the proliferation of AMs. Bulk RNA sequencing further revealed that co-culture of AMs with PR8-neutrophils induced IFN-α and -γ responses and inflammatory response, and AMs co-cultured with BAL-neutrophils showed higher expression of metabolism- and ROS-associated genes; in addition, BAL-neutrophils from PR8-infected mice modulated AM polarization and phagocytosis. BAL-neutrophil-mediated suppression of AM proliferation was abrogated by a combination of inhibitors of different neutrophil death pathways. Collectively, our findings suggest that multiple cell death pathways of neutrophils regulate the proliferation of AMs. Targeting neutrophil death may represent a potential therapeutic strategy for improving AM homeostasis during respiratory diseases.

Anxiety, Depression, and PTSD among College Students in the Post-COVID-19 Era: A Cross-Sectional Study.

In the post-COVID-19 era, significant changes have taken place regarding the epidemic, the economy, family and social life. However, it remains unclear how these changes encompass the psychological symptoms of college students. We carried out a cross-sectional study to investigate anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms among college students from 10 November 2020, to 16 November 2020. The questionnaire included a self-designed canvas, Generalized Anxiety Disorder 7 (GAD-7), Patient Health Questionnaire 9 (PHQ-9), and Impact of Event Scale (IES-R). Factors associated with psychological symptoms were estimated by ordered and non-conditional logistic regression analysis. Of 4754 participants, 25.0%, 29.7%, 3.4%, 15.3%, 17.1%, and 2.9% reported anxiety, depression, PTSD symptoms, one, any two, and all three, respectively. In cases with anxiety or depression symptoms, there was a 9.11% comorbidity with PTSD. Factors associated with fears of being infected, social, family, and economic changes increased the risk of psychological symptoms in college students caused by COVID-19. Female college students, identified with anxiety or depression symptoms, were at a lower risk of developing PTSD symptoms (OR, 0.61, 95% CI: 0.43-0.86). Non-medical majors at university, rural residence, higher educational background, fear of taking public transport, and deterioration of family relationships increased the risk for PTSD symptoms among male respondents with anxiety or depression symptoms due to COVID-19. Factors correlated with psychological symptoms had expanded from the fear of being infected to extensive social, family, and economic changes caused by COVID-19. Therefore, screening and interventions for psychological symptoms should be consistently strengthened and more targeted to college students in the post-COVID-19 era.

Evaluating the performance of futures hedging using factors-driven realized volatility

The complexity and uncertainty of the financial market mainly stem from the rich market internal transaction information and a wide range effect of external factors. To this end, this paper proposes the combination factors-driven forecasting method to predict realized volatilities of the CSI 300 index and index futures. Based on the volatilities predicted by the proposed method, we further evaluate the ex-ante hedging performance in comparison to the conventional HAR model as well as GARCH-type models. The empirical results indicate that the factors-driven realized volatility model significantly dominates the other commonly used models in terms of hedging effectiveness. Furthermore, the superiority of the proposed method is robust in different market conditions, including significant rising or falling and abnormal market fluctuations in the COVID-19 pandemic, and in different index markets. Therefore, this paper improves the prediction accuracy of volatility by integrating market internal transaction information and external factor information, and the proposed method in this paper can be used by investors to obtain an excellent hedging effect.

Molecular insight into pentraxin-3: Update advances in innate immunity, inflammation, tissue remodeling, diseases, and drug role.

Pentraxin-3 (PTX3) is the prototype of the long pentraxin subfamily, an acute-phase protein consisting of a C-terminal pentraxin domain and a unique N-terminal domain. PTX3 was initially isolated from human umbilical vein endothelial cells and human FS-4 fibroblasts. It was subsequently found to be also produced by synoviocytes, chondrocytes, osteoblasts, smooth muscle cells, myeloid dendritic cells, epithelial cells, and tumor cells. Various modulatory factors, such as miRNAs, cytokines, drugs, and hypoxic conditions, could regulate the expression level of PTX3. PTX3 is essential in regulating innate immunity, inflammation, angiogenesis, and tissue remodeling. Besides, PTX3 may play dual (pro-tumor and anti-tumor) roles in oncogenesis. PTX3 is involved in the occurrence and development of many non-cancerous diseases, including COVID-19, and might be a potential biomarker indicating the prognosis, activity,and severity of diseases. In this review, we summarize and discuss the potential roles of PTX3 in the oncogenesis and pathogenesis of non-cancerous diseases and potential targeted therapies based on PTX3.

Flight crew fatigue risk assessment for international flights under the COVID-19 outbreak response exemption policy.

BACKGROUND: In response to the COVID-19 outbreak, the Civil Aviation Administration of China (CAAC) has formulated Implementation Measures for Exemption of Crew Duty Periods and Flight Time Restrictions during the COVID-19 Outbreak. This exemption policy imposes temporary deviations from the approved crew duty periods and flight time restrictions for some transport airlines and regulates the use of multiple crews for continuous round-trip flights. However, no research has been conducted on flight crew fatigue under this exemption policy. That is, the exemption policy lacks theoretical analysis and scientific validation. METHODS: Firstly, flight plans for international flights under both the exemption and the CCAR-121 Policy schemes (with three flight departure scenarios: early morning, midday and evening) are designed, and flight plans are simulated based on the SAFE model. The Karolinska Sleepiness Scale (KSS) and the PVT objective test of alertness, both of which are commonly used in the aviation industry, are then selected for use in an empirical experimental study of flight crew fatigue on two flights subject to the exemption and CCAR-121 policies. RESULTS: The SAFE model simulation found that the fatigue risk results based on flight crews for flights departing in the early morning (4:00), at noon (12:00) and in the evening (20:00) indicate that the fatigue risk levels of flight crews operating under the exemption policy are overwhelmingly lower than or similar to those operating under the CCAR-121 policy. However, there were a few periods when the fatigue risk of crews flying under the exemption policy was higher than that of crews flying under the CCAR-121 policy, but at these times, the crews flying under both policies were either at a lower level of fatigue risk or were in the rest phase of their shifts. In the experimental study section, 40 pilots from each of the early morning (4:00), noon (12:00) and evening (20:00) departures operating under the exemption policy were selected to collect KSS scale data and PVT test data during their duty periods, and a total of 120 other pilots operating under the CCAR-121 policy were selected for the same experiment. First, the KSS scale data results found that flight pilots, whether flying under the exemption policy or under the CCAR-121 policy, had overall similar KSS scores, maintained KSS scores below the fatigue risk threshold (i.e., KSS score < 6) during the flights and that the empirical KSS data and the model simulation results from the KSS data were overall identical at the test nodes during the flight and had nearly identical trends. Finally, the results of the PVT objective test indicators showed that the overall change in 1/RT of the crews flying under the exemption policy was less than or similar to that of the crews flying under the CCAR-121 policy, while the maximum change in 1/RT of the crews under both policies was between 1 and 1.5. This indicates that the overall level of alertness of the crew flying under the exemption policy is higher than or similar to that of the crew flying under the CCAR-121 policy, while the change in alertness level of the crew before and after the mission is relatively small when flying under either policy. CONCLUSION: Based on the model simulation results and the results of the empirical study, it was verified that the overall fatigue risk level of flight crews operating under the exemption policy is lower than or similar to the fatigue risk level of flight crews operating under the CCAR-121 policy. Therefore, the exemption policy in response to the COVID-19 outbreak does not result in an overall increase in the level of flight crew fatigue risk compared to the original CCAR-121 policy.

Assessment of Clinician Diagnostic Concordance With Video Telemedicine in the Integrated Multispecialty Practice at Mayo Clinic During the Beginning of COVID-19 Pandemic From March to June 2020.

Importance: There was a shift in patient volume from in-person to video telemedicine visits during the COVID-19 pandemic. Objective: To determine the concordance of provisional diagnoses established at a video telemedicine visit with diagnoses established at an in-person visit for patients presenting with a new clinical problem. Design, Setting, and Participants: This is a diagnostic study of patients who underwent a video telemedicine consultation followed by an in-person outpatient visit for the same clinical problem in the same specialty within a 90-day window. The provisional diagnosis made during the video telemedicine visit was compared with the reference standard diagnosis by 2 blinded, independent medical reviewers. A multivariate logistic regression model was used to determine factors significantly related to diagnostic concordance. The study was conducted at a large academic integrated multispecialty health care institution (Mayo Clinic locations in Rochester, Minnesota; Scottsdale and Phoenix, Arizona; and Jacksonville, Florida; and Mayo Clinic Health System locations in Iowa, Wisconsin, and Minnesota) between March 24 and June 24, 2020. Participants included Mayo Clinic patients residing in the US without age restriction. Data analysis was performed from December 2020 to June 2021. Exposures: New clinical problem assessed via video telemedicine visit to home using Zoom Care Anyplace integrated into Epic. Main Outcomes and Measures: Concordance of provisional diagnoses established over video telemedicine visits compared against a reference standard diagnosis. Results: There were 2393 participants in the analysis. The median (IQR) age of patients was 53 (37-64) years; 1381 (57.7%) identified as female, and 1012 (42.3%) identified as male. Overall, the provisional diagnosis established over video telemedicine visit was concordant with the in-person reference standard diagnosis in 2080 of 2393 cases (86.9%; 95% CI, 85.6%-88.3%). Diagnostic concordance by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision chapter ranged from 64.7% (95% CI, 42.0%-87.4%) for diseases of the ear and mastoid process to 96.8% (95% CI, 94.7%-98.8%) for neoplasms. Diagnostic concordance by medical specialty ranged from 77.3% (95% CI, 64.9%-89.7%) for otorhinolaryngology to 96.0% (92.1%-99.8%) for psychiatry. Specialty care was found to be significantly more likely than primary care to result in video telemedicine diagnoses concordant with a subsequent in-person visit (odds ratio, 1.69; 95% CI, 1.24-2.30; P < .001). Conclusions and Relevance: This diagnostic study of video telemedicine visits yielded a high degree of diagnostic concordance compared with in-person visits for most new clinical concerns. Some specific clinical circumstances over video telemedicine were associated with a lower diagnostic concordance, and these patients may benefit from timely in-person follow-up.

Smartphones as an Ecological Niche of Microorganisms: Microbial Activities, Assembly, and Opportunistic Pathogens.

Smartphone usage and contact frequency are unprecedentedly high in this era, and they affect humans mentally and physically. However, the characteristics of the microorganisms associated with smartphones and smartphone hygiene habits remain unclear. In this study, using various culture-independent techniques, including high-throughput sequencing, real-time quantitative PCR (RT-qPCR), the ATP bioluminescence system, and electron microscopy, we investigated the structure, assembly, quantity, and dynamic metabolic activity of the bacterial community on smartphone surfaces and the user's dominant and nondominant hands. We found that smartphone microbiotas are more similar to the nondominant hand microbiotas than the dominant hand microbiotas and show significantly decreased phylogenetic diversity and stronger deterministic processes than the hand microbiota. Significant interindividual microbiota differences were observed, contributing to an average owner identification accuracy of 70.6% using smartphone microbiota. Furthermore, it is estimated that approximately 1.75 × 106 bacteria (2.24 × 104/cm2) exist on the touchscreen of a single smartphone, and microbial activities remain stable for at least 48 h. Scanning electron microscopy detected large fragments harboring microorganisms, suggesting that smartphone microbiotas live on the secreta or other substances, e.g., human cell debris and food debris. Fortunately, simple smartphone cleaning/hygiene could significantly reduce the bacterial load. Taken together, our results demonstrate that smartphone surfaces not only are a reservoir of microbes but also provide an ecological niche in which microbiotas, particularly opportunistic pathogens, can survive, be active, and even grow. IMPORTANCE Currently, people spend an average of 4.2 h per day on their smartphones. Due to the COVID-19 pandemic, this figure may still be increasing. The high frequency of smartphone usage may allow microbes, particularly pathogens, to attach to-and even survive on-phone surfaces, potentially causing adverse effects on humans. We employed various culture-independent techniques in this study to evaluate the microbiological features and hygiene of smartphones, including community assembly, bacterial load, and activity. Our data showed that deterministic processes drive smartphone microbiota assembly and that approximately 1.75 × 106 bacteria exist on a single smartphone touchscreen, with activities being stable for at least 48 h. Fortunately, simple smartphone cleaning/hygiene could significantly reduce the bacterial load. This work expands our understanding of the microbial ecology of smartphone surfaces and might facilitate the development of electronic device cleaning/hygiene guidelines to support public health.

Charge transport properties of SARS-CoV-2 Delta variant (B.1.617.2).

The B.1.617.2 (Delta) variant of concern is causing a new wave of infections in many countries. In order to better understand the changes of the SARS-CoV-2 mutation at the genetic level, we selected six mutations in the S region of the Delta variant compared with the native SARS-CoV-2 and get the conductance information of these six short RNA oligonucleotides groups by construct RNA: DNA hybrids. The electronic characteristics are investigated by the combination of density functional theory and non-equilibrium Green's function formulation with decoherence. We found that conductance is very sensitive to small changes in virus sequence. Among the 6 mutations in the Delta S region, D950N shows the largest change in relative conductance, reaching a surprising 4104.75%. These results provide new insights into the Delta variant from the perspective of its electrical properties. This may be a new method to distinguish virus variation and possess great research prospects.

Psychological health intervention for children and adolescents during outbreak of novel coronavirus

The COVID-19 pandemic has severely affected people's daily life globally, especially for the physical and mental health of children and adolescents, the vulnerable group. This paper reviews the studies, up to August 24, 2020, focusing on the following four aspects. Firstly, the mental stressors among children and adolescents are discussed from national and society, school and community, family and individual perspectives, such as the social isolation, the health care facility closures, the school closures, the economic deterioration, the home quarantine, the domestic violence and abuse, the increased screen time, and others. Secondly, the main types of psychological problems in teenagers during the COVID-19 are discussed. Emotional problems mainly include the anxiety, the depression, the loneliness, the sleep problems, the psychosomatic problems and the stress-related problems. Behavioral problems mainly include:the internet addiction, the sexual abuse behaviors, the parent-child conflicts, and others. Finally, children and adolescents are divided into five categories according to different risks under the background of COVID-19:the ordinary children, the children living in high exposure risk areas, the children with their caregivers being affected or being frontline workers, the quarantined children, the children with other diseases and the infected children. And intervention recommendations include the health education, the epidemic prevention, the knowledge popularization, the parent accompaniment;the hospital 24-hour on-duty nursing system, the online consultation and the online pharmacy;the remote interactive online education, the remote psychiatry, the book therapy, the music therapy, the emotion-focused therapy (EFT), the parent-child interaction therapy (PCIT), the cognitive behavioral writing therapy(CBWT), the eye movement desensitization and reprocessing (EMDR) and the drug therapy.

Mechanistic insights into the generation and control of Cl-DBPs during wastewater sludge chlorination disinfection process.

Chlorination disinfection has been widely used to kill the pathogenic microorganisms in wastewater sludge during the special Covid-19 period, but sludge chlorination might cause the generation of harmful disinfection byproducts (DBPs). In this work, the transformation of extracellular polymeric substance (EPS) and mechanisms of Cl-DBPs generation during sludge disinfection by sodium hypochlorite (NaClO) were investigated using multispectral analysis in combination with Fourier transform ion cyclotron resonance mass spectrometry (FTICR-MS). The microorganism Escherichia coli (E. coli) was effectively inactivated by active chlorine generated from NaClO. However, a high diversity of Cl-DBPs were produced with the addition of NaClO into sludge, causing the increase of acute toxicity on Q67 luminous bacteria of chlorinated EPS. A variety of N-containing molecular formulas were produced after chlorination, but N-containing DBPs were not detected, which might be the indicative of the dissociation of -NH2 groups after Cl-DBPs generated. Additionally, the release of N-containing compounds was increased in alkaline environment caused by NaClO addition, resulted in more Cl-DBPs generation via nucleophilic substitutions. Whereas, less N-compounds and Cl-DBPs were detected after EPS chlorination under acidic environment, leading to lower cell cytotoxicity. Therefore, N-containing compounds of lignin derivatives in sludge were the major Cl-DBPs precursors, and acidic environment could control the release of N-compounds by eliminating the dissociation of functional groups in lignin derivatives, consequently reducing the generation and cytotoxicity of Cl-DBPs. This study highlights the importance to control the alkalinity of sludge to reduce Cl-DBPs generation prior to chlorination disinfection process, and ensure the safety of subsequential disposal for wastewater sludge.

A pilot study of vidofludimus calcium for treatment of primary sclerosing cholangitis.

The purpose of this pilot study was to explore the efficacy, safety, and tolerability of vidofludimus calcium (VC) in the treatment of primary sclerosing cholangitis (PSC). This was a single-arm open-label pilot study with a cohort of 18 patients with PSC. Study patients received VC for a period of 6 months. The study was undertaken at two sites, Mayo Clinic, Rochester, MN, and Mayo Clinic, Phoenix, AZ. The primary endpoint of the study was improvement of serum alkaline phosphatase (ALP) at the end of the study. Secondary endpoints included assessment of other liver biomarkers (bilirubin, alanine aminotransferase, and aspartate aminotransferase). Of 18 patients enrolled, 11 completed the 6 months of study treatment. Patients who completed treatment versus those who did not were similar other than a significantly higher direct bilirubin at baseline in the group that completed treatment (mean ± SD, 0.4 ± 0.3 versus 0.1 ± 0.1, p = 0.04). By intent to treat analysis, the primary outcome was met in 16.7% (3/18) of patients. By per-protocol analysis, including only patients who completed treatment, normalization of ALP occurred in 27.7% (3/11) at week 24 (95% confidence interval, 6.0% to 61.0%). VC was well tolerated with no drug-related serious adverse events. Conclusion: This proof of concept study provides support for further exploration of VC in patients with PSC.