CCTwins: A Weakly-Supervised Transformer-based Crowd Counting Method with Adaptive Scene Consistency Attention

Recently, crowd counting has attracted significant attention, particularly in the context of the COVID-19 pandemic, due to its ability to automatically provide accurate crowd numbers in images. To address the challenges of location-level labeling, several transformer-based crowd counting methods have been proposed with only count-level supervision. However, these methods directly use the transformer as an encoder without considering the uneven crowd distribution. To address this issue, we propose CCTwins, a novel transformer-based crowd counting method with only count-level supervision. Specifically, we introduce an adaptive scene consistency attention mechanism to enhance the transformer-based model Twins-SVT-L for feature extraction in crowded scenes. Additionally, we design a multi-level weakly-supervised loss function that generates estimated crowd numbers in a coarse-to-fine manner, making it more appropriate for weakly-supervised settings. Moreover, intermediate features supervised by count-level labels are utilized to fuse multi-scale features. Experimental results on four public datasets demonstrate that our proposed method outperforms the state-of-the-art weakly-supervised methods, achieving up to a 16.6% improvement in MAE and up to a 13.8% improvement in RMSE across all evaluation settings. Moreover, the proposed CCTwins obtains competitive counting performance, even when compared to the state-of-the-art fully-supervised methods. IEEE

Research progress of COVID‑19 vaccination in organ transplant recipients

The pandemic has been relieved all over the world with the popularity of the COVID-19 vaccine. However, transplant recipients are still at risk of COVID-19 because they require lifelong immunosuppressive therapy, and the effectiveness and safety of vaccination are often lower than that of the normal population. Meanwhile, the effectiveness and safety of COVID-19 vaccination have not yet been demonstrated in the immunosuppressive population, due to the lack of proper clinical trials on this group. Therefore, the present study reviews the current situation and concept of vaccination for patients after organ transplantation, and the effectiveness and safety of the new coronavirus vaccine which has been put into use in China, so as to provide a theoretical basis for the vaccination of COVID-19 vaccine for these patients, and to reduce the risk of COVID-19 infection in these patients. © 2022 Editorial Board of Medical Journal of Wuhan University. All rights reserved.

Vaccination with Span, an antigen guided by SARS-CoV-2 S protein evolution, protects against challenge with viral variants in mice

SARS-CoV-2 continues to accumulate mutations to evade immunity, leading to breakthrough infections after vaccination. How researchers can anticipate the evolutionary trajectory of the virus in advance in the design of next-generation vaccines requires investigation. Here, we performed a comprehensive study of 11,650,487 SARS-CoV-2 sequences, which revealed that the SARS-CoV-2 spike (S) protein evolved not randomly but into directional paths of either high infectivity plus low immune resistance or low infectivity plus high immune resistance. The viral infectivity and immune resistance of variants are generally incompatible, except for limited variants such as Beta and Kappa. The Omicron variant has the highest immune resistance but showed high infectivity in only one of the tested cell lines. To provide cross-clade immunity against variants that undergo diverse evolutionary pathways, we designed a new pan-vaccine antigen (Span). Span was designed by analyzing the homology of 2675 SARS-CoV-2 S protein sequences from the NCBI database before the Delta variant emerged. The refined Span protein harbors high-frequency residues at given positions that reflect cross-clade generality in sequence evolution. Compared with a prototype wild-type (Swt) vaccine, which, when administered to mice, induced serum with decreased neutralization activity against emerging variants, Span vaccination of mice elicited broad immunity to a wide range of variants, including those that emerged after our design. Moreover, vaccinating mice with a heterologous Span booster conferred complete protection against lethal infection with the Omicron variant. Our results highlight the importance and feasibility of a universal vaccine to fight against SARS-CoV-2 antigenic drift.

Risk Factors of In-hospital Death in COVID-19 Patients：a Meta-analysis

Background The worldwide COVID-19 pandemic has turned into a global catastrophic public health crisis，and the conclusion about the risk factors of hospital death in COVID-19 patients is not uniform. Objective To explore risk factors of in-hospital death in patients with COVID-19 by a meta-analysis. Methods Case-control studies about risk factors of in-hospital death in COVID-19 patients were searched from databases of the Cochrane Library，ScienceDirect，PubMed，Medline，Wanfang Data，CNKI and CQVIP from inception to October 1，2021. Literature screening，data extraction and methodological quality assessment were conducted. Meta-analysis was performed using Stata 15.1. Meta-regression was used to explore the potential sources of heterogeneity. Results Eighty studies were included which involving 405 157 cases〔349 923 were survivors（86.37%），and 55 234 deaths（13.63%）〕，that were rated as being of high quality by the Newcastle-Ottawa Scale. Meta-analysis showed that being male〔OR=1.49，95%CI（1.41，1.57），P<0.001），older age〔WMD=10.44，95%CI（9.79，11.09），P<0.001〕，dyspnoea〔OR=2.09，95%CI（1.80，2.43），P<0.001〕，fatigue〔OR=1.49，95%CI（1.31，1.69），P<0.001〕，obesity〔OR=1.46，95%CI（1.43，1.50），P<0.001〕，smoking〔OR=1.18，95%CI （1.14，1.23），P<0.001〕，stroke〔OR=2.26，95%CI（1.41，3.62），P<0.001〕，kidney disease〔OR=3.62，95%CI （3.26，4.03），P<0.001〕，cardiovascular disease〔OR=2.34，95%CI（2.21，2.47），P<0.001〕，hypertension〔OR=2.23，95%CI（2.10，2.37），P<0.001〕，diabetes〔OR=1.84，95%CI（1.74，1.94），P<0.001〕，cancer〔OR=1.86，95%CI （1.69，2.05），P<0.001〕，pulmonary disease〔OR=2.38，95%CI（2.19，2.58），P<0.001〕，liver disease〔OR=1.65，95%CI（1.36，2.01），P<0.001〕，elevated levels of white blood cell count〔WMD=2.03，95%CI（1.74，2.32），P<0.001〕，neutrophil count〔WMD=1.77，95%CI（1.49，2.05），P<0.001〕，total bilirubin〔WMD=3.19，95%CI（1.96，4.42），P<0.001〕，aspartate transaminase〔WMD=13.02，95%CI（11.70，14.34），P<0.001〕，alanine transaminase 〔WMD=2.76，95%CI（1.68，3.85），P<0.001〕，lactate dehydrogenase〔WMD=166.91，95%CI（150.17，183.64），P<0.001〕，blood urea nitrogen〔WMD=3.11，95%CI（2.61，3.60），P<0.001〕，serum creatinine〔WMD=22.06，95%CI （19.41，24.72），P<0.001〕，C-reactive protein〔WMD=76.45，95%CI （71.33，81.56），P<0.001〕，interleukin-6 〔WMD=28.21，95%CI（14.98，41.44），P<0.001〕，and erythrocyte sedimentation rate〔WMD=8.48，95%CI（5.79，11.17），P<0.001〕were associated with increased risk of in-hospital death for patients with COVID-19，while myalgia〔OR=0.73，95%CI（0.62，0.85），P<0.001〕，cough〔OR=0.87，95%CI（0.78，0.97），P=0.013〕，vomiting〔OR=0.73，95%CI （0.54，0.98），P=0.030〕，diarrhoea〔OR=0.79，95%CI（0.69，0.92），P=0.001〕，headache〔OR=0.55，95%CI（0.45，0.68），P<0.001〕，asthma〔OR=0.73，95%CI（0.69，0.78），P<0.001〕，low body mass index〔WMD=-0.58，95%CI （-1.10，-0.06），P=0.029〕，decreased lymphocyte count〔WMD=-0.36，95%CI（-0.39，-0.32），P<0.001〕，decreased platelet count 〔WMD=-38.26，95%CI（-44.37，-32.15），P<0.001〕，increased D-dimer〔WMD=0.79，95%CI（0.63，0.95），P<0.001〕，longer prothrombin time〔WMD=0.78，95%CI（0.61，0.94），P<0.001〕，lower albumin〔WMD =-1.88，95%CI（-2.35，-1.40），P<0.001〕，increased procalcitonin〔WMD=0.27，95%CI（0.24，0.31），P<0.001〕，and increased cardiac troponin〔WMD=0.04，95%CI（0.03，0.04），P<0.001〕were associated with decreased risk of in-hospital death due to COVID-19. According to the meta-regression result，the heterogeneity in gender，renal disease，cardiovascular diseases，asthma，white blood cell count，neutrophil count，platelet count，hemoglobin，and urea nitrogen differed siangificnatly by country（P<0.05）. Conclusion The risk of in-hospital death due to COVID-19 may be increased by 25 factors（including being male，older age，dyspnoea，fatigue，obesity，smoking，stroke，kidney disease，cardiovascular disease，hypertension，diabetes，cancer，pulmonary disease，liver disease，elevated levels of white blood cells，neutrophil count，total bilirubin，aspartate transaminase，alanine transaminase，lactate dehydrogenase，blood urea nitrogen，serum creatinine，C-reactive protein，interleukin-6，and erythrocyte sedimentation rate），and may be decreased by 13 factors（including myalgia，cough，vomiting，diarrhoea，headache，asthma，low body mass index，decreased lymphocyte count and platelet count，increased D-dimer，longer prothrombin time，lower albumin，increased procalcitonin and cardiac troponin）. The conclusion drawn from this study needs to be further confirmed by high-quality，multicenter，large-sample，real-world studies. © 2023 Chinese General Practice. All rights reserved.

Risk Factors of In-hospital Death in COVID-19 Patients：a Meta-analysis

Background The worldwide COVID-19 pandemic has turned into a global catastrophic public health crisis，and the conclusion about the risk factors of hospital death in COVID-19 patients is not uniform. Objective To explore risk factors of in-hospital death in patients with COVID-19 by a meta-analysis. Methods Case-control studies about risk factors of in-hospital death in COVID-19 patients were searched from databases of the Cochrane Library，ScienceDirect，PubMed，Medline，Wanfang Data，CNKI and CQVIP from inception to October 1，2021. Literature screening，data extraction and methodological quality assessment were conducted. Meta-analysis was performed using Stata 15.1. Meta-regression was used to explore the potential sources of heterogeneity. Results Eighty studies were included which involving 405 157 cases〔349 923 were survivors（86.37%），and 55 234 deaths（13.63%）〕，that were rated as being of high quality by the Newcastle-Ottawa Scale. Meta-analysis showed that being male〔OR=1.49，95%CI（1.41，1.57），P<0.001），older age〔WMD=10.44，95%CI（9.79，11.09），P<0.001〕，dyspnoea〔OR=2.09，95%CI（1.80，2.43），P<0.001〕，fatigue〔OR=1.49，95%CI（1.31，1.69），P<0.001〕，obesity〔OR=1.46，95%CI（1.43，1.50），P<0.001〕，smoking〔OR=1.18，95%CI （1.14，1.23），P<0.001〕，stroke〔OR=2.26，95%CI（1.41，3.62），P<0.001〕，kidney disease〔OR=3.62，95%CI （3.26，4.03），P<0.001〕，cardiovascular disease〔OR=2.34，95%CI（2.21，2.47），P<0.001〕，hypertension〔OR=2.23，95%CI（2.10，2.37），P<0.001〕，diabetes〔OR=1.84，95%CI（1.74，1.94），P<0.001〕，cancer〔OR=1.86，95%CI （1.69，2.05），P<0.001〕，pulmonary disease〔OR=2.38，95%CI（2.19，2.58），P<0.001〕，liver disease〔OR=1.65，95%CI（1.36，2.01），P<0.001〕，elevated levels of white blood cell count〔WMD=2.03，95%CI（1.74，2.32），P<0.001〕，neutrophil count〔WMD=1.77，95%CI（1.49，2.05），P<0.001〕，total bilirubin〔WMD=3.19，95%CI（1.96，4.42），P<0.001〕，aspartate transaminase〔WMD=13.02，95%CI（11.70，14.34），P<0.001〕，alanine transaminase 〔WMD=2.76，95%CI（1.68，3.85），P<0.001〕，lactate dehydrogenase〔WMD=166.91，95%CI（150.17，183.64），P<0.001〕，blood urea nitrogen〔WMD=3.11，95%CI（2.61，3.60），P<0.001〕，serum creatinine〔WMD=22.06，95%CI （19.41，24.72），P<0.001〕，C-reactive protein〔WMD=76.45，95%CI （71.33，81.56），P<0.001〕，interleukin-6 〔WMD=28.21，95%CI（14.98，41.44），P<0.001〕，and erythrocyte sedimentation rate〔WMD=8.48，95%CI（5.79，11.17），P<0.001〕were associated with increased risk of in-hospital death for patients with COVID-19，while myalgia〔OR=0.73，95%CI（0.62，0.85），P<0.001〕，cough〔OR=0.87，95%CI（0.78，0.97），P=0.013〕，vomiting〔OR=0.73，95%CI （0.54，0.98），P=0.030〕，diarrhoea〔OR=0.79，95%CI（0.69，0.92），P=0.001〕，headache〔OR=0.55，95%CI（0.45，0.68），P<0.001〕，asthma〔OR=0.73，95%CI（0.69，0.78），P<0.001〕，low body mass index〔WMD=-0.58，95%CI （-1.10，-0.06），P=0.029〕，decreased lymphocyte count〔WMD=-0.36，95%CI（-0.39，-0.32），P<0.001〕，decreased platelet count 〔WMD=-38.26，95%CI（-44.37，-32.15），P<0.001〕，increased D-dimer〔WMD=0.79，95%CI（0.63，0.95），P<0.001〕，longer prothrombin time〔WMD=0.78，95%CI（0.61，0.94），P<0.001〕，lower albumin〔WMD =-1.88，95%CI（-2.35，-1.40），P<0.001〕，increased procalcitonin〔WMD=0.27，95%CI（0.24，0.31），P<0.001〕，and increased cardiac troponin〔WMD=0.04，95%CI（0.03，0.04），P<0.001〕were associated with decreased risk of in-hospital death due to COVID-19. According to the meta-regression result，the heterogeneity in gender，renal disease，cardiovascular diseases，asthma，white blood cell count，neutrophil count，platelet count，hemoglobin，and urea nitrogen differed siangificnatly by country（P<0.05）. Conclusion The risk of in-hospital death due to COVID-19 may be increased by 25 factors（including being male，older age，dyspnoea，fatigue，obesity，smoking，stroke，kidney disease，cardiovascular disease，hypertension，diabetes，cancer，pulmonary disease，liver disease，elevated levels of white blood cells，neutrophil count，total bilirubin，aspartate transaminase，alanine transaminase，lactate dehydrogenase，blood urea nitrogen，serum creatinine，C-reactive protein，interleukin-6，and erythrocyte sedimentation rate），and may be decreased by 13 factors（including myalgia，cough，vomiting，diarrhoea，headache，asthma，low body mass index，decreased lymphocyte count and platelet count，increased D-dimer，longer prothrombin time，lower albumin，increased procalcitonin and cardiac troponin）. The conclusion drawn from this study needs to be further confirmed by high-quality，multicenter，large-sample，real-world studies. © 2023 Chinese General Practice. All rights reserved.

Design and Optimize of Campus Nucleic Acid Tests Queuing System

Covid-19 is more likely to spread in campus than it in other places because students live together without masks. In this case, it is necessary to take nucleic acid tests in a unified time regularly. To make nucleic acid tests efficient and convenient to manage students and the testing time, this article would apply queuing theory to design a nucleic acid tests queuing system by using the data from Sanda University in April 2022. According to the special conditions on campus, such as course schedule, students' daily activities, and campus management, students would be grouped by several management styles. The system would calculate the start time and waiting time for each group and would strive to take nucleic acid tests in an orderly manner with minimal waiting time. © 2022 IEEE.

Global air quality change during the COVID-19 pandemic: Regionally different ozone pollution responses COVID-19: 疫情期间全球空气质量变化:臭氧响应的区域间差异

The explosive spread of the 2019 novel coronavirus (COVID-19) provides a unique chance to rethink the relationship between human activity and air pollution. Though related studies have revealed substantial reductions in primary emissions, obvious differences do exist in the responses of secondary pollutants, like ozone (O3) pollution. However, the regional disparities of O3 responses and their causes have still not been fully investigated. To better elucidate the interrelationship between anthropogenic emissions, chemical production, and meteorological conditions, O3 responses caused by lockdowns over different regions were comprehensively explored at a global scale. Observational signals of air-quality change were derived from multi-year surface measurements and satellite retrievals. With similar substantial drops in nitrogen dioxide (NO2), ozone shows rising signals in most areas of both East Asia and Europe, even up to ∼14 ppb, while a non-negligible declining signal exists in North America, by about 2–4 ppb. Furthermore, the drivers behind the different O3 responses are discussed based on meteorological analysis and O3 sensitivity diagnosis. On the one hand, O3 responses to NO2 declines can be affected by the primary dependence on its precursors. On the other hand, it is also highly dependent on meteorological factors, especially temperature. Our study further highlights the great importance of taking into consideration both the regional disparities and synergistic effects of precursor reductions and meteorological influence for scientific mitigation of O3 pollution.摘要疫情期间全球各地一次排放大幅削减, 而臭氧等二次污染的响应则存在着区域间差异.结合地面和卫星观测发现, 同在氮氧化物大幅下降的情况下,臭氧在东亚和欧洲呈现出可达14ppb的上升信号, 而北美则下降为主 (约2–4ppb) .我们结合气象分析和臭氧敏感性进一步讨论了臭氧响应差异性的原因, 一方面受臭氧与前体物间关系的影响;另一方面来自于气象, 尤其是温度.研究明晰了人为排放,化学和气象三者的内在关联, 强调了在臭氧控制过程中考虑前体物削减和气象条件协同的重要性.

Collection and quality characteristics of Coronavirus Disease 2019 convalescent plasma

Objective To explore the application and safety of apheresis technology in collection of Coronavirus Disease 2019 (COVID-19) convalescent plasma (CP), and to analyze the quality characteristics of the plasma. Methods The general data of COVID-19 convalescent plasma (CP) donors, including gender, age, date of discharge or release from medical isolation, were collected based on informed consent. After physical examination, the CP was collected by apheresis technology with plasma separator, inactivated with methylene blue, and determined for severe acute respiratory symptom Coronavirus 2 (SARS-CoV-2) nucleic acid and specific antibody (RBD-IgG) against SARS-CoV-2. Results The collection process went well, and no serious adverse events related to plasma collection were reported during or after the collection. The average age of COVID-19 CP donors was 38 years (n = 933). The distributions of blood groups A, B, AB and 0 in RhD (+) COVID-19 CP were 33. 4%, 29. 2%, 10% and 27. 2% respectively. The plasma donation date was 18 d from the discharge date in average. All the test results of SARS-CoV-2 nucleic acid in CP were negative, while the proportion of plasma samples at SARS-CoV-2 antibody titer of more than 1: 160 was 92. 60%. Conclusion Apheresis technology was safe and reliable. The COVID-19 CP contained high titer antibody. Large-scale collection and preparation of inactivated plasma against SARS-CoV-2 played an important role in the treatment of COVID-19.

New Advances in Nanomaterial-Based Antiviral Strategies

The ongoing coronavirus disease 2019 (COVID-19) pandemic and other major viral infectious diseases have become a significant threat to people's life and economic/social development. In recent years, with the development of nanotechnology, nanomaterial-based antiviral agents have been extensively studied. However, the clinical applications of antiviral nanomaterials are still limited. Herein, the recent advances in nanomaterial-based antiviral strategies, mainly including antiviral nanodrugs, drug nanocarriers, and nanovaccines, are summarized. The clinical challenges and prospects of nanomaterial-based antiviral strategies are also discussed.

"Not a perfect situation, but..." A single-practice survey of patient experience of phone consultations during COVID-19 Alert Level 4 in New Zealand

AIM: To explore patients' experiences of virtual consultations during the COVID-19 Alert Level 4 lockdown in New Zealand. METHOD: A single-practice retrospective phone survey exploring patients' satisfaction with the phone consultation process during Alert Level 4 lockdown. RESULTS: Of 259 eligible patients, 108 (42%) participated in the survey. Overall satisfaction with phone consultations was high, with a median score 9 out of 10 (95% CI 9-9). Participants were highly likely to recommend phone consultations to others, with a median score of 9 (95% CI 7-9). This was consistent across age groups, ethnicities and socioeconomic groupings. Men were less satisfied with phone consultations than women, with a 2 point (95% CI -3--1) lower median score than women, but they were not less likely to recommend phone consultations. Most participants found phone consultations to be convenient and time-saving and considered not seeing the doctor to be acceptable in the context of the lockdown. Few participants experienced technical difficulties over the phone. Issues of communication and appropriateness of consultations to the medium of the phone were raised. CONCLUSION: This single-centre study demonstrates the acceptability of phone consults for most patients presenting to general practice during a pandemic. These findings need further exploration in broader general practice settings and non-pandemic contexts.

The efficacy equivalence of generic levetiracetam in West China: A perspective study

Purpose: During the COVID-19 pandemic, the supply chain of the anti-seizure medication has been challenged. On the other side, the “4+7” drug procurement reform launching in China also force the promotion of generics. This study is aimed to investigate the attitude and efficacy of the antiseizure drug levetiracetam and its genric production in Chinese people with epilepsy. Method: The study is conducting in the clinic in 10 epilepsy centers in Westchina.The inclusion criteria are 1) diagnosed with epilepsy for more than 3 months;2) has started standard levetiracetam treatment for more than 3 months during the course;3) informed consent was obtained. Participates were consecutively recruited. The data is collected through fact-to-face interview and self-report surveys. Result: This ongoing study has currently enrolled 40 people with epilepsy. The average age is 24.3 yrs, the median age is 25.0 yrs. 72.5% of them was female. Twenty-eight of them were diagnosed with focal onset seizure, four has generalized onset seizure. Of 39 patients who are currently using levetiracetam, 29 (74.3%) were using the brand drug. 30% of patients had switch the brand without discussion with doctors. Mainly because of the unstabled supply and expenses. In 3 cases, participates complains the difference in efficacy of the treatment. Only 40% of the participates agree that the efficacy and safety of generic drugs are equal to the brand product. Conclusions: From the preliminary results, there are a large proportion of people with epilepsy has switched the brand of their levetiracetam drug. While a limited number of cases showed differences in efficacy and safety, most of the patients doubt the equivalence.

Research progress on biosafety materials for the prevention and control of the coronavirus disease 2019

Biosafety has seriously threatened the survival and development of human beings. Under the situation of the coronavirus disease 2019 (COVID-19) epidemic and the normalization of anti-epidemic, biosafety prevention and control is becoming more and more important, which is directly related to the development of society, economy and politics. At the beginning of COVID-19 epidemic, there was a serious lack of personal protective equipment, due to the shortage of medical emergency supplies and the lack of ability to public health emergencies. In the face of the severe challenge of the epidemic, interdisciplinary and multidisciplinary cooperation is the key to scientific epidemic prevention. The characteristics of the material, such as optical, electrical acoustic magnetic thermal are helpfulforth designandpr parationofmulti-functional new materials which can met the requirements of biosafety prevention indetection prevention and treatment. We should give fulplay to the advantages of biosafety and materials science. Using new biosafety materials to overcome the short coming soft raditional materials can improve or provide new detection methods. Not only can we use biosafety materials to develope a variety of highly effective, low toxicity drugs and vaccines but also to produce multifunctional masks and protective clothing. What we have done has contributed to the preparation of medical emergence supplies and to the fight against the COVID-19 pandemic. At the same time the toxicit of new biosafety materials can not be ignored. Only be accelerating industrialization based on basic research and practical problems can we better cope with other emerging outbreaks of infectious diseases in the future. © 2021, Science in China Press. All rights reserved.

Understanding the collaborative process and its effects on perceived outcomes during emergency response in china: From perspectives of local government sectors

In contemporary China, the rapidly urbanized cities are exposed to a broad range of natural and human-made emergencies, such as COVID-19. Responding to emergencies successfully requires widespread participation of local government sectors that engages in diversified collaboration behav-iors across organizational boundaries for achieving sustainability. However, the multi-organizational collaborative process is highly dynamic and complex, as well as its outcomes are uncertain under-lying the emergency response network. Examining characteristics of the collaborative process and exploring how collaborative behaviors local governmental sectors engaging in the impact their perceived outcomes is essential to understand how disastrous situations are addressed by collaborative efforts in emergency management. This research investigates diversified collaborative behaviors in emergency response and then examines this using a multi-dimensional model consisting of joint decision making, joint implementation, compromised autonomy, resource sharing, and trust building. We surveyed 148 local governments and their affiliated sectors in China in-depth understanding how collaborative processes contribute to perceived outcomes from perspectives of participating sectors in the context of a centralized political-administrative system. A structural equation model (SEM) is employed to encode multiple dimensions of the collaborative process, perceived outcomes, as well as their relationships. The empirical finding indicates that joint decision making and implementation positively affect the perceived outcomes significantly. The empirical results indicate that joint decision making and joint implementation affect perceived outcomes significantly. Instead, resource sharing and trust building do not affect the outcomes positively as expected. Additionally, compromised autonomy negatively affects the collaborative outcomes. We also discuss the institutional advantages for achieving successful outcomes in emergency management in China by reducing the degree of compromised autonomy. Our findings provide insight that can improve efforts to build and maintain a collaborative process to respond to emergencies. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.