Good adaptability of freshmen in medical universities under the Coronavirus 2019 pandemic: a questionnaire-based single center study in China.

OBJECTIVE: To investigate the adaptability of freshmen in medical universities to the Coronavirus Disease 2019 (COVID-19) pandemic and to understand the relevant factors affecting their adaptation in medical university. METHODS: Freshmen in a medical university in Guangdong Province were selected and surveyed using a self-administered general questionnaire and a college student adjustment scale prepared by Fang Xiaoyi et al. The results were analyzed statistically. RESULTS: A total of 741 questionnaires were collected and 736 valid questionnaires were recovered. The adaptation level of freshmen in the medical university was moderately high. There were no differences in gender, age, family geographical location, or higher education level, but there were significant differences in major, type of household, only children (yes/no), and voluntary enrollment in medicine (yes/no). The survey showed that 30.3% of the students had discomfort at the beginning of the semester, 92.5% chose medical university voluntarily, and 83.4% expressed their enhanced motivation to study medicine after the COVID-19 outbreak, but 65.1% exhibited influence in study and life caused by COVID-19, which were statistically significant factors affecting the adaptation score. CONCLUSIONS: Freshmen in the medical university are generally well-adjusted with many influencing factors. Medical schools should strengthen adaptability management in order to timely identify the adaptation challenges of the students.

Tourism entrepreneurship in rural destinations: measuring the effects of capital configurations using the fsQCA approach

PurposeThe purpose of this study was to investigate the causal configuration effect of the determinants of tourism entrepreneurship in rural tourism destinations based on the capital framework.Design/methodology/approachThe data for this research were collected from a sample comprising 140 rural enterprise owners in China and analyzed via fuzzy-set qualitative comparative analysis.FindingsAll the investigated capital factors were relevant to tourism entrepreneurship, although they only facilitated tourism entrepreneurship when combined. It was observed here that four capital configurations promoted tourism entrepreneurship in rural destinations, highlighting the multiple paths toward rural tourism entrepreneurship. The human and physical capitals of entrepreneurs were key to tourism entrepreneurship.Practical implicationsIt is relevant for entrepreneurs and managers to realize that there are multiple strategies for promoting tourism entrepreneurship in rural destinations. The four capital configurations revealed here offer guidelines for evaluating the potential and possibility of rural tourism entrepreneurship. Local managers and governments must prioritize human and physical capitals when the venture capital and resources are limited.Originality/valueFirst, the findings of this study deepened the understanding of the factors influencing tourism entrepreneurship using the capital framework. Second, it revealed that capital configurations determined tourism entrepreneurship and that existence and interactions of the various forms of capital affect rural entrepreneurship. Third, this study revealed that the success of tourism entrepreneurship depends on the entrepreneur's ability to combine the various forms of capital and resources.

Modeling tourists' preference between hotels and peer-to-peer (P2P) sharing accommodation: a pre- and post-COVID-19 comparison. (Special Issue: The sharing economy in a post-pandemic world.)

Purpose: With the rapid development of sharing economy, travelers are facing choices between conventional hotels and the peer-to-peer sharing accommodation in urban tourism. The purpose of this study is to examine how travelers form their preferences in such choice situations and whether/how their preference formation mode would change with the COVID-19 pandemic. Design/methodology/approach: A relative preference model was constructed and estimated for both domestic and outbound tourists, based on two waves of survey data collected before and after the COVID-19. The results of this study were compared to derive the evolution of preference formation patterns. Findings: A set of 15 key value attributes and personal traits was identified, together with their differential effects with the pandemic. Their divergent effects between domestic and outbound trips were also delineated. Based on these findings, the competitive edges and advantageous market profiles were depicted for both hotel and sharing accommodation sectors. Originality/value: This study contributes to the knowledge of tourists' preference between accommodation types and adds empirical evidences to the impact of the pandemic on tourist behavior patterns. Both hotel and sharing accommodation practitioners can benefit from the findings to enhance their competitiveness.

Association between inequalities in human resources for health and all cause and cause specific mortality in 172 countries and territories, 1990-2019: observational study.

OBJECTIVE: To explore inequalities in human resources for health (HRH) in relation to all cause and cause specific mortality globally in 1990-2019. DESIGN: Observational study. SETTING: 172 countries and territories. DATA SOURCES: Databases of the Global Burden of Disease Study 2019, United Nations Statistics, and Our World in Data. MAIN OUTCOME MEASURES: The main outcome was age standardized all cause mortality per 100 000 population in relation to HRH density per 10 000 population, and secondary outcome was age standardized cause specific mortality. The Lorenz curve and the concentration index (CCI) were used to assess trends and inequalities in HRH. RESULTS: Globally, the total HRH density per 10 000 population increased, from 56.0 in 1990 to 142.5 in 2019, whereas age standardized all cause mortality per 100 000 population decreased, from 995.5 in 1990 to 743.8 in 2019. The Lorenz curve lay below the equality line and CCI was 0.43 (P<0.05), indicating that the health workforce was more concentrated among countries and territories ranked high on the human development index. The CCI for HRH was stable, at about 0.42-0.43 between 1990 and 2001 and continued to decline (narrowed inequality), from 0.43 in 2001 to 0.38 in 2019 (P<0.001). In the multivariable generalized estimating equation model, a negative association was found between total HRH level and all cause mortality, with the highest levels of HRH as reference (low: incidence risk ratio 1.15, 95% confidence interval 1.00 to 1.32; middle: 1.14, 1.01 to 1.29; high: 1.18, 1.08 to 1.28). A negative association between total HRH density and mortality rate was more pronounced for some types of cause specific mortality, including neglected tropical diseases and malaria, enteric infections, maternal and neonatal disorders, and diabetes and kidney diseases. The risk of death was more likely to be higher in people from countries and territories with a lower density of doctors, dentistry staff, pharmaceutical staff, aides and emergency medical workers, optometrists, psychologists, personal care workers, physiotherapists, and radiographers. CONCLUSIONS: Inequalities in HRH have been decreasing over the past 30 years globally but persist. All cause mortality and most types of cause specific mortality were relatively higher in countries and territories with a limited health workforce, especially for several specific HRH types among priority diseases. The findings highlight the importance of strengthening political commitment to develop equity oriented health workforce policies, expanding health financing, and implementing targeted measures to reduce deaths related to inadequate HRH to achieve universal health coverage by 2030.

Comparative analysis of SARS-CoV-2 variants with two high-throughput sequencing platforms

Whole-genome sequencing of upper respiratory tract specimens from patients with confirmed COVID-19 in Henan Province was performed to compare the performance of the Illumina and Oxford Nanopore sequencing platforms, thus providing a reference for whole-genome monitoring of the novel coronavirus (SARS-CoV-2). Ten samples from COVID-19 cases in Henan Province from June 2021 to January 2022 were collected and sequenced with Illumina and Nanopore high-through-put sequencing technology to obtain full genome sequences of the novel coronavirus, which were compared with the Wuhan reference sequence (Wuhan-Hu-1). Bioinformatics software (CLC) was used for sequence alignment analysis. Three of the ten samples were Omicron (BA.1) variants with 55,61 nucleotide variation sites. One sample was an Alpha (B.1.1.7) variant with 41 nucleotide variation sites. Six samples were Delta (8.1.617.2) variants with 35,42,47 nucleotide variation sites. The sequence identity of mutation sites in six samples was 100%, and the mutation sites in the S genome segment of seven samples were consistent. For samples with a Ct value < 33, both next-generation and third-generation sequencing achieved high genome coverage and sequencing depth. A significant difference in coverage was observed between second-generation sequencing and third-generation sequencing (t=-2.037, P < 0.06). However, the coverage at different time points of the third-generation sequencing did not significantly differ (F=2.498, P > 0.05). The needs for SARS-CoV-2 mutant detection could be met through use of either high-throughput sequencing platform. The identification of mutations in the novel coronavirus through Illumina high-throughput sequencing was more accurate, whereas Nanopore high-throughput sequencing technology could be used for rapid detection and typing of different novel coronaviruses.

Dysbiosis of oropharyngeal microbiome and antibiotic resistance in hospitalized COVID-19 patients.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is ongoing and multiple studies have elucidated its pathogenesis, however, the related- microbiome imbalance caused by SARS-CoV-2 is still not clear. In this study, we have comprehensively compared the microbiome composition and associated function alterations in the oropharyngeal swabs of healthy controls and coronavirus disease 2019 (COVID-19) patients with moderate or severe symptoms by metatranscriptomic sequencing. We did observe a reduced microbiome alpha-diversity but significant enrichment of opportunistic microorganisms in patients with COVID-19 compared with healthy controls, and the microbial homeostasis was rebuilt following the recovery of COVID-19 patients. Correspondingly, less functional genes in multiple biological processes and weakened metabolic pathways such as carbohydrate metabolism, energy metabolism were also observed in COVID-19 patients. We only found higher relative abundance of limited genera such as Lachnoanaerobaculum between severe patients and moderate patients while no worthy-noting microbiome diversity and function alteration were observed. Finally, we noticed that the co-occurrence of antibiotic resistance and virulence was closely related to the microbiome alteration caused by SRAS-CoV-2. Overall, our findings demonstrate that microbial dysbiosis may enhance the pathogenesis of SARS-CoV-2 and the antibiotics treatment should be critically considered.

Epidemiological characteristics of respiratory viruses in hospitalized children during the COVID-19 pandemic in southwestern China.

Background: Multinational studies have reported that the implementation of nonpharmaceutical interventions (NPIs) to control severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission coincided with the decline of other respiratory viruses, such as influenza viruses and respiratory syncytial virus. Objective: To investigate the prevalence of common respiratory viruses during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Respiratory specimens of children with lower respiratory tract infections (LRTIs) hospitalized at the Children's Hospital of Chongqing Medical University from January 1, 2018 to December 31, 2021 were collected. Seven common pathogens, including respiratory syncytial virus (RSV), adenovirus (ADV), influenza virus A and B (Flu A, Flu B), and parainfluenza virus types 1-3 (PIV1-3), were detected by a multiplex direct immunofluorescence assay (DFA). Demographic data and laboratory test results were analyzed. Results: 1) A total of 31,113 children with LRTIs were enrolled, including 8141 in 2018, 8681 in 2019, 6252 in 2020, and 8059 in 2021.The overall detection rates decreased in 2020 and 2021 (P < 0.001). The detection rates of RSV, ADV, Flu A, PIV-1, and PIV-3 decreased when NPIs were active from February to August 2020, with Flu A decreasing most predominantly, from 2.7% to 0.3% (P < 0.05). The detection rates of RSV and PIV-1 resurged and even surpassed the historical level of 2018-2019, while Flu A continued decreasing when NPIs were lifted (P < 0.05). 2) Seasonal patterns of Flu A completely disappeared in 2020 and 2021. The Flu B epidemic was observed until October 2021 after a long period of low detection in 2020. RSV decreased sharply after January 2020 and stayed in a nearly dormant state during the next seven months. Nevertheless, the detection rates of RSV were abnormally higher than 10% in the summer of 2021. PIV-3 decreased significantly after the COVID-19 pandemic; however, it atypically surged from August to November 2020. Conclusion: The NPIs implemented during the COVID-19 pandemic affected the prevalence and seasonal patterns of certain viruses such as RSV, PIV-3, and influenza viruses. We recommend continuous surveillance of the epidemiological and evolutionary dynamics of multiple respiratory pathogens, especially when NPIs are no longer necessary.

National approaches for citizen data management in response to COVID-19: An overview and implications of contact tracing apps in 21 countries

The COVID-19 pandemic brings the topic of citizen data management (CDAMA) into the public eye. This study is one of the first attempts to analyze the national approaches for CDAMA applied by governments of different countries and continents in public sectors. The study first conducts a systematic overview of the representative contact tracing apps in 21 countries of four continents, collecting information of the four aspects of the CDAMA system. It then summarizes and analyzes the various governments' approaches to the CDAMA system applied by different countries and continents based on the app overview. We found that governments' priority between national safety (i.e., public health in this study) and citizen privacy is different in terms of their national approaches for CDAMA. For example, governments of Asian countries are more intrusive and hold a stricter attitude in their national CDAMA approach than countries elsewhere. Our study has contributions both theoretically and practically. Theoretically, it fills the literature gap about data management by discussing the data management in governments;practically, the study provides the background information as well as implications for future debates and discussions on governments' data management system and citizen data use.

Modeling tourists' preference between hotels and peer-to-peer (P2P) sharing accommodation: a pre- and post-COVID-19 comparison

PurposeWith the rapid development of sharing economy, travelers are facing choices between conventional hotels and the peer-to-peer sharing accommodation in urban tourism. The purpose of this study is to examine how travelers form their preferences in such choice situations and whether/how their preference formation mode would change with the COVID-19 pandemic.Design/methodology/approachA relative preference model was constructed and estimated for both domestic and outbound tourists, based on two waves of survey data collected before and after the COVID-19. The results of this study were compared to derive the evolution of preference formation patterns.FindingsA set of 15 key value attributes and personal traits was identified, together with their differential effects with the pandemic. Their divergent effects between domestic and outbound trips were also delineated. Based on these findings, the competitive edges and advantageous market profiles were depicted for both hotel and sharing accommodation sectors.Originality/valueThis study contributes to the knowledge of tourists' preference between accommodation types and adds empirical evidences to the impact of the pandemic on tourist behavior patterns. Both hotel and sharing accommodation practitioners can benefit from the findings to enhance their competitiveness.

Assessing vaccine literacy and exploring its association with vaccine hesitancy: A validation of the vaccine literacy scale in China.

BACKGROUND: Assessment of vaccine literacy is essential for understanding people's ability to access various vaccine information to meet health demands. Few studies have examined the role of vaccine literacy in vaccine hesitancy, which is a psychological state. This study aimed to validate the applicability of the HLVa-IT (Vaccine Health Literacy of Adults in Italian) scale in Chinese settings and to explore the association between vaccine literacy and vaccine hesitancy. METHODS: From May to June 2022, we conducted an online cross-sectional survey in mainland China. Potential factor domains were obtained by the exploratory factor analysis. Cronbach's alpha coefficient, composite reliability values, and square root values of average variances extracted were calculated to determine the internal consistency and discriminant validity. The association between vaccine literacy, vaccine acceptance, with vaccine hesitancy was assessed using logistic regression analysis. RESULTS: Totally, 12,586 participants completed the survey. Two potential dimensions, the functional and the interactive/critical, were identified. Cronbach's alpha coefficient and composite reliability values were >0.90. The square root values of average variances extracted exceeded the related correlations. The functional dimension (adjusted odds ratio (aOR): 0579; 95 % Confidence Interval (CI); 0.529, 0.635), interactive (aOR: 0.654; 95%CI: 0.531, 0.806)/critical (aOR: 0.709; 95%CI: 0.575, 0.873) dimension were significantly and negatively associated with vaccine hesitancy. Similar results were also found in different vaccines acceptance subgroups. LIMITATIONS: This report is limited by the convenience sampling method. CONCLUSIONS: The modified HLVa-IT is suitable for use in Chinese settings. Vaccine literacy was negatively associated with vaccine hesitancy.

Chemical Composition of Honeysuckle (Lonicerae japonicae) Extracts and Their Potential in Inhibiting the SARS-CoV-2 Spike Protein and ACE2 Binding, Suppressing ACE2, and Scavenging Radicals.

Honeysuckle (Lonicerae japonicae) has been used in functional tea products. The chemical compositions of the water and ethanol extracts of honeysuckle were examined in the present study, along with their potential in inhibiting SARS-CoV-2 spike protein binding to ACE2, suppressing ACE2 activity, and scavenging reactive free radicals. Thirty-six compounds were tentatively identified from the honeysuckle extracts using HPLC-MS/MS, with ten reported for the first time in honeysuckle. Both honeysuckle extracts inhibited the binding of SARS-CoV-2 spike protein to ACE2, as well as ACE2 activity. The ethanol extract exhibited a 100% inhibition on binding of the SARS-CoV-2 spike protein to ACE2 at 100 mg botanical equivalent/mL, whereas the water extract had a 65% binding inhibition at the same concentration. Furthermore, the water extract exhibited 90% ACE2 activity inhibition, which was stronger than that of the ethanol extract (62% inhibition) at the same botanical weight concentration. In addition, higher total phenolic contents and greater scavenging activities against hydroxyl (HO•), DPPH•, and ABTS•+ radicals were observed in the water extract than the ethanol extract counterpart on a dry botanical weight concentration basis. These findings suggest honeysuckle has the potential to reduce the risk of SARS-CoV-2 infection and the development of severe COVID-19 symptoms.

Symptoms and Quality of Life Characteristics of Family Therapy Patients Infected with Omicron in China ——a Retrospective Observational Study (preprint)

Objectives To describe the clinical symptoms and quality of life characteristics of family therapy patients after infection with omicron in China.Methods We conducted a survey of 732 Chinese residents and screened 526 patients who had been infected with Omicron. These patients received treatment at home and have recovered. We conducted a retrospective survey of symptoms and quality of life in these patients.Results Fever is the most common symptom with an incidence of 88.97% among Omicron infected individuals treated at home, and followed by cough, headache, rhinobyon, and weakness. During the acute phase after infection with omicron, the sleep quality and appetite of patients decrease to varying degrees. What’s more, physical fatigue in infected individuals was significantly more severe than in uninfected individuals. It took about 2 to 3days to recover from symptoms in the acute phase for patients with mild symptoms of Omicron treated at home, however it took 1 to 2 months to recover from fatigue and other syndromes of Omicron.Conclusion Fever is the most typical symptom of Omicron infected patients undergoing home treatment. COVID-19 has a negative impact on sleep quality and appetite, and has a short-term impact on work and learning.

Trends and disparities in 44 national notifiable infectious diseases in China: an analysis of national surveillance data from 2010 to 2019.

BACKGROUND: Research assessing the changing epidemiology of infectious diseases in China after the implementation of new health-care reform in 2009 was scarce. We aimed to get the latest trends and disparities of national notifiable infectious diseases by age, sex, province and seasons in China from 2010 to 2019. METHODS: The number of incident cases and deaths, incidence rate and mortality of 44 national notifiable infectious diseases by sex, age groups, and provincial regions from 2010 to 2019 was extracted from the China Information System for Disease Control and Prevention and official reports, and divided into six kinds of infectious diseases by transmission routes and three classes (A, B and C) in this descriptive study. Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends of incidence and mortality rate. We calculated concentration index to measure economic-related inequality. Segmented interrupted time-series analysis was used to estimate the impact of the COVID-19 pandemic on the epidemic of notifiable infectious disease. RESULTS: The trend of incidence rate on six kinds of infectious diseases by transmission routes was stable, while only mortality of sexual, blood-borne, and mother-to-child-borne infectious diseases increased from 0.6466 per 100 000 population in 2010 to 1.5499 per 100 000 population in 2019 by 8.76% per year (95%CI: 6.88-10.68). There was a decreasing trend of incidence rate on Class-A infectious diseases (EAPC=-16.30%; 95%CI: -27.93 - -2.79) and Class-B infectious diseases (EAPC=-1.05%; 95%CI: -1.56 - -0.54), while an increasing trend on Class-C infectious diseases (EAPC=6.22%; 95%CI: 2.13~10.48). For mortality, there was a decreasing trend on Class-C infectious diseases (EAPC=-14.76%; 95%CI: -23.46 - -5.07), and an increasing trend on Class-B infectious diseases (EAPC=4.56%; 95%CI: 2.44-6.72). In 2019, the infectious diseases with highest incidence rate and mortality were respiratory diseases (340.95 per 100 000 population), and sexual, blood-borne, and mother-to-child-borne infectious diseases (1.5459 per 100 000 population), respectively. The greatest increasing trend of incidence rate was observed in seasonal influenza, from 4.83 per 100 000 population in 2010 to 253.36 per 100 000 population in 2019 by 45.16% per year (95%CI: 29.81-62.33), especially among female and children aged 0 - 4 years old. The top disease with highest mortality was still AIDs which had the highest average yearly mortality in 24 provinces from 2010 to 2019, and its incidence rate (EAPC=14.99%; 95%CI: 8.75-21.59) and mortality (EAPC=9.65; 95%CI: 7.71-11.63) both increased from 2010 to 2019, especially among people aged 44 - 59 years old and 60 or older. Male incidence rate and mortality were higher than females each year from 2010 to 2018 on 29 and 10 infectious diseases, respectively. Additionally, sex differences of incidence and mortality of AIDS were becoming larger. The curve lay above the equality line, with the negative value of the concentration index, which indicated that economic-related health disparities exist in the distribution of incidence rate and mortality of respiratory diseases (incidence rate: the concentration index = -0.063, P<0.0001; mortality: the concentration index = -0.131, P<0.001), sexual, blood-borne, and mother-to-child-borne infectious diseases (incidence rate: the concentration index = -0.039, P=0.0192; mortality: the concentration index = -0.207, P<0.0001), and the inequality disadvantageous to the poor (pro-rich). Respiratory diseases (Dec, Jan), intestinal diseases (May, Jun, July), zoonotic infectious diseases (Mar-Jul) and vector-borne infectious diseases (Sep-Oct) had distinct seasonal epidemic patterns. In addition, segmented interrupted time-series analyses showed that, after adjusted for potential seasonality, autocorrelation, GDP per capita, number of primary medical institutions and other factors, there was no significant impact of COVID-19 epidemic on the monthly incidence rate of six kinds of infectious diseases by transmission routes from 2018 to 2020 (all P>0.05). CONCLUSIONS: The incidence rates of six kinds of infectious diseases were stable in the past decade, and incidence rates of Class-A and Class-B infectious diseases were deceasing, because of comprehensive prevention and control measures and strengthened health system after the implementation of the new health-care reform in China since 2009. However, age, gender, regional and economic disparities were still observed. Concerted efforts are needed to reduce the impact of seasonal influenza (especially among children aged 0 - 4 years old) and the mortality of AIDs (especially among people aged 44 - 59 years old and 60 or older). More attention should be paid to the disparities on the burden of infectious diseases. This article is protected by copyright. All rights reserved.

Factors Affecting Continuance Intention in Non-Face-to-Face Telemedicine Services: Trust Typology and Privacy Concern Perspectives.

As the COVID-19 pandemic progressed, the resulting demand for telemedicine services increased. This research empirically examines the role of trust, privacy concerns, and perceived usefulness in customer confirmation, satisfaction, and continuing intention in telemedicine. A typology of trust was employed to classify trust into three dimensions and explore the mediating role of the three dimensions of trust in the relationship between satisfaction, perceived usefulness, and continued intention. We also examined the moderating role of personal privacy concerns in the relationship between trust and continued intention. For this study, we developed a structural equation model based on expectation confirmation theory and analyzed 465 questionnaires from Chinese online users. The expectancy confirmation theory (ECT) was reaffirmed by empirical evidence. The results showed that the relationship between perceived usefulness and satisfaction with continued intention is moderated by the three dimensions of trust. Privacy concerns can negatively moderate the relationship between structural assurance-based trust and continued intention. This study also identified potential threats to telehealth market growth alongside new insights.

Understanding Drivers of Vaccine Hesitancy During the COVID-19 Pandemic Among Older Adults in Jiangsu Province, China: Cross-sectional Survey.

BACKGROUND: Older adults are particularly at risk from infectious diseases, including serve complications, hospitalization, and death. OBJECTIVE: This study aimed to explore the drivers of vaccine hesitancy among older adults based on the "3Cs" (confidence, complacency, and convenience) framework, where socioeconomic status and vaccination history played the role of moderators. METHODS: A cross-sectional questionnaire survey was conducted in Jiangsu Province, China, between June 1 and July 20, 2021. Older adults (aged ≥60 years) were recruited using a stratified sampling method. Vaccine hesitancy was influenced by the 3Cs in the model. Socioeconomic status and vaccination history processed through the item parceling method were used to moderate associations between the 3Cs and hesitancy. Hierarchical regression analyses and structural equation modeling were used to test the validity of the new framework. We performed 5000 trials of bootstrapping to calculate the 95% CI of the pathway's coefficients. RESULTS: A total of 1341 older adults participated. The mean age was 71.3 (SD 5.4) years, and 44.7% (599/1341) of participants were men. Confidence (b=0.967; 95% CI 0.759-1.201; P=.002), convenience (b=0.458; 95% CI 0.333-0.590; P=.002), and less complacency (b=0.301; 95% CI 0.187-0.408; P=.002) were positively associated with less vaccine hesitancy. Socioeconomic status weakened the positive effect of low complacency (b=-0.065; P=.03) on low vaccine hesitancy. COVID-19 vaccination history negatively moderated the positive association between confidence (b=-0.071; P=.02) and lower vaccine hesitancy. CONCLUSIONS: Our study identified that confidence was the more influential dimension in reducing vaccine hesitancy among older adults. COVID-19 vaccination history, as well as confidence, had a positive association with less vaccine hesitancy and could weaken the role of confidence in vaccine hesitancy. Socioeconomic status had a substitution relationship with less complacency, which suggested a competitive positive association between them on less vaccine hesitancy.

Analogous comparison unravels heightened antiviral defense and boosted viral infection upon immunosuppression in bat organoids.

Horseshoe bats host numerous SARS-related coronaviruses without overt disease signs. Bat intestinal organoids, a unique model of bat intestinal epithelium, allow direct comparison with human intestinal organoids. We sought to unravel the cellular mechanism(s) underlying bat tolerance of coronaviruses by comparing the innate immunity in bat and human organoids. We optimized the culture medium, which enabled a consecutive passage of bat intestinal organoids for over one year. Basal expression levels of IFNs and IFN-stimulated genes were higher in bat organoids than in their human counterparts. Notably, bat organoids mounted a more rapid, robust and prolonged antiviral defense than human organoids upon Poly(I:C) stimulation. TLR3 and RLR might be the conserved pathways mediating antiviral response in bat and human intestinal organoids. The susceptibility of bat organoids to a bat coronavirus CoV-HKU4, but resistance to EV-71, an enterovirus of exclusive human origin, indicated that bat organoids adequately recapitulated the authentic susceptibility of bats to certain viruses. Importantly, TLR3/RLR inhibition in bat organoids significantly boosted viral growth in the early phase after SARS-CoV-2 or CoV-HKU4 infection. Collectively, the higher basal expression of antiviral genes, especially more rapid and robust induction of innate immune response, empowered bat cells to curtail virus propagation in the early phase of infection.

A national risk analysis model (NRAM) for the assessment of COVID-19 epidemic.

COVID-19 has caused a critical health concern and severe economic crisis worldwide. With multiple variants, the epidemic has triggered waves of mass transmission for nearly 3 years. In order to coordinate epidemic control and economic development, it is important to support decision-making on precautions or prevention measures based on the risk analysis for different countries. This study proposes a national risk analysis model (NRAM) combining Bayesian network (BN) with other methods. The model is built and applied through three steps. (1) The key factors affecting the epidemic spreading are identified to form the nodes of BN. Then, each node can be assigned state values after data collection and analysis. (2) The model (NRAM) will be built through the determination of the structure and parameters of the network based on some integrated methods. (3) The model will be applied to scenario deduction and sensitivity analysis to support decision-making in the context of COVID-19. Through the comparison with other models, NRAM shows better performance in the assessment of spreading risk at different countries. Moreover, the model reveals that the higher education level and stricter government measures can achieve better epidemic prevention and control effects. This study provides a new insight into the prevention and control of COVID-19 at the national level.

Exploring Factors Associated with Chinese-Americans' Willingness to Receive an Additional Hypothetical Annual Dose of the COVID-19 Vaccine.

Chinese-Americans are one of the largest groups of Asian-Americans in the US with distinctive behavioral and cultural characteristics that influence health service use. Although Chinese-Americans have significantly higher COVID-19-related mortality rates, relative to other racial and ethnic groups, limited literature is available examining their willingness to accept the COVID-19 vaccine. With recent development of the combination influenza-COVID-19 vaccine by biotechnology companies to mitigate COVID-19 infection, we examined factors associated with Chinese-Americans' acceptance of hypothetical annual doses of COVID-19 vaccination before the vaccine rollout. A total of 241 Chinese-Americans who received at least one dose of the COVID-19 vaccine completed an online questionnaire developed and based on health behavior theories. Our results indicated that Chinese-American participants who were satisfied with their prior COVID-19 vaccination experience, who had more accurate knowledge and perceived higher susceptibility of getting COVID-19, were more willing to receive the annual COVID-19 vaccine in the future. The findings of our current study may be used to guide the development of strategic messages to promote uptake of the annual COVID-19 vaccine by Chinese-Americans in the U.S.

Pre-existing humoral immunity to low pathogenic human coronaviruses exhibits limited cross-reactive antibodies response against SARS-CoV-2 in children.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes asymptomatic or mild symptoms, even rare hospitalization in children. A major concern is whether the pre-existing antibodies induced by low pathogenic human coronaviruses (LPH-CoVs) in children can cross-react with SARS-CoV-2. To address this unresolved question, we analyzed the pre-existing spike (S)-specific immunoglobin (Ig) G antibodies against LPH-CoVs and the cross-reactive antibodies against SARS-CoV-2 in 658 serum samples collected from children prior to SARS-CoV-2 outbreak. We found that the seroprevalence of these four LPH-CoVs reached 75.84%, and about 24.64% of the seropositive samples had cross-reactive IgG antibodies against the nucleocapsid, S, and receptor binding domain antigens of SARS-CoV-2. Additionally, the re-infections with different LPH-CoVs occurred frequently in children and tended to increase the cross-reactive antibodies against SARS-CoV-2. From the forty-nine serum samples with cross-reactive anti-S IgG antibodies against SARS-CoV-2, we found that seven samples with a median age of 1.4 years old had detected neutralizing activity for the wild-type or mutant SARS-CoV-2 S pseudotypes. Interestingly, all of the seven samples contained anti-S IgG antibodies against HCoV-OC43. Together, these data suggest that children's pre-existing antibodies to LPH-CoVs have limited cross-reactive neutralizing antibodies against SRAS-CoV-2.

CASA: a comprehensive database resource for the COVID-19 Alternative Splicing Atlas.

BACKGROUND: As a key process in transcriptional regulatory mechanisms, alternative splicing (AS) plays a crucial role in maintaining the diversity of RNA and protein expression, and mediates the immune response in infectious diseases, especially for the COVID-19. Therefore, urgent data gathering and more research of AS profiles in microbe-infected human cells are needed to improve understanding of COVID-19 and related infectious diseases. Herein, we have created CASA, the COVID-19 Alternative Splicing Atlas to provide a convenient computing platform for studies of AS in COVID-19 and COVID-19-related infectious diseases. METHODS: In CASA, we reanalyzed thousands of RNA-seq datasets generated from 65 different tissues, organoids and cell lines to systematically obtain quantitative data on AS events under different conditions. A total of 262,994 AS events from various infectious diseases with differing severity were detected and visualized in this database. In order to explore the potential function of dynamics AS events, we performed analysis of functional annotations and drug-target interactions affected by AS in each dataset. RNA-binding proteins (RBPs), which may regulate these dynamic AS events are also provided for users in this database. RESULTS: CASA displays microbe-induced alterations of the host cell splicing landscape across different virus families and helps users identify condition-specific splicing patterns, as well as their potential regulators. CASA may greatly facilitate the exploration of AS profiles and novel mechanisms of host cell splicing by viral manipulation. CASA is freely available at http://www.splicedb.net/casa/ .