Analysing the factors affecting medical waste generation in China

Medical waste deserves particular attention due to its potential for causing serious damage to people and the environment. Although the factors influencing the generation of medical waste are critical for designing policies aimed at effectively reducing medical waste and improving medical waste management, they have not been extensively studied. The rapid development of China's medical and health services and the sudden outbreak of Covid-19 have brought significant challenges to managing medical waste in China. Therefore, based on panel data from eight cities in China from 2013 to 2019, this study used a fixed-effects model to investigate the influencing factors of medical waste generation (MWG) in China, and tested the environmental Kuznets curve (EKC) hypothesis. The results show that there is a non-linear N-shaped curve relationship between MWG and per capita gross domestic product (GDP);MWG will continue to increase with economic growth, but the growth rate will slow down from fast to slow, and then from slow to fast with economic growth. The analysis also reveals that implementing a tiered diagnosis and treatment policy may negatively affect MWG by reducing the waste of medical resources and thus reducing the generation of medical waste. The positive effect of population size on MWG is also highly significant, so when the aging of the population increases, the generation of medical waste also increases. The three policy suggestions are provided: 1) improve the disposal capacity and efficiency of medical waste;2) give full play to the advantages of hierarchical diagnosis and treatment policy;3) improve the management level of medical waste in primary medical institutions. © 2023

Broad and Potent Activity Against Sars-Like Viruses by an Engineered Human Monoclonal Antibody

The recurrent zoonotic spillover of coronaviruses (CoVs) into the human population underscores the need for broadly active countermeasures. We employed a directed evolution approach to engineer three SARS-CoV-2 antibodies for enhanced neutralization breadth and potency. One of the affinity-matured variants, ADG-2, displays strong binding activity to a large panel of sarbecovirus receptor binding domains (RBDs) and neutralizes representative epidemic sarbecoviruses with high potency. Structural and biochemical studies demonstrate that ADG-2 employs a distinct angle of approach to recognize a highly conserved epitope overlapping the receptor binding site. In immunocompetent mouse models of SARS and COVID-19, prophylactic administration of ADG-2 provided complete protection against respiratory burden, viral replication in the lungs, and lung pathology. Altogether, ADG-2 represents a promising broad-spectrum therapeutic candidate against clade 1 sarbecoviruses.

[Research progress on antibody-dependent enhancement in infectious diseases].

Antibody-dependent enhancement (ADE) refers to the process in which some virus-specific antibodies (generally non-neutralizing antibodies) bind to the virus and bind to some cells expressing FcR on the surface through their Fc segment, thereby mediating the endocytosis and replication of the virus and enhancing the infection of the virus. This review summarized experience of ADE in respiratory syncytial virus, dengue virus, influenza virus infection and explored the possible mechanism of COVID-19 high incidence and severity of the disease, which implied challenges in the process of vaccine development and provided some insights for COVID-19 pathogenesis.

[Psychological and behavioral functioning of children and adolescents during long-term home-schooling].

Objective: To study the characteristics and risk factors of psychological and behavioral problems of children and adolescents of different ages and genders in long-term home-schooling during the coronavirus disease-2019 pandemic. Further, to provide scientific basis for more targeted psychological intervention and coping strategies in the future. Methods: A cross-sectional survey using an online questionnaire was conducted on students aged 6-16 years old in five representative cities of North (Beijing), East (Shanghai), West (Chongqing), South (Guangzhou) and Middle (Wuhan) in China. In this study, the social behavior and psychological abnormalities which was defined as the positive of any dimension were investigated in multiple dimensions during long-term home-schooling. The influencing factors of psycho-behavioral problems were analyzed by Logistic regression, and the confounding factors were corrected with graded multivariable adjustment. Results: A total of 6 906 valid questionnaires were collected including 3 592 boys and 3 314 girls, of whom 3 626 were children (6-11 years old) and 3 280 were adolescents (12-16 years old). The positive detection rate of psychosocial-behavioral problems were 13.0% (900/6 906) totally, 9.6% (344/3 592) in boys and 16.8% (556/3 314) in girls respectively, and 7.3%(142/1 946) in boys aged 6-11, 14.0%(235/1 680) in girls aged 6-11, 12.3%(202/1 646) in boys aged 12-16, 19.6%(321/1 634) in girls aged 12-16 respectively. There were significant differences between the psychological problems group and the non-psychological problems group in gender, parent-offspring conflict, number of close friends, family income change, sedentary time, homework time, screen exposure time, physical activity, dietary problems (χ²=78.851, 285.264, 52.839, 26.284, 22.778, 11.024, 10.688, 36.814, 70.982, all P<0.01). The most common symptoms in boys aged 6-11 years were compulsive activity, schizoid and depression, in girls aged 6-11 years were schizoid/compulsive activity, hyperactivity and social withdrawal, in boys aged 12-16 years were hyperactivity, compulsive activity and aggressive behavior, and in girls aged 12-16 years were schizoid, anxiety/compulsive activity and depression/withdrawal, respectively. After graded multivariable adjustment, besides the common risk factors, homework time and online study time were the risk factors of 6-11 years old groups [boys OR(95%CI): 1.750 (1.32-2.32), 1.214(1.00-1.47), girls: 1.579(1.25-1.99), 1.222(1.05-1.42), all P<0.05], videogames time were the risk factors of 12-16 years old groups [ boys: 2.237 (1.60-3.13), girls: 1.272 (1.00-1.61), all P<0.05]. Conclusions: Some children and adolescents may have psychological and behavioral problems during long-term home-schooling. The psychological and behavioral manifestations differed in age and gender subgroups, which deserve special attention in each subgroups. Schools, families and specialists should actively provide precise psychological support and comprehensive intervention strategies according to special features and risk factors.