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1.
Chinese Journal of Psychiatry ; 55(1):8-13, 2022.
Article in Chinese | Scopus | ID: covidwho-1911764

ABSTRACT

The COVID-19 epidemic has caused serious and long-lasting health and social harm. Vaccination is considered as the most effective way to prevent the COVID-19 epidemic. Patients with mental disorders are at high risk of COVID-19 infection who are in urgent need to get protection. However, due to the particularity of their conditions, whether these patients should be vaccinated has become a tough issue that obsesses doctors, patients with mental disorders, and their families. In light of this issue, this article provides expert advice on the safety, legal and ethical issues of vaccination for patients with mental disorders to regulate the vaccination of these vulnerable populations against COVID-19. © 2022 Chinese Journal of Psychiatry. All rights reserved.

2.
New England Journal of Medicine ; 386(22):2097-2111, 2022.
Article in English | Academic Search Complete | ID: covidwho-1890335

ABSTRACT

BACKGROUND The ZF2001 vaccine, which contains a dimeric form of the receptor-binding domain ofsevere acute respiratory syndrome coronavirus 2 and aluminum hydroxide as an adjuvant, was shown to be safe, with an acceptable side-effect profile, and immuno-genie in adults in phase 1 and 2 clinical trials. METHODS We conducted a randomized, double-blind, placebo-controlled, phase 3 trial to in. vestigate the efficacy and confirm the safety of ZF2001. The trial was performed at 31 clinical centers across Uzbekistan, Indonesia, Pakistan, and Ecuador;an addi-tional center in China was included in the safety analysis only. Adult participants (218 years of age) were randomly assigned in a 1:1 ratio to receive a total of three 25-/Lg doses (30 days aparO of ZF2001 or placebo. The primary end point was the occurrence of symptomatic coronavirus disease 2019 (Covid-19), as confirmed on polymerase-chain-reaction assay, at least 7 days after receipt of the third dose. A key secondary efficacy end point was the occurrence of severe-to-critical Covid-19 (including Covid-19-related death) at least 7 days after receipt of the third dose. RESULTS Between December 12, 2020, and December 15, 2021, a total of28,873 participants received at least one dose of ZF2OO1 or placebo and were ineluded in the safety analysis;25,193 participants who had completed the three-dose regimen, for whom there were approximately 6 months of follow-up data, were included in the updated primary efficacy analysis that was conducted at the second data cutoff date of December 15, 2021. In the updated analysis, primary end-point cases were reported in 158 of 12,625 participants in the ZF2001 group and in 580 of 12,568 participants in the placebo group, for a vaccine efficacy of 75.7°/0 (95°6 confidence interval [CI], 71.0 to 79.8). Severe-to-critical Covid-19 occurred in 6 participants in the ZF2001 group and in 43 in the placebo group, for a vaccine efficacy of 87.6% (95% CI, 70.6 to 95.7);Covid-19-related death occurred in 2 and 12 participants, respectively, for a vaccine efficacy of 86.5% (95% CI, 38.9 to 98.5). The incidence of adverse events and serious adverse events was balanced in the two groups, and there were no vaccine-related deaths. Most adverse reactions (98.590) were of grade 1 or 2. CONCLUSIONS In a large cohort of adults, the ZF2001 vaccine was shown to be safe and effective against symptomatic and severe-to-critical Covid-19 for at least 6 months after full vaccination. (Funded by the National Science and Technology Major Project and others;ClinicalTrials.gov number, NCT04646590.). [ FROM AUTHOR] Copyright of New England Journal of Medicine is the property of New England Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

3.
2021 IEEE/WIC/ACM International Conference on Web Intelligence and Intelligent Agent Technology, WI-IAT 2021 ; : 320-326, 2021.
Article in English | Scopus | ID: covidwho-1832583

ABSTRACT

Various measures have been taken to prevent the spread of COVID-19. Even with widespread vaccination, the control of the epidemic is still difficult due to the mutation of the virus. When an epidemic breaks out, the simplest and most efficient method of control is still social isolation, which greatly affects daily lives and mobility patterns. To study mobility patterns, we leveraged mobile base station data in Shulan, China, during the epidemic. Our main discoveries are as follows: (1) With the development of COVID-19, travel volumes and the scopes of trips were gradually reduced. (2) In addition to the government's prevention policy, media coverage of COVID-19 had a huge impact on mobility patterns. (3) Previous studies focused on morning and evening rush hours. However, our results show that humans tend to intensively travel at noon. (4) The travel network was significantly more active in the early stages of the COVID-19 outbreak;hence, the possibility of disease transmission was greater. (5) With the development of the epidemic, travel intervals became increasingly longer, and the number of contacts between base stations decreased. (6) By analyzing the temporal path length, we found that some nodes were still active during the epidemic. © 2021 ACM.

4.
Non-conventional in English | National Technical Information Service, Grey literature | ID: grc-753463

ABSTRACT

Despite current aggressive regimens, the majority of patients with MYCN amplification die due to drug-resistant disease, and further intensification ofchemotherapy will not significantly improve this outcome. We propose an entirely novel strategy to oppose MYCN oncogenic function in NB: by blockingthe metabolic reprogramming driven by MYCN. Based on our data and the recent literature, our guiding hypotheses are that: a) lipid metabolism is requiredfor NB tumorigenesis, and b) targeting MYCN-driven lipogenesis will effectively block NB tumor growth. We have demonstrated that lipid metabolism is aselective metabolic dependency of MYCN-driven tumors. MYCN drives both fatty acid (FA) synthesis and FA uptake to maintain NB cell survival. TargetingFA uptake effectively blocks NB in vivo tumor growth.

5.
Open Forum Infectious Diseases ; 8(SUPPL 1):S731, 2021.
Article in English | EMBASE | ID: covidwho-1746305

ABSTRACT

Background. We report on a 56 year-old male with prolonged COVID-19 pneumonia who initially improved with dexamethasone and intubation but quickly decompensated. Clinical and radiologic features were consistent with VAP. Tracheal aspirate cultures grew carbapenem-resistant Enterobacter cloacae;meropenem (MEM) MIC was >8 ug/ml (resistant) while ceftazidime-avibactam (CZA) MIC was 2/4 ug/ml (susceptible). Lateral flow antigen assay detected a KPC enzyme. The patient was treated with CZA with steady improvement in respiratory function over the next two weeks. He then experienced an episode of tachycardia, prompting repeat culture. At this point the patient had been extubated: sputum culture grew KPC+ E. cloacae that now showed CZA-resistance (MIC >8/4 ug/ml) and paradoxical decrease in MEM MIC (4 ug/ml);meropenem-vaborbactam (< 2/8 ug/ml) was susceptible. Methods. The pre- & post-CZA therapy E. cloacae isolates underwent whole genome sequencing using the Illumina 150bp paired end protocol;sequences were quality trimmed and compared. Results. A point mutation in the plasmid blaKPC3 gene was identified in the post-CZA therapy isolate, an R163S mutation in the omega loop of the enzyme. ompC and ompF porin genes were analyzed to rule-out decreased influx as a mechanism for CZA-resistance: the pre- and post-CZA isolates had identical porin sequences. Conclusion. This case highlights emerging mutations within KPC carbapenemases that lead to resistance to 'last-line' antimicrobials like CZA. The presumptive mechanism is increased KPC active site promiscuity due to increased omega loop flexibility, allowing increased ceftazidime binding and hydrolysis, and decreased avibactam binding and beta lactamase inhibition. Paradoxically, MEM susceptibility improves after such omega loop mutations, likely due to decreased active site binding affinity, a 'seesaw' effect between MEM and CZA. While authors have reported MEM MICs falling into the 'susceptible' category after an omega loop variant, these bacteria invariably develop secondary mutations leading to MEM treatment failure. Fortunately, given our patient's improved respiratory status, the post-CZA E. cloacae isolate was felt to reflect colonization and the patient was discharged home without antimicrobial therapy.

6.
Jisuanji Jicheng Zhizao Xitong/Computer Integrated Manufacturing Systems, CIMS ; 28(1):242-257, 2022.
Article in Chinese | Scopus | ID: covidwho-1698657

ABSTRACT

COVID-19 has an impact on the global supply chain, which is mainly manifested in the simultaneous interruption of production capacity and demand. To explore the impact of government subsidy strategies on recovery in the context of supply chain interruption, the low-demand products during the epidemic were used as the research object, and the government's choice of subsidies for production capacity and demand interruption as a recovery strategy. The cumulative profit of supply chain members was taken as the recovery index, and system dynamics was used to construct the "manufacturer-distribution center" secondary supply chain. The changes in cumulative profits for different subsidy options were simulate under partial and complete interruption scenarios. The simulation results showed that the choice of government subsidy strategies under different interruption scenarios had different effects on the supply chain recovery effect. In the scenario of partial demand interruption, government subsidies for manufacturers with interrupted production capacity would make the supply chain recovery better. In the scenario of complete demand interruption, government subsidies for distribution centers with interrupted demand would make the supply chain recovery better. © 2022, Editorial Department of CIMS. All right reserved.

7.
Preprint in English | bioRxiv | ID: ppbiorxiv-474132

ABSTRACT

Vaccine-elicited SARS-CoV-2 antibody responses are an established correlate of protection against viral infection in humans and non-human primates. However, it is less clear that vaccine-induced immunity is able to limit infection-elicited inflammation in the lower respiratory tract. To assess this, we collected bronchoalveolar lavage fluid samples post-SARS-CoV-2 strain USA-WA1/2020 challenge from rhesus macaques vaccinated with mRNA-1273 in a dose-reduction study. Single-cell transcriptomic profiling revealed a broad cellular landscape 48 hours post-challenge with distinct inflammatory signatures that correlated with viral RNA burden in the lower respiratory tract. These inflammatory signatures included phagocyte-restricted expression of chemokines such as CXCL10 (IP10) and CCL3 (MIP-1A) and the broad expression of interferon-induced genes such as MX1, ISG15, and IFIT1. Induction of these inflammatory profiles was suppressed by prior mRNA-1273 vaccination in a dose-dependent manner, and negatively correlated with pre-challenge serum and lung antibody titers against SARS-CoV-2 spike. These observations were replicated and validated in a second independent macaque challenge study using the B.1.351/beta-variant of SARS-CoV-2. These data support a model wherein vaccine-elicited antibody responses restrict viral replication following SARS-CoV-2 exposure, including limiting viral dissemination to the lower respiratory tract and infection-mediated inflammation and pathogenesis. One Sentence SummarySingle cell RNA sequencing analysis demonstrates that mRNA-1273 vaccination limits the development of lower respiratory tract inflammation in SARS-CoV-2 challenged rhesus macaques

8.
Chinese Journal of Emergency Medicine ; 30(10):1220-1228, 2021.
Article in Chinese | Scopus | ID: covidwho-1576023

ABSTRACT

Objective To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment. Methods A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University. Results The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant (P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥ 39 °C);other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥ 39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases (P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases (OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively. © 2021 Chinese Medical Association. All rights reserved.

10.
12.
Journal of Mens Health ; 17(3):47-53, 2021.
Article in English | Web of Science | ID: covidwho-1326151

ABSTRACT

Objective: To understand the family function, psychological status, and influencing factors of the family members of the frontline medical staff fighting COVID-19. Methods: A psychological questionnaire survey was conducted on the families of 189 clinical front line medical staff who participated in the fight against COVID-19 by using the general information questionnaire, the fam- ily care index scale (APGAR), the generalized anxiety scale (GAD-7), and the depression screening scale (PHQ-9), and the influencing factors were analyzed. Results: The score of family function was 7.00 (5.00, 10.00), 105 individuals (55.6%) had good family function, 72 individuals (38.1%) had moderate family dysfunction, and 12 of them (6.3%) had severe family dysfunction. Multiple linear regression analysis showed that gender, age, educational background, working status during the epidemic, and anxiety level were the influencing factors of the family function status of frontline medical staff (p < 0.05). Conclusion: The family function of the medical staff participating in the clinical frontline fight against COVID-19 is at a medium level. Gender, age, educational background, working status during the epidemic, and anxiety level are the influencing factors of the family function status of this group. The family members of medical personnel have a certain extent of anxiety and depression, so the nursing manager should improve the family function and relieve them of anxiety and depression through psychological counseling and humanistic care, so as to improve their family function.

13.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-8354

ABSTRACT

Pregnant women are a high-risk population for severe/critical COVID-19 and mortality. However, the maternal-fetal immune responses initiated by SARS-CoV-2 infection, and whether this virus is detectable in the placenta, are still under investigation. Herein, we report that SARS-CoV-2 infection during pregnancy primarily induced specific maternal inflammatory responses in the circulation and at the maternal-fetal interface, the latter being governed by T cells and macrophages. SARS-CoV-2 infection during pregnancy was also associated with a cytokine response in the fetal circulation (i.e. umbilical cord blood) without compromising the cellular immune repertoire. Moreover, SARS-CoV-2 infection neither altered fetal cellular immune responses in the placenta nor induced elevated cord blood levels of IgM. Importantly, SARS-CoV-2 was not detected in the placental tissues, nor was the sterility of the placenta compromised by maternal viral infection. This study provides insight into the maternal-fetal immune responses triggered by SARS-CoV-2 and further emphasizes the rarity of placental infection.

14.
Chinese Public Administration Review ; 11(2):122-131, 2020.
Article in English | Web of Science | ID: covidwho-1052699

ABSTRACT

A nation's governing system shapes its capacity for emergency preparedness and management. Designed to maintain the central government's absolute authority, China's governing system limits local governments' initiative and capacity in responding to mass emergencies. By examining China's fight against COVID-19, this essay dynamically demonstrates how the country's governing regime constrains the initial response of local officials and other non-state entities to the virus but facilitated large-scale mobilization once the crisis was recognized by the central leadership. Four essential factors for an adaptive emergency management system are identified: 1) raising the central government's ability to recognize mass emergencies, 2) changing political incentives of local cadres, 3) creating a flexible and efficient ad-hoc resource allocation mechanism, and 4) embracing the participation of non-governmental actors. This study provides insights into how political realities explain the disparity in pandemic control performance across nations. It also shows how the resilience of a mass emergency management system can be enhanced within the constraints of existing governing institutions.

15.
Journal of the American Society of Nephrology ; 31:253, 2020.
Article in English | EMBASE | ID: covidwho-984967

ABSTRACT

Background: Due to its high infectivity and mortality, coronavirus disease 2019 (COVID-19) has become a global public health issue. The kidneys act as critical metabolic organs, therefore, whether COVID-19 can induce renal damage is of utmost importance but remains controversial, and the prognosis of COVID-19 encountering acute kidney injury (AKI) is unknown. Moreover, the efficacy of different treatments that COVID-19 patients undergo needs to be explored. In this study, we aimed to explore these questions. Methods: A single-centered, retrospective study was conducted in which 96 patients with COVID-19 were enrolled. Epidemiological, clinical, and laboratory characteristics, as well as treatments and patient outcomes were described. Characteristics were compared between severe cases and critical cases. Relevant factors of AKI were filtrated, and the treatment efficacy was also evaluated. Results: A total of 6 patients (6.3%) died during hospitalization. Four patients (4.2%) developed AKI, among which 3 patients (75%) died. Statistical analysis indicated that AKI was not common in COVID-19 patients without underlying kidney disease, but was related to mortality. Age, severity of disease, procalcitonin, C-reactive protein and interleukin-6 were correlated with AKI onset in COVID-19 patients, while lymphocyte count and estimated glomerular filtration rate at admission were inversely related to the development of AKI. Conclusions: In conclusion, AKI is not common in COVID-19 patients without underlying kidney disease but related to mortality.

16.
Chinese General Practice ; 23(9):1083-1089 and 1090, 2020.
Article in Chinese | Scopus | ID: covidwho-826665

ABSTRACT

Background: The medical device-related pressure injury(DRPI), which mainly occurs in critical patients and orthopedic patients, has been a research hotspot for the safety management and specialized care of inpatients worldwide, but there have been few reports on DRPI of medical staff. During the prevention and control of COVID-19, a large number of medical staff are fighting at the front. However, wearing protective equipment for a long time can easily cause skin injury, which seriously harms the medical staff and increases their risk of infection. Therefore, how to protect medical personnel from skin damage is an urgent problem. Objective: To investigate the incidence and epidemic characteristics of medical staff's skin injuries caused by personal protective equipment in fighting against the COVID-19 in order to provide a basis for the formulation of effective protection countermeasures. Methods: A research questionnaire was developed by our research group, including the basic information of medical staff, the wearing situation of protective equipment, the skin damage situation, preventive measures against skin damage, and the post-injury treatment. The questionnaire was released through the Questionnaire Star website to front-line medical staff fighting against the COVID-19 through Wechat app from February 8 to 15 in 2020.The survey was completed by voluntary participation and online filling. The survey data were collected in one week and a database was established. Statistical analysis was made on the incidence of skin injuries, the types of injuries, and epidemic characteristics. Results: A total of 2 901 effective questionnaires were collected from 145 hospitals in 19 provinces, 3 autonomous regions and 4 municipalities in China. Among them, there were 214(7.38%) males and 2 687(92.62%) females, and 147(5.07%) doctors and 2 754(94.93%) nurses. And 825(28.44 %) cases of the medical staff suffered skin injuries due to wearing protective equipment, and the total number of skin damage sites was 2 794.The main types of skin injuries were pressure injury〔771(26.58%)cases, 2.53 per capita〕, moisture-associated skin damage〔256(8.83%)cases, 2.77 per capita〕, and skin tear〔42(1.45%)cases, 3.12 per capita〕.Of the 825 medical staff who had skin injuries, 221(26.79%) cases had skin injuries≥2 types. Univariate analysis showed that the incidence of skin injuries caused by protective equipment was higher in men than in women(P 0.05), in those aged 31-45 than in those ≤30(P 0.016 7), in those who worked 10 years than in those who worked 5 years(P 0.016 7), in doctors than in nurses(P 0.05), in designated epidemic prevention hospitals in Wuhan than in other hospitals(P 0.003 3)and among other hospitals, in Infectious Disease Department than in other departments(P 0.003 3), and in tertiary protection than in secondary protection followed by primary protection(P 0.016 7).However, there was no significant difference in the incidence of skin injuries among medical staff with different continuous wearing time of protective equipment(P 0.05).Conclusion The incidence of skin injuries caused by personal protective equipment in fighting against COVID-19 is high among medical staff. Multiple types and multiple sites of skin injuries are coexisted. It is recommended to take comprehensive preventive measures of pressure relief, friction reduction, moisture absorption, and skin care to reduce skin damage of medical staff. Meanwhile, it is suggested to pay attention to human resource management factors such as gender, age, and job position. Copyright © 2020 by the Chinese General Practice.

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