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1.
2022 IEEE International Conference on Communications, ICC 2022 ; 2022-May:4104-4113, 2022.
Article in English | Scopus | ID: covidwho-2029228

ABSTRACT

The topic of source identification has attracted wide attention from researchers. In practice, the source identification method aims to locate the sources of rumors, computer viruses, and epidemics, such as COVID-19. However, there are two main problems with existing propagation source detection methods. First, most source detection methods are based on infinite networks, not in line with reality. Second, sources are often randomly selected in simulations, but different sources often cause significantly different detection results in real-world applications. To this end, we study how does the source location impact the effectiveness of source detection in finite networks. This paper first proposes a diameter-based node division method to classify the nodes based on their structural location. We further offer different evaluation indicators to measure the effectiveness of source detection methods. Then, we conduct systematic experiments on three synthetic networks and two real-world networks. Our experiments demonstrate that the location of the source directly effects detection effectiveness in finite networks for all source detection methods. Specifically, sources closer to the network boundary will lead to worse detection performance. It means that attackers can choose sources close to the network boundary to reduce the probability of detection to achieve a larger spreading scale. © 2022 IEEE.

2.
Gut Microbes ; 14(1):2117503, 2022.
Article in English | MEDLINE | ID: covidwho-2028942

ABSTRACT

The origins of preexisting SARS-CoV-2 cross-reactive antibodies and their potential impacts on vaccine efficacy have not been fully clarified. In this study, we demonstrated that S2 was the prevailing target of the preexisting S protein cross-reactive antibodies in both healthy human and SPF mice. A dominant antibody epitope was identified on the connector domain of S2 (1147-SFKEELDKYFKNHT-1160, P144), which could be recognized by preexisting antibodies in both human and mouse. Through metagenomic sequencing and fecal bacteria transplant, we demonstrated that the generation of S2 cross-reactive antibodies was associated with commensal gut bacteria. Furthermore, six P144 reactive monoclonal antibodies were isolated from naive SPF mice and were proven to cross-react with commensal gut bacteria collected from both human and mouse. A variety of cross-reactive microbial proteins were identified using LC-MS, of which E. coli derived HSP60 and HSP70 proteins were confirmed to be able to bind to one of the isolated monoclonal antibodies. Mice with high levels of preexisting S2 cross-reactive antibodies mounted higher S protein specific binding antibodies, especially against S2, after being immunized with a SARS-CoV-2 S DNA vaccine. Similarly, we found that levels of preexisting S2 and P144-specific antibodies correlated positively with RBD binding antibody titers after two doses of inactivated SARS-CoV-2 vaccination in human. Collectively, our study revealed an alternative origin of preexisting S2-targeted antibodies and disclosed a previously neglected aspect of the impact of gut microbiota on host anti-SARS-CoV-2 immunity.

3.
Internal & Emergency Medicine ; 14:14, 2022.
Article in English | MEDLINE | ID: covidwho-2027644

ABSTRACT

COVID-19 has rapidly evolved since it was first discovered in December 2019. We aimed to retrospectively review our experience with COVID-19 infection across 2020-2022, focusing on differences in laboratory markers at presentation. Consecutive adult patients admitted to hospital with confirmed COVID-19 infection were retrospectively reviewed across three periods (29/3/2020-29/9/2020, 16/8/2021-13/10/2021 and 1/1/2022-31/1/2022), correlating with the lineages B.1.338, Delta (B.1.617.2) and Omicron (B.1.1.159), respectively. Laboratory findings of the first requested blood test within 24 h of presentation were recorded and correlated with patient outcome. The primary outcome was requirement for oxygen therapy at any point. Inflammatory markers, namely serum ferritin, lactate dehydrogenase (LDH), C-reactive protein (CRP) were significantly lower on presentation during 2022 compared to 2021, corresponding to a milder disease course. More than 80% of 2022 patients had received 2 or more vaccine doses and fully vaccinated patients displayed significantly lower inflammatory markers at presentation. Using 2022 data, a multivariate prediction model was constructed to predict for oxygen requirement, with c-statistic 0.86. Patients in 2022, corresponding with the Omicron variant, displayed a milder disease course, even in hospitalised patients, with the majority not requiring oxygen and lower inflammatory markers. We constructed a simple-to-use risk prediction model with c-statistic 0.86 which may identify individuals who can be safely managed as outpatients in the era of highly transmissible variants.

4.
Xitong Fangzhen Xuebao / Journal of System Simulation ; 34(7):1532-1546, 2022.
Article in Chinese | Scopus | ID: covidwho-2025824

ABSTRACT

With the spread of the novel coronavirus pneumonia around the world, the data and transmission mechanism are analyzed. The SEIiRD model is constructed based on the existing SEIRD model, and the infected population is divided into asymptomatic infections, mild infections, severe infections and critical infections. The impact of the transmission rate of different infected people on the development of the epidemic was analyzed. Simulation experiments were carried out on the basis of fitting real data, and it was found that the main infected populations that affected the discovery of the epidemic were asymptomatic and mildly infected. On this basis, the transmission rate of different asymptomatic and mildly infected people was further analyzed. The impact of different intervention times on the number of infections and deaths was simulated. Results show that the model can effectively simulate the spread of COVID-19 and provide decision-making support to the departments to implement corresponding epidemic prevention and control strategies. © 2022 Acta Simulata Systematica Sinica. All rights reserved.

5.
World Journal of Oncology ; 13(4):172-184, 2022.
Article in English | Web of Science | ID: covidwho-2025722

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is a global pandemic. Breast cancer is the most commonly diagnosed malignant cancer in China. Considering the specific national conditions, no evidence is available for factors associated with COVID-19 vaccination in patients with breast cancer. Methods: This was a cross-sectional survey, fielded from June 21 through June 27, 2021. A total of 944 nationally representative samples of Chinese breast cancer patients participating in the survey were included. Participant surveys included questions addressing who finished COVID-19 vaccination with the question "Have you taken the COVID-19 vaccine?", and response options were "Yes" and "No". Results: Overall, 730 (77.33%) women with breast cancer were unvaccinated, and only 214 (22.67%) were vaccinated with the COVID-19 vaccine. After adjusting for potential confounders, including both sociodemographic and clinical characteristics, we found that external support, including positive doctor suggestions (odds ratio (OR): 5.52;95% confidence interval (CI): 3.50 - 8.71;P < 0.0001), positive support from surrounding people (OR: 11.65;95% CI: 7.57 - 17.91;P < 0.0001), and negative initiative from the community (OR: 0.15;95% CI: 0.06 - 0.35;P < 0.0001), was associated with COVID-19 vaccination rates among breast cancer patients. These results remain stable in subgroup analyses. We found that most participants (82.52%) understood the necessity of COVID-19 vaccinations in China was strong;however, the recognition regarding the COVID-19 vaccine showed different patterns between vaccinated and unvaccinated participants. Conclusions: Our findings suggest external support, including vaccination suggestions from surgeons or oncologists, vaccination suggestions from associated people, and residents' committee mandated vaccinations, was associated with the COVID-19 vaccination rates. Interventions regarding these factors and improving publicity as well as education regarding COVID-19 vaccines among breast cancer patients are warranted.

6.
China Biotechnology ; 42(5):106-116, 2022.
Article in Chinese | Scopus | ID: covidwho-2025662

ABSTRACT

To evaluate the immune protection of recombinant SARS-CoV-2 S1 and S protein vaccine. Methods;Recombinant SARS-CoV-2 S1 or S protein combined with aluminum hydroxide adjuvant was inoculated at different doses of 0.1 μg, 1 μg, 5 μg and 10 μg per mouse for 6-8 weeks. Serum IgG antibody liters were detected by enzyme linked immunosorbent assay (ELISA) after second immunization. The serum neutralizing antibody titers of the immunized mice against pseudotype SARS-CoV-2-Fluc WT, B. 1.1. 7, P. 1, B. 1.617.2, B. 1.621, 501Y. V2-1 strains were compared by pseudovirus neutralization test. The cellular immune levels of sera were detected by enzyme-linked immunospot assay (ELISpot). Results;Both SARS-CoV-2 S and S1 proteins could induce strong IgG antibody levels in mouse model. The sera of mice immunized with S1 protein showed obvious neutralization activity against SARS-CoV-2-Fluc WT, B. 1. 1.7 and P. 1. The sera of mice immunized with the recombinant S protein also showed obvious neutralization activity against SARS-CoV-2-Fluc B. 1.617.2 in addition to SARS-CoV-2-Fluc WT, B. 1. 1.7 and P. 1. The serum of mice immunized with two kinds of proteins had the strongest neutralizing effect on SARS-CoV-2-Fluc WT. Mouse spleen cells immunized with S protein could significantly induce the production of interferon-γ (IFN--γ) and interleukin-4 (IL-4). The levels of IgG antibody, neutralizing antibody and cellular immunity induced by S protein were higher than those of S1. Conclusion;Recombinant SARS-CoV-2 S protein vaccine can induce protective immune responses. © 2022, China Biotechnology. All rights reserved.

7.
Frontiers in Public Health ; 10:978159, 2022.
Article in English | MEDLINE | ID: covidwho-2023005

ABSTRACT

During the COVID-19 pandemic in 2020, a tuberculosis outbreak occurred in a university in eastern China, with 4,488 students and 421 staff on the campus. A 19-year-old student was diagnosed in August 2019. Later, the first round of screening was initiated among close contacts, but no active cases were found. Till September 2020, four rounds of screening were performed. Four rounds of screening were conducted on September 9, November 8, November 22-25 in 2019 and September 2020, with 0, 5, 0 and 43 cases identified, respectively. A total of 66 active tuberculosis were found in the same university, including 4 sputum culture-positive and 7 sputum smear-positive. The total attack rate of active tuberculosis was 1.34% (66/4909). The whole-genome sequencing showed that the isolates belonged to the same L2 sub-specie and were sensitive to all tested antituberculosis drugs. Delay detection, diagnosis and report of cases were the major cause of this university tuberculosis epidemic. More attention should be paid to the asymptomatic students in the index class. After the occurrence of tuberculosis cases in schools, multiple rounds of screening should be carried out, and preventive therapy should be applied in a timely manner.

8.
Front Public Health ; 10:952916, 2022.
Article in English | PubMed | ID: covidwho-2022976

ABSTRACT

With the COVID-19 pandemic continuing, more contagious SARS-CoV-2 variants, including Omicron, have been emerging. The mutations, especially those that occurred on the spike (S) protein receptor-binding domain (RBD), are of significant concern due to their potential capacity to increase viral infectivity, virulence, and breakthrough antibodies' protection. However, the molecular mechanism involved in the pathophysiological change of SARS-CoV-2 mutations remains poorly understood. Here, we summarized 21 RBD mutations and their human angiotensin-converting enzyme 2 (hACE2) and/or neutralizing antibodies' binding characteristics. We found that most RBD mutations, which could increase surface positive charge or polarity, enhanced their hACE2 binding affinity and immune evasion. Based on the dependence of electrostatic interaction of the epitope residue of virus and docking protein (like virus receptors or antibodies) for its invasion, we postulated that the charge and/or polarity changes of novel mutations on the RBD domain of S protein could affect its affinity for the hACE2 and antibodies. Thus, we modeled mutant S trimers and RBD-hACE2 complexes and calculated their electrotactic distribution to study surface charge changes. Meanwhile, we emphasized that heparan sulfate proteoglycans (HSPGs) might play an important role in the hACE2-mediated entry of SARS-CoV-2 into cells. Those hypotheses provide some hints on how SARS-CoV-2 mutations enhance viral fitness and immune evasion, which may indicate potential ways for drug design, next-generation vaccine development, and antibody therapies.

9.
Front Public Health ; 10:936700, 2022.
Article in English | PubMed | ID: covidwho-2022963

ABSTRACT

OBJECTIVE: College students are one of the most vulnerable populations to the COVID-19 pandemic's mental health effects. During the coronavirus disease 2019 (COVID-19) outbreak, we wanted to see how common depressive symptoms were among college students and what factors contributed to that. METHODS: Between 21 and 27 May 2021, 140,259 college students from three cities in Henan Province, China, were involved. The Patient Health Questionnaire-9 was used to determine depressive symptoms (PHQ-9). Multiple logistic regression analysis was used to calculate odds ratios (ORs) and 95% CIs for potential depressive symptom factors. RESULTS: Mild depressive symptoms and above are present in 21.12% of college students. Women had a higher prevalence of mild depressive symptoms than men (61.38 vs. 59.75%), and depressive symptoms were most prevalent among rural students and least prevalent among city students (21.44 vs. 20.29%). Participants with depressive symptoms are also more likely to have a poor-behavioral status. From none-to-severe depressive symptoms, 78.88, 15.78, 2.80, 1.67, and 0.88% had them. Gender, residential location, and behavioral status were found to be associated with depressive symptoms after adjusting for potential confounders. CONCLUSION: This cross-sectional study identified the factors that influence the prevalence of depression in college students. It found that the government should pay more attention to mental health issues affecting college students in combating the COVID-19 epidemic normalization.

10.
Frontiers in Public Health ; 10, 2022.
Article in English | Web of Science | ID: covidwho-2022954

ABSTRACT

The pathogen laboratory (p-lab) is the core and primary department of centers for disease control and prevention (CDCs) in China to respond to infectious disease outbreaks such as COVID-19. To understand the current status and capacity of p-labs in Chinese CDCs during the COVID-19 pandemic, we conducted a nationwide cross-sectional survey among 399 respondents from 239 CDCs. Differences in the current status of p-labs in CDCs of provinces, cities, and counties mainly comprised laboratory equipment, IEIs, mastery of personal occupational skills, and maximum detection capacity. Most CDCs reported a lack of staff and funds for personnel, which should be a priority in China's upcoming public health reform. The development of sequencing technologies has received considerable attention in CDCs. These are mainly used to study respiratory viruses such as influenza and SARS-CoV-2. The COVID-19 pandemic has driven development of the CDCs in China, and personnel and funds are considered key factors in improving the detection capacity of CDC p-labs.

11.
Frontiers in Public Health ; 10:881660, 2022.
Article in English | MEDLINE | ID: covidwho-2022932

ABSTRACT

Background: The differential effect of comorbidities on COVID-19 severe outcomes by sex has not been fully evaluated. Objective: To examine the association of major comorbidities and COVID-19 mortality in men and women separately. Methods: We performed a retrospective cohort analysis using a large electronic health record (EHR) database in the U.S. We included adult patients with a clinical diagnosis of COVID-19 who also had necessary information on demographics and comorbidities from January 1, 2016 to October 31, 2021. We defined comorbidities by the Charlson Comorbidity Index (CCI) using ICD-10 codes at or before the COVID-19 diagnosis. We conducted logistic regressions to compare the risk of death associated with comorbidities stratifying by sex. Results: A total of 121,342 patients were included in the final analysis. We found significant sex differences in the association between comorbidities and COVID-19 death. Specifically, moderate/severe liver disease, dementia, metastatic solid tumor, and heart failure and the increased number of comorbidities appeared to confer a greater magnitude of mortality risk in women compared to men. Conclusions: Our study suggests sex differences in the effect of comorbidities on COVID-19 mortality and highlights the importance of implementing sex-specific preventive or treatment approaches in patients with COVID-19.

12.
Frontiers in Pharmacology ; 13, 2022.
Article in English | Web of Science | ID: covidwho-2022844

ABSTRACT

Patients with breast cancer are prone to SARS-CoV-2 infection [the causative virus of coronavirus disease (COVID-19)] due to their lack of immunity. In the current study, we examined the mechanism of action of Diosmetin, a flavonoid with anti-inflammatory properties, in patients with BRCA infected with SARS-CoV-2.We used bioinformatics technology to analyze the binding ability, biological function, and other biological characteristics of Diosmetin in vivo and examine the core target and potential mechanism of action of Diosmetin in patients with patients with breast cancer infected with SARS-CoV-2. A prognostic model of SARS-COV-2-infected breast cancer patients was constructed, and the core genes were screened out, revealing the correlation between these core genes and clinicopathological characteristics, survival rate, and high-risk and low-risk populations. The docking results revealed that Diosmetin binds well to the core genes of patients with breast cancer with COVID-19. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses suggested that Diosmetin inhibited inflammation, enhanced immune function, and regulated the cellular microenvironment in patients with BRCA/COVID-19. For the first time, we reveal the molecular functions and potential targets of Diosmetin in patients with breast cancer infected with SARS-CoV-2, improving the reliability of the new drug and laying the foundation for further research and development.

13.
Frontiers in Pharmacology ; 13:936925, 2022.
Article in English | MEDLINE | ID: covidwho-2022836

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) was declared a global pandemic in March 2020 by the World Health Organization (WHO). As of July 2, 2022, COVID-19 has caused more than 545 million infections and 6.3 million deaths worldwide, posing a significant threat to human health. Currently, there is still a lack of effective prevention and control strategies for the variation and transmission of SARS-CoV-2. Traditional Chinese medicine (TCM), which has a unique theoretical system, has treated various conditions for thousands of years. Importantly, recent studies have revealed that TCM contributed significantly to COVID-19. SanHanHuaShi (SHHS) granules, a Chinese herbal medicine, which has been included in Protocol for the Diagnosis and Treatment of Novel Coronavirus Disease 2019 (6th to 9th editions) issued by the National Health Commission of China and used to prevent and treat COVID-19 disease. A previous retrospective cohort study showed that SHHS could significantly reduce the severity of mild and moderate COVID-19. However, there is an absence of high-quality randomized controlled clinical studies to confirm the clinical effectiveness of SHHS. Therefore, a clinical study protocol and a statistical analysis plan were designed to investigate the efficacy and safety of SHHS for the prevention and treatment of COVID-19. This study will increase the integrity and data transparency of the clinical research process, which is of great significance for improving the practical application of SHHS granules in the future. Methods and analysis: The study was designed as a 7-day, randomized, parallel controlled, open-label, noninferiority clinical trial of positive drugs. A total of 240 patients with mild and moderate COVID-19 will be enrolled and randomly assigned to receive SanHanHuaShi granules or LianHuaQingWen granules treatment in a 1:1 ratio. Disease classification, vital signs, SARS-CoV-2 nucleic acid testing, symptoms, medications, adverse events, and safety evaluations will be recorded at each visit. The primary outcome will be the clinical symptom recovery rate. Secondary outcomes will include the recovery time of clinical symptoms, negative conversion time of SARS-CoV-2 nucleic acid test negative conversion rate, hospitalization time, antipyretic time, rate of conversion to severe patients, and time and rate of single symptom recovery. Adverse incidents and safety assessments will be documented. All data will be analyzed using a predetermined statistical analysis plan, including our method for imputation of missing data, primary and secondary outcome analyses, and safety outcomes. Discussion: The results of this study will provide robust evidence to confirm the effectiveness and safety of SHHS in the treatment of COVID-19. Clinical Trial Registration: http://www.chictr.org.cn. Trial number: ChiCTR2200058080. Registered on 29 March 2022.

14.
Frontiers in Microbiology ; 13:968036, 2022.
Article in English | MEDLINE | ID: covidwho-2022794

ABSTRACT

To combat the continued pandemic of COVID-19, multiplex serological assays have been developed to comprehensively monitor the humoral immune response and help to design new vaccination protocols to different SARS-CoV-2 variants. However, multiplex beads and stably transfected cell lines require stringent production and storage conditions, and assays based on flow cytometry is time-consuming and its application is therefore restricted. Here, we describe a phage display system to distinguish the differences of immune response to antigenic domains of multiple SARS-CoV-2 variants simultaneously. Compared with linear peptides, the recombinant antigens displayed on the phage surface have shown some function that requires the correct folding to form a stable structure, and the binding efficiency between the recombinant phage and existing antibodies is reduced by mutations on antigens known to be important for antigen-antibody interaction. By using Phage display mediated immuno-multiplex quantitative PCR (Pi-mqPCR), the binding efficiency between the antibody and antigens of different SARS-CoV-2 variants can be measured in one amplification reaction. Overall, these data show that this assay is a valuable tool to evaluate the humoral response to the same antigen of different SARS-CoV-2 variants or antigens of different pathogens. Combined with high-throughput DNA sequencing technology, this phage display system can be further applied in monitoring humoral immune response in a large population before and after vaccination.

15.
Frontiers in Immunology ; 13, 2022.
Article in English | Web of Science | ID: covidwho-2022731

ABSTRACT

To cope with the decline in COVID-19 vaccine-induced immunity caused by emerging SARS-CoV-2 variants, a heterologous immunization regimen using chimpanzee adenovirus vectored vaccine expressing SARS-CoV-2 spike (ChAd-S) and an inactivated vaccine (IV) was tested in mice and non-human primates (NHPs). Heterologous regimen successfully enhanced or at least maintained antibody and T cell responses and effectively protected against SARS-CoV-2 variants in mice and NHPs. An additional heterologous booster in mice further improved and prolonged the spike-specific antibody response and conferred effective neutralizing activity against the Omicron variant. Interestingly, priming with ChAd-S and boosting with IV reduced the lung injury risk caused by T cell over activation in NHPs compared to homologous ChAd-S regimen, meanwhile maintained the flexibility of antibody regulation system to react to virus invasion by upregulating or preserving antibody levels. This study demonstrated the satisfactory compatibility of ChAd-S and IV in prime-boost vaccination in animal models.

16.
Frontiers in Immunology ; 13, 2022.
Article in English | Web of Science | ID: covidwho-2022721

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally since December 2019. Several studies reported that SARS-CoV-2 infections may produce false-positive reactions in dengue virus (DENV) serology tests and vice versa. However, it remains unclear whether SARS-CoV-2 and DENV cross-reactive antibodies provide cross-protection against each disease or promote disease severity. In this study, we confirmed that antibodies against the SARS-CoV-2 spike protein and its receptor-binding domain (S1-RBD) were significantly increased in dengue patients compared to normal controls. In addition, anti-S1-RBD IgG purified from S1-RBD hyperimmune rabbit sera could cross-react with both DENV envelope protein (E) and nonstructural protein 1 (NS1). The potential epitopes of DENV E and NS1 recognized by these antibodies were identified by a phage-displayed random peptide library. In addition, DENV infection and DENV NS1-induced endothelial hyperpermeability in vitro were inhibited in the presence of anti-S1-RBD IgG. Passive transfer anti-S1-RBD IgG into mice also reduced prolonged bleeding time and decreased NS1 seral level in DENV-infected mice. Lastly, COVID-19 patients' sera showed neutralizing ability against dengue infection in vitro. Thus, our results suggest that the antigenic cross-reactivity between the SARS-CoV-2 S1-RBD and DENV can induce the production of anti-SARS-CoV-2 S1-RBD antibodies that cross-react with DENV which may hinder dengue pathogenesis.

17.
Front Immunol ; 13:917141, 2022.
Article in English | PubMed | ID: covidwho-2022706

ABSTRACT

COVID-19 caused by SARS-CoV-2 can cause various systemic diseases such as acute pneumonia with cytokine storm. Constituted of necroptosis, pyroptosis, and ferroptosis, regulated necrosis constitutes the cell death patterns under the low apoptosis condition commonly observed in COVID-19. Regulated necrosis is involved in the release of cytokines like TNF-α, IL-1 β, and IL-6 and cell contents such as alarmins, PAMPs, and DAMPs, leading to more severe inflammation. Uncontrolled regulated necrosis may explain the poor prognosis and cytokine storm observed in COVID-19. In this review, the pathophysiology and mechanism of regulated necrosis with the double-edged sword effect in COVID-19 are thoroughly discussed in detail. Furthermore, this review also focuses on the biomarkers and potential therapeutic targets of the regulated necrosis pathway in COVID-19, providing practical guidance to judge the severity, prognosis, and clinical treatment of COVID-19 and guiding the development of clinical anti-SARS-CoV-2 drugs.

18.
China Finance and Economic Review ; 10(2):88-109, 2021.
Article in English | Scopus | ID: covidwho-2022035

ABSTRACT

The reasonable allocation of healthcare resources across different levels of healthcare facilities is the key to promoting the tiered diagnosis and treatment approach. The sudden outbreak of COVID-19 underscores the shortage of resources and service capability of China's primary healthcare facilities. From the perspective of the vertical division of labor in the healthcare service system and based on the quality adjustment and quantitative correction of healthcare workers, this paper comprehensively calculates and analyzes the evenness of resources allocation between hospitals and primary healthcare facilities;and then, combining the theoretical model derivation with China's empirical data test, this paper demonstrates how the misallocation of healthcare resources affects their utilization efficiency. The results are as below. (1) There are varying degrees of quantity and quality imbalance in various healthcare resources between hospitals and primary healthcare facilities. (2) When other conditions remain unchanged, the more misallocated healthcare resources are, the lower the "actual"utilization efficiency after quality adjustment is. (3) Compared with the absence of price regulation, government price regulation has led to a relative "overtreatment equilibrium"in the healthcare service market. Therefore, measures should be taken to optimize the structure of healthcare resources allocation and improve the efficiency of resources utilization, such as strengthening the government's healthcare financing function, formulating policies that favor primary healthcare facilities, and encouraging social capital to invest at the community level. © 2021 Junhao Wang and Jia Wanwen, published by De Gruyter.

19.
PLoS One ; 17(9):e0273676, 2022.
Article in English | PubMed | ID: covidwho-2021933

ABSTRACT

BACKGROUND: COVID-19 vaccination is essential. However, no study has reported adverse events (AEs) after ChAdOx1 nCoV-19 vaccination in patients with end-stage renal disease (ESRD) on hemodialysis (HD). This study investigated the AEs within 30-days after the first dose of ChAdOx1 nCoV19 (Oxford-AstraZeneca) in ESRD patients on HD. METHODS AND FINDINGS: A total of 270 ESRD patients on HD were enrolled in this study. To determine the significance of vascular access thrombosis (VAT) post vaccination, we performed a self-controlled case study (SCCS) analysis. Of these patients, 38.5% had local AEs;local pain (29.6%), tenderness (28.9%), and induration (15.6%) were the most common. Further, 62.2% had systemic AEs;fatigue (41.1%), feverishness (20%), and lethargy (19.9%) were the most common. In addition, post-vaccination thirst affected 18.9% of the participants with female predominance. Younger age, female sex, and diabetes mellitus were risk factors for AEs. Five patients had severe AEs, including fever (n = 1), herpes zoster (HZ) reactivation (n = 1), and acute VAT (n = 3). However, the SCCS analysis revealed no association between vaccination and VAT;the incidence rate ratio (IRR)-person ratio was 0.56 (95% CI 0.13-2.33) and 0.78 (95% CI 0.20-2.93) [IRR-event ratio 0.78 (95% CI 0.15-4.10) and 1.00 (95% CI 0.20-4.93)] in the 0-3 months and 3-6 months period prior to vaccination, respectively. CONCLUSIONS: Though some ESRD patients on HD had local and systemic AEs after first-dose vaccination, the clinical significance of these symptoms was minor. Our study confirmed the safety profile of ChAdOx1 nCoV-19 in HD patients and presented a new viewpoint on vaccine-related AEs. The SCCS analysis did not find an elevated risk of VAT at 1 month following vaccination. Apart from VAT, other vaccine-related AEs, irrespective of local or systemic symptoms, had minor clinical significance on safety issues. Nonetheless, further coordinated, multi-center, or registry-based studies are needed to establish the causality.

20.
Fluctuation and Noise Letters ; 2022.
Article in English | Scopus | ID: covidwho-2020348

ABSTRACT

This paper investigates the presence and asymmetry of cross-correlations between agricultural futures markets in China and the US as well as the impact of price support policies and public emergencies (Sino-US trade conflict and COVID-19 pandemic) on the cross-correlations by the multifractal methods. The results show that the fluctuation characteristics and conduction directions of cross-correlations are asymmetric. The price fluctuations of soybean and corn futures in China are easier to be affected by the US soybean and corn futures. We find that the cross-correlations are multifractal under different price support policies and pubic emergencies. The price support policies with greater interventions on soybean and corn prices have aggravated the complexity of cross-correlations between the two futures markets in China and the US. The soybean and corn futures in China are hardly correlated to the US futures under the dual effect of the Sino-US trade conflict and the COVID-19 pandemic. The Sino-US trade conflict strengthens the complexity of cross-correlation for soybean futures and weakens it for corn futures, while the COVID-19 pandemic enhances the complexity of cross-correlations for soybean and corn futures. In addition, the fat-tailed probability distributions in different price support policy and public emergency periods have a dominant influence on the multifractality of cross-correlations. © 2022 World Scientific Publishing Company.

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