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1.
Analytica Chimica Acta ; : 341378, 2023.
Article in English | ScienceDirect | ID: covidwho-20240124

ABSTRACT

The lack of enough diagnostic capacity to detect severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has been one of the major challenges in the control the 2019 COVID pandemic;this led to significant delay in prompt treatment of COVID-19 patients or accurately estimate disease situation. Current methods for the diagnosis of SARS-COV-2 infection on clinical specimens (e.g. nasal swabs) include polymerase chain reaction (PCR) based methods, such as real-time reverse transcription (rRT) PCR, real-time reverse transcription loop-mediated isothermal amplification (rRT-LAMP), and immunoassay based methods, such as rapid antigen test (RAT). These conventional PCR methods excel in sensitivity and specificity but require a laboratory setting and typically take up to six hours to obtain the results whereas RAT has a low sensitivity (typically at least 3000 TCID50/ml) although with the results with 15 mins. We have developed a robust micro-electro-mechanical system (MEMS) based impedance biosensor fit for rapid and accurate detection of SARS-COV-2 of clinical samples in the field with minimal training. The biosensor consisted of three regions that enabled concentrating, trapping, and sensing the virus present in low quantities with high selectivity and sensitivity in 40 minutes using an electrode coated with a specific SARS-COV-2 antibody cross-linker mixture. Changes in the impedance value due to the binding of the SARS-COV-2 antigen to the antibody will indicate positive or negative result. The testing results showed that the biosensor's limit of detection (LoD) for detection of inactivated SARS-COV-2 antigen in phosphate buffer saline (PBS) was as low as 50 TCID50/ml. The biosensor specificity was confirmed using the influenza virus while the selectivity was confirmed using influenza polyclonal sera. Overall, the results showed that the biosensor is able to detect SARS-COV-2 in clinical samples (swabs) in 40 min with a sensitivity of 26 TCID50/ml.

2.
Stroke Vasc Neurol ; 2023 Jun 09.
Article in English | MEDLINE | ID: covidwho-20245352

ABSTRACT

BACKGROUND: Unruptured intracranial aneurysm treatment aims to reduce the risk of aneurysm rupture and bleeding, relieves symptoms and improve the quality of life for patients. This study aimed to assess the safety and efficacy of Pipeline Embolization Device (PED, Covidien/Medtronic, Irvine, CA) treatment for intracranial aneurysms presenting with mass effect in real-world settings. METHODS: We selected patients from the PED in China Post-Market Multi-Center Registry Study with mass effect presentation. The study endpoints included postoperative mass effect deterioration and mass effect relief at follow-up (3-36 months). We conducted multivariate analysis to identify factors associated with mass effect relief. Subgroup analyses by aneurysm location, size and form were also performed. RESULTS: This study included 218 patients with a mean age of 54.3±11.8 years and a female predominance of 74.0% (162/218). The postoperative mass effect deterioration rate was 9.6% (21/218). During a median follow-up period of 8.4 months, the mass effect relief rate was 71.6% (156/218). Notably, immediate aneurysm occlusion following treatment was significantly associated with mass effect relief (OR 0.392, 95% CI, 0.170 to 0.907, p=0.029). Subgroup analysis demonstrated that adjunctive coiling contributed to mass effect relief in cavernous aneurysms, while dense embolism impeded symptom relief in aneurysms<10 mm and saccular aneurysms. CONCLUSIONS: Our data confirmed the efficacy of PED in relieving mass effect. The findings of this study provide support for endovascular treatment to alleviate mass effect in unruptured intracranial aneurysms. TRIAL REGISTRATION NUMBER: NCT03831672.

3.
Front Immunol ; 14: 1160048, 2023.
Article in English | MEDLINE | ID: covidwho-2327129

ABSTRACT

Background: Immune thrombocytopenia (ITP) is an autoimmune disease characterized by isolated thrombocytopenia. Recently, the pathophysiology and novel drugs of ITP have been the focus of researchers with plenty of publications emerging. Bibliometrics is the process of extracting measurable data through statistical analysis of published research studies to provide an insight into the trends and hotspots. Objective: This study aimed to provide an insight into developing trends and hotspots in the field of ITP by bibliometric analysis. Methods: By using three bibliometric mapping tools (bibliometrix R package, VOSviewer, CiteSpace), we summarized the overview information of retrieved publications, as well as the analysis of keyword co-occurrence and reference co-citation. Results: A total of 3299 publications with 78066 citations on ITP research were included in the analysis. The keyword co-occurrence network identified 4 clusters relating to the diagnosis, pathophysiology, and treatment of ITP respectively. Then the reference co-citation analysis produced 12 clusters with a well-structured and highly credible clustering model, and they can be divided into 5 trends: second-line treatment, chronic ITP, novel therapy and pathogenesis, COVID-19 vaccine. Treg cells, spleen tyrosine kinase, and mesenchymal stem cells were the latest hotspots with strong burstness. Conclusion: This bibliometric analysis provided a comprehensive insight into research hotspots and trends on ITP, which would enrich the review of the ITP research.


Subject(s)
COVID-19 , Purpura, Thrombocytopenic, Idiopathic , Thrombocytopenia , Humans , Purpura, Thrombocytopenic, Idiopathic/therapy , COVID-19 Vaccines , Bibliometrics
4.
Front Immunol ; 14: 1174223, 2023.
Article in English | MEDLINE | ID: covidwho-2327003

ABSTRACT

Monkeypox virus (MPXV) cases have increased dramatically worldwide since May 2022. The Atlanta Center for Disease Control and Prevention (Atlanta CDC) had reported a total of 85,922 cases as of February 20th, 2023. During the COVID-19 pandemic, MPXV has emerged as a potential public threat. MPXV transmission and prevalence must be closely monitored. In this comprehensive review, we explained the basic characteristics and transmission routes of MPXV, individuals susceptible to it, as well as highlight the impact of the behavior of men who have sex with men (MSM) and airline traveling on recent outbreaks of MPXV. We also describe the clinical implications, the prevention of MPXV, and clinical measures of viral detection.


Subject(s)
COVID-19 , Monkeypox , Sexual and Gender Minorities , Male , Humans , Monkeypox virus , Monkeypox/epidemiology , Homosexuality, Male , Pandemics , COVID-19/epidemiology
5.
Educ Inf Technol (Dordr) ; : 1-15, 2022 Nov 14.
Article in English | MEDLINE | ID: covidwho-2326997

ABSTRACT

Online learning emerged as a solution to continue with teaching and learning during the Coronavirus (COVID-19) pandemic. Nonetheless, teaching online consumes considerable time and put pressure on teachers' daily lives. Thus, the internal mechanism of preservice teachers' intention to teach online is analyzed in this study. Specifically, this study analyzed preservice teachers' intention to teach online in China and America to illuminate the internal mechanism of teachers' intention to teach online in different cultural backgrounds. One hundred seventy-six Chinese preservice teachers and two hundred forty-one American preservice teachers participated in this study. The confirmatory factor analysis supported that the Intention to Teach Online Scale was reliable in three constructs: online teaching attitude, perceived control, and subjective norm. The result demonstrates that there is a significant difference between Chinese and American preservice teachers' intention to teach online in the online teaching attitude and perceived control. In addition, it is supported that there is a significant difference between the effects of Chinese and American preservice teachers' teaching attitude, perceived control, and subjective norm on their intention to teach online. Moreover, there is a difference in the relationships among Chinese and American teachers' online teaching attitudes, perceived control, and subjective norm. The preservice teachers' demographic features can be factors that caused this difference. Research and practice implications of this study are proposed.

6.
Sci Total Environ ; 887: 164055, 2023 Aug 20.
Article in English | MEDLINE | ID: covidwho-2320305

ABSTRACT

Face masks are an indispensable low-cost public healthcare necessity for containing viral transmission. After the coronavirus disease (COVID-19) became a pandemic, there was an unprecedented demand for, and subsequent increase in face mask production and use, leading to global ecological challenges, including excessive resource consumption and significant environmental pollution. Here, we review the global demand volume for face masks and the associated energy consumption and pollution potential throughout their life cycle. First, the production and distribution processes consume petroleum-based raw materials and other energy sources and release greenhouse gases. Second, most methods of mask waste disposal result in secondary microplastic pollution and the release of toxic gases and organic substances. Third, face masks discarded in outdoor environments represent a new plastic pollutant and pose significant challenges to the environment and wildlife in various ecosystems. Therefore, the long-term impacts on environmental and wildlife health aspects related to the production, use, and disposal of face masks should be considered and urgently investigated. Here, we propose five reasonable countermeasures to alleviate these global-scale ecological crises induced by mask use during and following the COVID-19 pandemic era: increasing public awareness; improving mask waste management; innovating waste disposal methods; developing biodegradable masks; and formulating relevant policies and regulations. Implementation of these measures will help address the pollution caused by face masks.


Subject(s)
Animals, Wild , COVID-19 , Humans , Animals , Ecosystem , Masks , Pandemics , Plastics , Environmental Pollution
7.
Health Serv Insights ; 16: 11786329231166522, 2023.
Article in English | MEDLINE | ID: covidwho-2292899

ABSTRACT

Background: The COVID-19 pandemic changed care delivery. But the mechanisms of changes were less understood. Objectives: Examine the extent to which the volume and pattern of hospital discharge and patient composition contributed to the changes in post-acute care (PAC) utilization and outcomes during the pandemic. Research design: Retrospective cohort study. Medicare claims data on hospital discharges in a large healthcare system from March 2018 to December 2020. Subjects: Medicare fee-for-service beneficiaries, 65 years or older, hospitalized for non-COVID diagnoses. Measures: Hospital discharges to Home Health Agencies (HHA), Skilled Nursing Facilities (SNF), and Inpatient Rehabilitation Facilities (IRF) versus home. Thirty- and ninety-day mortality and readmission rates. Outcomes were compared before and during the pandemic with and without adjustment for patient characteristics and/or interactions with the pandemic onset. Results: During the pandemic, hospital discharges declined by 27%. Patients were more likely to be discharged to HHA (+4.6%, 95% CI [3.2%, 6.0%]) and less likely to be discharged to either SNF (-3.9%, CI [-5.2%, -2.7%]) or to home (-2.8% CI [-4.4%, -1.3%]). Thirty- and ninety-day mortality rates were significantly higher by 2% to 3% points post-pandemic. Readmission were not significantly different. Up to 15% of the changes in discharge patterns and 5% in mortality rates were attributable to patient characteristics. Conclusions: Shift in discharge locations were the main driver of changes in PAC utilization during the pandemic. Changes in patient characteristics explained only a small portion of changes in discharge patterns and were mainly channeled through general impacts rather than differentiated responses to the pandemic.

8.
Chinese Journal of Viral Diseases ; 12(5):385-389, 2022.
Article in Chinese | GIM | ID: covidwho-2301665

ABSTRACT

The COVID-19 pandemic continues to rage worldwide and the SARS-CoV-2 Omicron variant has now replaced the Delta variant as the leading epidemic strain. Omicron, as one of the SARS-COV-2 variants, incorporates the most critical mutations of the Alpha and Delta variants, and is characterized by having multiple mutation sites, high viral load, stronger infectivity and immune escape, which significantly reduced the protective effect of the vaccine. However, compared with the previous SARS-CoV-2 strains, the Omicron variant is less likely to infect lung tissue, it usually causes mild clinical symptom with reduced hospitalization rate, severe disease rate and fatality rate. Three doses of allogeneic vaccine can offer better tolerance and immunogenicity, and improve the protective effect of the vaccines. The application of small-molecule antiviral drugs and neutralizing antibodies can significantly reduce the hospitalization rate and mortality rate.In this paper, the epidemiological and characteristics of the Omicron variant were reviewed in order to provide reference for clinical diagnosis and treatment of the disease.

9.
Virus Res ; 328: 199075, 2023 04 15.
Article in English | MEDLINE | ID: covidwho-2255888

ABSTRACT

SARS-CoV-2, known as severe acute respiratory syndrome coronavirus 2, is causing a massive global public health dilemma. In particular, the outbreak of the Omicron variants of SARS-CoV-2 in several countries has aroused the great attention of the World Health Organization (WHO). As of February 1st, 2023, the WHO had counted 671,016,135 confirmed cases and 6,835,595 deaths worldwide. Despite effective vaccines and drug treatments, there is currently no way to completely and directly eliminate SARS-CoV-2. Moreover, frequent cases of SARS-CoV-2 infection in animals have also been reported. In this review, we suggest that SARS-CoV-2, as a zoonotic virus, may be frequently transmitted between animals and humans in the future, which provides a reference and warning for rational prevention and control of COVID-19.


Subject(s)
COVID-19 , SARS-CoV-2 , Animals , Humans , Disease Outbreaks , World Health Organization
10.
Proc Natl Acad Sci U S A ; 120(11): e2219523120, 2023 03 14.
Article in English | MEDLINE | ID: covidwho-2262238

ABSTRACT

The continuous evolution of SARS-CoV-2 variants complicates efforts to combat the ongoing pandemic, underscoring the need for a dynamic platform for the rapid development of pan-viral variant therapeutics. Oligonucleotide therapeutics are enhancing the treatment of numerous diseases with unprecedented potency, duration of effect, and safety. Through the systematic screening of hundreds of oligonucleotide sequences, we identified fully chemically stabilized siRNAs and ASOs that target regions of the SARS-CoV-2 genome conserved in all variants of concern, including delta and omicron. We successively evaluated candidates in cellular reporter assays, followed by viral inhibition in cell culture, with eventual testing of leads for in vivo antiviral activity in the lung. Previous attempts to deliver therapeutic oligonucleotides to the lung have met with only modest success. Here, we report the development of a platform for identifying and generating potent, chemically modified multimeric siRNAs bioavailable in the lung after local intranasal and intratracheal delivery. The optimized divalent siRNAs showed robust antiviral activity in human cells and mouse models of SARS-CoV-2 infection and represent a new paradigm for antiviral therapeutic development for current and future pandemics.


Subject(s)
COVID-19 , Humans , Animals , Mice , RNA, Small Interfering/genetics , COVID-19/therapy , SARS-CoV-2/genetics , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Oligonucleotides , Lung
11.
Can J Infect Dis Med Microbiol ; 2023: 5262117, 2023.
Article in English | MEDLINE | ID: covidwho-2268861

ABSTRACT

To describe the epidemiological characteristics and transmission dynamics of SARS-CoV-2 Omicron variant during "Dynamic Zero" period, we analyzed data on the 108 laboratory-confirmed SARS-CoV-2 cases during 14 to 30 May 2022 in Beichen district, Tianjin, China. We collected information on demographic characteristics, exposure history, and illness timelines of the 108 cases. We described characteristics of the patients and estimated the key epidemiological parameters, including serial interval and the time-dependent reproduction number of the Omicron variant, Rt. Among the 108 laboratory-confirmed patients, the median age was 38 years old, and 50.9% were females. Obvious symptoms were observed among 67.6% (73/108) of all cases, and major clinical manifestations included fever, sore throat, and cough, which occurred in 31.5%, 26.9%, and 19.4% of the 108 cases, respectively. The mean and standard deviation of the SI were estimated as 2.89 and 0.95 days, the Rt varied from 1.24 to 0.27 for a 7-day timelapse. The low reproduction number and the Omicron outbreak being suppressed within a short time marked the effectiveness of the implemented public health measures, such as nucleic acid screening, social distancing, masking, vaccination, medical treatment of patients, and isolation of close contacts. These measures play an important role in fulfilling the goal of controlling the spread of the disease.

12.
Front Immunol ; 13: 1066733, 2022.
Article in English | MEDLINE | ID: covidwho-2288033

ABSTRACT

COVID-19 often manifests with different outcomes in different patients, highlighting the complexity of the host-pathogen interactions involved in manifestations of the disease at the molecular and cellular levels. In this paper, we propose a set of postulates and a framework for systematically understanding complex molecular host-pathogen interaction networks. Specifically, we first propose four host-pathogen interaction (HPI) postulates as the basis for understanding molecular and cellular host-pathogen interactions and their relations to disease outcomes. These four postulates cover the evolutionary dispositions involved in HPIs, the dynamic nature of HPI outcomes, roles that HPI components may occupy leading to such outcomes, and HPI checkpoints that are critical for specific disease outcomes. Based on these postulates, an HPI Postulate and Ontology (HPIPO) framework is proposed to apply interoperable ontologies to systematically model and represent various granular details and knowledge within the scope of the HPI postulates, in a way that will support AI-ready data standardization, sharing, integration, and analysis. As a demonstration, the HPI postulates and the HPIPO framework were applied to study COVID-19 with the Coronavirus Infectious Disease Ontology (CIDO), leading to a novel approach to rational design of drug/vaccine cocktails aimed at interrupting processes occurring at critical host-coronavirus interaction checkpoints. Furthermore, the host-coronavirus protein-protein interactions (PPIs) relevant to COVID-19 were predicted and evaluated based on prior knowledge of curated PPIs and domain-domain interactions, and how such studies can be further explored with the HPI postulates and the HPIPO framework is discussed.


Subject(s)
COVID-19 , Humans , Host-Pathogen Interactions
13.
Chin Med J (Engl) ; 136(2): 207-212, 2023 Jan 20.
Article in English | MEDLINE | ID: covidwho-2287872

ABSTRACT

BACKGROUND: Vaccination against coronavirus disease 2019 (COVID-19) has become the primary approach in the fight against the spread of COVID-19. Studies have shown that vaccination against COVID-19 has adverse effects, particularly on human reproductive health, despite the fact that vaccination rates are still on the rise. However, few studies have reported whether vaccination affects the outcome of in vitro fertilization-embryo transfer (IVF-ET) or not. In this study, we compared the outcome of IVF-ET and the development of follicles and embryos between vaccinated and unvaccinated groups. METHODS: A single-center retrospective cohort study of 10,541 in vitro fertilization (IVF) cycles was conducted from June 2020 to August 2021. 835 IVF cycles with a history of vaccination against COVID-19 and 1670 IVF cycles that served as negative controls were selected and analyzed utilizing the Matchlt package of R software ( http://www.R-project.org/ ) and the nearest neighbor matching algorithm for propensity-matched analysis at a 1:2 ratio. RESULTS: The number of oocytes collected in the vaccinated group and the unvaccinated group were 8.00 (0, 40.00) and 9.00 (0, 77.00) ( P  = 0.073) and the good-quality embryo rates of the two groups were 0.56±0.32 and 0.56±0.31 averagely ( P  = 0.964). Clinical pregnancy rates for the vaccinated group and unvaccinated group were 42.4% (155/366) and 40.2% (328/816) ( P  = 0.486) and biochemical pregnancy rates were 7.1% (26/366) and 8.7% (71/816) ( P  = 0.355). Two other factors were analyzed in this study; vaccination among different genders and different types (inactivated vaccine or recombinant adenovirus vaccine) showed no statistically significant effect on the above outcomes. CONCLUSIONS: In our findings, vaccination against COVID-19 showed no statistically significant effect on the outcomes of IVF-ET and the development of follicles and embryos, nor did the gender of the vaccinated person or the formulation of vaccines show significant effects.


Subject(s)
COVID-19 , Pregnancy , Humans , Female , Male , Retrospective Studies , COVID-19/prevention & control , Embryo Transfer , Fertilization in Vitro , Pregnancy Rate , Vaccination
14.
mBio ; 14(2): e0362122, 2023 04 25.
Article in English | MEDLINE | ID: covidwho-2286249

ABSTRACT

Millions of Norway rats (Rattus norvegicus) inhabit New York City (NYC), presenting the potential for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from humans to rats. We evaluated SARS-CoV-2 exposure among 79 rats captured from NYC during the fall of 2021. Our results showed that 13 of the 79 rats (16.5%) tested IgG- or IgM-positive, and partial SARS-CoV-2 genomes were recovered from all 4 rats that were qRT-PCR (reverse transcription-quantitative PCR)-positive. Genomic analyses suggest these viruses were associated with genetic lineage B, which was predominant in NYC in the spring of 2020 during the early pandemic period. To further investigate rat susceptibility to SARS-CoV-2 variants, we conducted a virus challenge study and showed that Alpha, Delta, and Omicron variants can cause infections in wild-type Sprague Dawley (SD) rats, including high replication levels in the upper and lower respiratory tracts and induction of both innate and adaptive immune responses. Additionally, the Delta variant resulted in the highest infectivity. In summary, our results indicate that rats are susceptible to infection with Alpha, Delta, and Omicron variants, and wild Norway rats in the NYC municipal sewer systems have been exposed to SARS-CoV-2. Our findings highlight the need for further monitoring of SARS-CoV-2 in urban rat populations and for evaluating the potential risk of secondary zoonotic transmission from these rat populations back to humans. IMPORTANCE The host tropism expansion of SARS-CoV-2 raises concern for the potential risk of reverse-zoonotic transmission of emerging variants into rodent species, including wild rat species. In this study, we present both genetic and serological evidence for SARS-CoV-2 exposure to the New York City wild rat population, and these viruses may be linked to the viruses that were circulating during the early stages of the pandemic. We also demonstrated that rats are susceptible to additional variants (i.e., Alpha, Delta, and Omicron) that have been predominant in humans and that susceptibility to infection varies by variant. Our findings highlight the reverse zoonosis of SARS-CoV-2 to urban rats and the need for further monitoring of SARS-CoV-2 in rat populations for potential secondary zoonotic transmission to humans.


Subject(s)
COVID-19 , Humans , Rats , Animals , Rats, Sprague-Dawley , New York City/epidemiology , SARS-CoV-2/genetics
15.
J Gen Intern Med ; 38(8): 1887-1893, 2023 Jun.
Article in English | MEDLINE | ID: covidwho-2286222

ABSTRACT

BACKGROUND: In response to the declining utilization and patient revenue due to the COVID-19 pandemic, the U.S. hospital industry furloughed at least 1.4 million health care workers to contain their clinical-related expenses. However, it remains unclear how hospitals responded by adjusting their administrative expenses, which account for more than a quarter of U.S. hospitals' spending, a proportion substantially higher than that of other industrialized countries. Examining changes in hospitals' administrative expenses during the COVID-19 pandemic is important for understanding hospitals' cost-containment behaviors under operational shocks during a pandemic. OBJECTIVE: To assess changes in hospitals' administrative expenses and clinical expenses during the COVID-19 pandemic in 2020. DESIGN: Time-series observational study. PARTICIPANTS: 1420 Medicare-certified general acute-care hospitals with fiscal years starting in January and continuously operating during 2016-2020. MAIN MEASURES: Hospitals' annual administrative expenses and clinical expenses. KEY RESULTS: Hospitals' median administrative and clinical expenses both increased consistently around 4% each year from 2016 to 2019. From 2019 to 2020, the median administrative expenses grew by 6.2% while the median clinical expenses grew by 0.6%. The interrupted time-series regression estimated an additional 6.4% (95% CI, 4.5 to 8.2%) increase in administrative expenses in 2020, relative to the pre-COVID annual increase of 3.9% (95% CI, 3.3 to 4.4%), while an additional increase in clinical expenses in 2020 (0.5%; 95% CI, -0.3 to 1.4%) did not differ from the pre-COVID annual increase of 3.7% (95% CI, 3.5 to 4%). Stratified analysis showed hospitals with larger utilization volume, located in states with lower COVID-19 burden, or situated in counties with higher median household income experienced larger increase in administrative expenses in 2020. CONCLUSIONS: In 2020, administrative expenses grew much faster than clinical expenses, resulting in a larger share of hospital financial resources allocated to administrative activities. Higher administrative expenses might reflect hospitals' operational effort in response to the pandemic or inefficient cost management.


Subject(s)
COVID-19 , Medicare , Aged , Humans , United States/epidemiology , Pandemics , COVID-19/epidemiology , Hospitals , Cost Control
16.
Comput Struct Biotechnol J ; 20: 6120-6137, 2022.
Article in English | MEDLINE | ID: covidwho-2278651

ABSTRACT

The International Society of RNA Nanotechnology and Nanomedicine (ISRNN) serves to further the development of a wide variety of functional nucleic acids and other related nanotechnology platforms. To aid in the dissemination of the most recent advancements, a biennial discussion focused on biomotors, viral assembly, and RNA nanobiotechnology has been established where international experts in interdisciplinary fields such as structural biology, biophysical chemistry, nanotechnology, cell and cancer biology, and pharmacology share their latest accomplishments and future perspectives. The results summarized here highlight advancements in our understanding of viral biology and the structure-function relationship of frame-shifting elements in genomic viral RNA, improvements in the predictions of SHAPE analysis of 3D RNA structures, and the understanding of dynamic RNA structures through a variety of experimental and computational means. Additionally, recent advances in the drug delivery, vaccine design, nanopore technologies, biomotor and biomachine development, DNA packaging, RNA nanotechnology, and drug delivery are included in this critical review. We emphasize some of the novel accomplishments, major discussion topics, and present current challenges and perspectives of these emerging fields.

17.
Anal Bioanal Chem ; 414(9): 2841-2881, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-2286262

ABSTRACT

Antigenic characterization of emerging and re-emerging viruses is necessary for the prevention of and response to outbreaks, evaluation of infection mechanisms, understanding of virus evolution, and selection of strains for vaccine development. Primary analytic methods, including enzyme-linked immunosorbent/lectin assays, hemagglutination inhibition, neuraminidase inhibition, micro-neutralization assays, and antigenic cartography, have been widely used in the field of influenza research. These techniques have been improved upon over time for increased analytical capacity, and some have been mobilized for the rapid characterization of the SARS-CoV-2 virus as well as its variants, facilitating the development of highly effective vaccines within 1 year of the initially reported outbreak. While great strides have been made for evaluating the antigenic properties of these viruses, multiple challenges prevent efficient vaccine strain selection and accurate assessment. For influenza, these barriers include the requirement for a large virus quantity to perform the assays, more than what can typically be provided by the clinical samples alone, cell- or egg-adapted mutations that can cause antigenic mismatch between the vaccine strain and circulating viruses, and up to a 6-month duration of vaccine development after vaccine strain selection, which allows viruses to continue evolving with potential for antigenic drift and, thus, antigenic mismatch between the vaccine strain and the emerging epidemic strain. SARS-CoV-2 characterization has faced similar challenges with the additional barrier of the need for facilities with high biosafety levels due to its infectious nature. In this study, we review the primary analytic methods used for antigenic characterization of influenza and SARS-CoV-2 and discuss the barriers of these methods and current developments for addressing these challenges.


Subject(s)
COVID-19 , Influenza Vaccines , Influenza, Human , Antigens, Viral , Hemagglutinin Glycoproteins, Influenza Virus , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , SARS-CoV-2
18.
JAMA Health Forum ; 3(5): e221018, 2022 05.
Article in English | MEDLINE | ID: covidwho-2286221

ABSTRACT

Importance: The COVID-19 pandemic has had a negative association with hospital operations. To help health care facilities and clinicians stay financially viable during the COVID-19 pandemic, Congress provided $175 billion in subsidies. It remains unclear how much financial losses hospitals incurred owing to operational disruptions during the COVID-19 pandemic and whether subsidies were sufficient to offset the financial losses. Objective: To assess changes in the operational financial performance and overall financial viability of hospitals during the COVID-19 pandemic. Design Setting and Participants: This cross-sectional study included 1378 US hospitals whose fiscal years began in January and 785 hospitals whose fiscal years began in July (all with continuous observations from 2016 through 2020). RAND Hospital Data, a compiled and processed version of Medicare Cost Reports, were used. The data were analyzed on March 12, 2022. Exposures: The operational disruptions experienced and relief funds received by US hospitals during the COVID-19 pandemic. Main Outcomes and Measures: A hospital's annual operating margin, overall profit margin, and other nonoperating income as a share of total revenue from January 2016 to December 2020. Results: Among the 1378 hospitals with fiscal years beginning in January, the mean operating margin declined from -1.0% (95% CI,-1.9% to -0.1%) in 2019 to -7.4% (95% CI, -8.5% to -6.3%) in 2020. The mean share of other nonoperating income grew from 4.4% (95% CI, 4% to 4.7%) in 2019 to 10.3% (95% CI, 9.9% to 10.8%) in 2020. The mean overall profit in 2020 (6.7%; 95% CI, 5.4% to 8.1%) remained as stable as prior years. Government, rural, and smaller hospitals showed higher mean overall profit margins in 2020 than in 2019 (7.2% vs 3.7%, 7.5% vs 1.9%, and 6.7% vs 3.5%, respectively). These results remained consistent when hospitals whose fiscal years began in July were examined. Conclusions and Relevance: The results of this cross-sectional study suggest that although hospitals experienced a sizeable reduction in operating margins in 2020, their overall profit margins remained similar to those in prior years, suggesting that the COVID-19 relief fund effectively offset the financial losses for hospitals during the COVID-19 pandemic. Government, rural, and smaller hospitals, which were supported by some targeted fund allocations, generated higher overall profit margins during 2020 than in prior years.


Subject(s)
COVID-19 , Aged , COVID-19/epidemiology , Cross-Sectional Studies , Hospitals, Private , Humans , Medicare , Pandemics , United States/epidemiology
19.
Emerg Microbes Infect ; : 1-30, 2022 Nov 18.
Article in English | MEDLINE | ID: covidwho-2246462

ABSTRACT

BACKGROUND: : It is critical to determine the real-world performance of vaccines against coronavirus disease 2019 (COVID-19) so that appropriate treatments and policies can be implemented. There was a rapid wave of infections by the Omicron variant in Jilin Province (China) during spring 2022. We examined the effectiveness of inactivated vaccines against Omicron using real-world data from this epidemic. METHODS: . This retrospective case-case study of vaccine effectiveness (VE) examined infected patients who were quarantined and treated from April 16 to June 8, 2022 and responded to an electronic questionnaire. Data were analyzed by univariable and multivariable analyses. RESULTS: . A total of 2968 cases with SARS-CoV-2 infections (asymptomatic: 1029, mild disease: 1858, pneumonia: 108, severe disease: 21) were enrolled in the study. Multivariable regression indicated that the risk for pneumonia or severe disease was greater in those who were older or had underlying diseases, but was less in those who received COVID-19 vaccines. Relative to no vaccination, VE against the composite of pneumonia and severe disease was significant for those who received 2 doses (60.1%, 95%CI: 40.0%, 73.5%) or 3 doses (68.1%, 95%CI: 44.6%, 81.7%), and VE was similar in the subgroups of males and females. However, VE against the composite of all three classes of symptomatic diseases was not significant overall, nor after stratification by sex. There was no statistical difference in the VE of vaccines from different manufacturers. CONCLUSION: . The inactivated COVID-19 vaccines protected patients against pneumonia and severe disease from Omicron infection, and booster vaccination enhanced this effect.

20.
J Infect Dis ; 2022 Oct 31.
Article in English | MEDLINE | ID: covidwho-2228160

ABSTRACT

BACKGROUND: Evaluating the performance of SARS-CoV-2 serological assays and clearly articulating the utility of selected antigen, isotypes and thresholds is crucial to understanding the prevalence of infection within selected communities. METHODS: This cross-sectional study, implemented in 2020, screened PCR-confirmed COVID-19 patients (n = 86), banked pre-pandemic and negative donors (n = 96), health care workers and family members (n = 552), and university employees (n = 327) for anti-SARS-CoV-2 receptor-binding domain (RBD), trimeric spike protein (S), and nucleocapsid protein (N) IgG and IgA antibodies with a laboratory developed Enzyme-Linked Immunosorbent Assay (ELISA) and tested how antigen, isotype and threshold choices affected the seroprevalence. The following threshold methods were evaluated: (i) mean + 3 standard deviations of the negative controls; (ii) 100% specificity for each antigen/isotype combination; and (iii) the maximal Youden index. RESULTS: We found vastly different seroprevalence estimates depending on selected antigens, isotypes and the applied threshold method, ranging from 0.0% to 85.4% . Subsequently, we maximized specificity and reported a seroprevalence, based on more than one antigen, ranging from 9.3% to 25.9%. CONCLUSIONS: This study revealed the importance of evaluating serosurvey tools for antigen, isotype, and threshold-specific sensitivity and specificity, in order to interpret qualitative serosurvey outcomes reliably and consistently across studies.

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