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1.
Mathematics ; 10(13):2234, 2022.
Article in English | ProQuest Central | ID: covidwho-1934163

ABSTRACT

With the development of the Internet and big data, more and more consumer behavior data are used in different forecasting problems, which greatly improve the performance of prediction. As the main travel tool, the sales of automobiles will change with the variations of the market and the external environment. Accurate prediction of automobile sales can not only help the dealers adjust their marketing plans dynamically but can also help the economy and the transportation sector make policy decisions. The automobile is a product with high value and high involvement, and its purchase decision can be affected by its own attributes, economy, policy and other factors. Furthermore, the sample data have the characteristics of various sources, great complexity and large volatility. Therefore, this paper uses the Support Vector Regression (SVR) model, which has global optimization, a simple structure, and strong generalization abilities and is suitable for multi-dimensional, small sample data to predict the monthly sales of automobiles. In addition, the parameters are optimized by the Grey Wolf Optimizer (GWO) algorithm to improve the prediction accuracy. First, the grey correlation analysis method is used to analyze and determine the factors that affect automobile sales. Second, it is used to build the GWO-SVR automobile sales prediction model. Third, the experimental analysis is carried out by using the data from Suteng and Kaluola in the Chinese car segment, and the proposed model is compared with the other four commonly used methods. The results show that the GWO-SVR model has the best performance of mean absolute percentage error (MAPE) and root mean square error (RMSE). Finally, some management implications are put forward for reference.

2.
Emerg Infect Dis ; 28(7): 1442-1445, 2022 07.
Article in English | MEDLINE | ID: covidwho-1917186

ABSTRACT

To detect new and changing SARS-CoV-2 variants, we investigated candidate Delta-Omicron recombinant genomes from Centers for Disease Control and Prevention national genomic surveillance. Laboratory and bioinformatic investigations identified and validated 9 genetically related SARS-CoV-2 viruses with a hybrid Delta-Omicron spike protein.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , Computational Biology , Humans , SARS-CoV-2/genetics , United States/epidemiology
3.
Lancet Respir Med ; 10(8): 739-748, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1852285

ABSTRACT

BACKGROUND: Due to waning immunity and protection against infection with SARS-CoV-2, a third dose of a homologous or heterologous COVID-19 vaccine has been proposed by health agencies for individuals who were previously primed with two doses of an inactivated COVID-19 vaccine. METHODS: We did a randomised, open-label, controlled trial to evaluate the safety and immunogenicity of heterologous boost immunisation with an orally administered aerosolised adenovirus type-5 vector-based COVID-19 vaccine (Ad5-nCoV) in Chinese adults (≥18 years old) who had previously received two doses of an inactivated SARS-CoV-2 vaccine-Sinovac CoronaVac. Eligible participants were randomly assigned (1:1:1) to receive a heterologous booster vaccination with a low dose (1·0 × 1011 viral particles per mL; 0·1 mL; low dose group), or a high dose (1·0 × 1011 viral particles per mL; 0·2 mL; high dose group) aerosolised Ad5-nCoV, or a homologous intramuscular vaccination with CoronaVac (0·5 mL). Only laboratory staff were masked to group assignment. The primary endpoint for safety was the incidence of adverse reactions within 14 days after the booster dose. The primary endpoint for immunogenicity was the geometric mean titres (GMTs) of serum neutralising antibodies (NAbs) against live SARS-CoV-2 virus 14 days after the booster dose. This study was registered with ClinicalTrials.gov, NCT05043259. FINDINGS: Between Sept 14 and 16, 2021, 420 participants were enrolled: 140 (33%) participants per group. Adverse reactions were reported by 26 (19%) participants in the low dose group and 33 (24%) in the high dose group within 14 days after the booster vaccination, significantly less than the 54 (39%) participants in the CoronaVac group (p<0·0001). The low dose group had a serum NAb GMT of 744·4 (95% CI 520·1-1065·6) and the high dose group had a GMT of 714·1 (479·4-1063·7) 14 days after booster dose, significantly higher than the GMT in the CoronaVac group (78·5 [60·5-101·7]; p<0·0001). INTERPRETATION: We found that a heterologous booster vaccine with an orally administered aerosolised Ad5-nCoV is safe and highly immunogenic in adults who have previously received two doses of CoronaVac as the primary series vaccination. FUNDING: National Natural Science Foundation of China and Jiangsu Provincial Key Research and Development Program.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , Adult , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Research , SARS-CoV-2 , Vaccination
4.
IEEE Signal Processing Letters ; 29:1147-1151, 2022.
Article in English | ProQuest Central | ID: covidwho-1840273

ABSTRACT

The COVID-19 pandemic makes wearing masks mandatory in supermarkets, pharmacies, public transport, etc. Existing facial recognition systems encounter severe performance degradation as the masks occlude key facial regions. Recently, simulation-based methods are proposed to generate masked faces from unmasked faces. However, among simulated faces, there are low-quality samples with negative occlusion, which leads to ambiguous or absent facial features. In this paper, we propose a consistent sub-decision network to obtain sub-decisions that correspond to different facial regions and constrain sub-decisions by weighted bidirectional KL divergence to make the network concentrate on the upper faces without occlusion. In addition, we perform knowledge distillation to drive the masked face embeddings towards an approximation of the original data distribution to mitigate the information loss. Experiments show that the proposed method performs better than the baseline on public masked face recognition datasets, i.e., RMFD, MFR2, and MLFW.

5.
J Infect Public Health ; 15(5): 499-507, 2022 May.
Article in English | MEDLINE | ID: covidwho-1814756

ABSTRACT

BACKGROUND: Critical questions remain regarding the need for intensity to continue NPIs as the public was vaccinated. We evaluated the association of intensity and duration of non-pharmaceutical interventions (NPIs) and vaccines with COVID-19 infection, death, and excess mortality in Europe. METHODS: Data comes from Our Word in Data. We included 22 European countries from January 20, 2020, to May 30, 2021. The time-varying constrained distribution lag model was used in each country to estimate the impact of different intensities and duration of NPIs on COVID-19 control, considering vaccination coverage. Country-specific effects were pooled through meta-analysis. RESULTS: This study found that high-intensity and long-duration of NPIs showed a positive main effect on reducing infection in the absence of vaccines, especially in the intensity above the 80th percentile and lasted for 7 days (RR = 0.93, 95% CI: 0.89-0.98). However, the adverse effect on excess mortality also increased with the duration and intensity. Specifically, it was associated with an increase of 44.16% (RR = 1.44, 95% CI: 1.27-1.64) in the excess mortality under the strict intervention (the intensity above the 80th percentile and lasted for 21 days). As the vaccine rollouts, the inhibition of the strict intervention on cases growth rate was increased (RR dropped from 0.95 to 0.87). Simultaneously, vaccination also alleviated the negative impact of the strict intervention on excess mortality (RR decreased from 1.44 to 1.25). Besides, maintaining the strict intervention appeared to more reduce the cases, as well as avoids more overall burden of death compared with weak intervention. CONCLUSIONS: Our study highlights the importance of continued high-intensity NPIs in low vaccine coverage. Lifting of NPIs in insufficient vaccination coverage may cause increased infections and death burden. Policymakers should coordinate the intensity and duration of NPIs and allocate medical resources reasonably with widespread vaccination.


Subject(s)
COVID-19 , Vaccines , COVID-19/prevention & control , Europe/epidemiology , Humans , SARS-CoV-2 , Vaccination
6.
Front Psychol ; 13: 779217, 2022.
Article in English | MEDLINE | ID: covidwho-1775765

ABSTRACT

During the COVID-19 pandemic, online education has become an important approach to learning in the information era and an important research topic in the field of educational technology as well as that of education in general. Teacher-student interaction in online education is an important factor affecting students' learning performance. This study employed a questionnaire survey to explore the influence of teacher-student interaction on learning effects in online education as well as the mediating role of psychological atmosphere and learning engagement. The study involved 398 college students studying at Chinese universities as the research object. Participants filled out a self-report questionnaire. The study found that (1) the level of teacher-student interaction positively affected students' learning effects (r = 0.649, p < 0.01). (2) The psychological atmosphere mediated the positive effect of the level of teacher-student interaction on learning effects with mediating effect value of 0.1248. (3) Learning engagement mediated the positive effect of teacher-student interaction on learning effects with a mediating effect value of 0.1539. (4) The psychological atmosphere and learning engagement play a chain-mediating role in the mechanism of teacher-student interaction affecting students' learning effects; that is, teacher-student interaction promotes students' learning engagement by creating a good psychological atmosphere, which, in turn, influences learning effects. The mediating effect value was 0.0403. The results indicate that teacher-student interaction not only directly affects students' learning effects but also influences students' learning effects through the mediating effect of the psychological atmosphere and learning engagement.

7.
Int J Qual Health Care ; 34(2)2022 04 11.
Article in English | MEDLINE | ID: covidwho-1764598
9.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-330917

ABSTRACT

Recombination between SARS-CoV-2 virus variants can result in different viral properties (e.g., infectiousness or pathogenicity). In this report, we describe viruses with recombinant genomes containing signature mutations from Delta and Omicron variants. These genomes are the first evidence for a Delta-Omicron hybrid Spike protein in the United States.

10.
Preprint in English | bioRxiv | ID: ppbiorxiv-484981

ABSTRACT

Recombination between SARS-CoV-2 virus variants can result in different viral properties (e.g., infectiousness or pathogenicity). In this report, we describe viruses with recombinant genomes containing signature mutations from Delta and Omicron variants. These genomes are the first evidence for a Delta-Omicron hybrid Spike protein in the United States.

11.
Environ Pollut ; 301: 119027, 2022 May 15.
Article in English | MEDLINE | ID: covidwho-1700515

ABSTRACT

During the COVID-19 lockdown, atmospheric PM2.5 in the Pearl River Delta (PRD) showed the highest reduction in China, but the reasons, being a critical question for future air quality policy design, are not yet clear. In this study, we analyzed the relationships among gaseous precursors, secondary aerosols and atmospheric oxidation capacity in Shenzhen, a megacity in the PRD, during the lockdown period in 2020 and the same period in 2021. The comprehensive observational datasets showed large lockdown declines in all primary and secondary pollutants (including O3). We found that, however, the daytime concentrations of secondary aerosols during the lockdown period and normal period were rather similar when the corresponding odd oxygen (Ox≡O3+NO2, an indicator of photochemical processing avoiding the titration effect of O3 by freshly emitted NO) were at similar levels. Therefore, reduced Ox, rather than the large reduction in precursors, was a direct driver to achieve the decline in secondary aerosols. Moreover, Ox was also found to determine the spatial distribution of intercity PM2.5 levels in winter PRD. Thus, an effective strategy for winter PM2.5 mitigation should emphasize on control of winter O3 formation in the PRD and other regions with similar conditions.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Ozone , Air Pollutants/analysis , Air Pollution/analysis , China , Communicable Disease Control , Environmental Monitoring , Humans , Ozone/analysis , Particulate Matter/analysis
12.
Stem Cell Reports ; 17(3): 538-555, 2022 03 08.
Article in English | MEDLINE | ID: covidwho-1692861

ABSTRACT

To date, the direct causative mechanism of SARS-CoV-2-induced endotheliitis remains unclear. Here, we report that human ECs barely express surface ACE2, and ECs express less intracellular ACE2 than non-ECs of the lungs. We ectopically expressed ACE2 in hESC-ECs to model SARS-CoV-2 infection. ACE2-deficient ECs are resistant to the infection but are more activated than ACE2-expressing ones. The virus directly induces endothelial activation by increasing monocyte adhesion, NO production, and enhanced phosphorylation of p38 mitogen-associated protein kinase (MAPK), NF-κB, and eNOS in ACE2-expressing and -deficient ECs. ACE2-deficient ECs respond to SARS-CoV-2 through TLR4 as treatment with its antagonist inhibits p38 MAPK/NF-κB/ interleukin-1ß (IL-1ß) activation after viral exposure. Genome-wide, single-cell RNA-seq analyses further confirm activation of the TLR4/MAPK14/RELA/IL-1ß axis in circulating ECs of mild and severe COVID-19 patients. Circulating ECs could serve as biomarkers for indicating patients with endotheliitis. Together, our findings support a direct role for SARS-CoV-2 in mediating endothelial inflammation in an ACE2-dependent or -independent manner.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , Models, Biological , SARS-CoV-2/physiology , Toll-Like Receptor 4/metabolism , Angiotensin-Converting Enzyme 2/genetics , COVID-19/pathology , COVID-19/virology , Endothelial Cells/cytology , Endothelial Cells/metabolism , Gene Expression Profiling , Human Umbilical Vein Endothelial Cells , Humans , Interleukin-1beta/genetics , Interleukin-1beta/metabolism , NF-kappa B/antagonists & inhibitors , NF-kappa B/genetics , NF-kappa B/metabolism , Pluripotent Stem Cells/cytology , Pluripotent Stem Cells/metabolism , SARS-CoV-2/isolation & purification , Severity of Illness Index , Single-Cell Analysis , Toll-Like Receptor 4/antagonists & inhibitors , Toll-Like Receptor 4/genetics , p38 Mitogen-Activated Protein Kinases/antagonists & inhibitors , p38 Mitogen-Activated Protein Kinases/genetics , p38 Mitogen-Activated Protein Kinases/metabolism
13.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-309723

ABSTRACT

Background: Non-suicidal self-injury (NSSI) in psychiatric hospitalized adolescents keeps growing after the outbreak of COVID-19. This study aims to explore the relationship between the pandemic and the NSSI among adolescents, focusing on the underlying reasons. Methods: : Through the retrospective analysis of medical record data retrieved from the electronic medical record system from January 2016 to March 2021, 609 medical records of adolescents were obtained. The main potential influencing factors were determined by the method of inductive content analysis. Results: : Among the 609 adolescents, 420 subjects had NSSI, while 189 did not. We found the percentage of NSSI adolescents in 2016 was only 29.2% (7/24), reaching 34.5% (29/55) in 2017, 45.7% (42/92) in 2018, 61.3% (76/124) in 2019, 92.5% (196/212) in 2020, and 95.9% (70/73) in 2021. In the Binary logistic regression model, gender (OR=0.075), age (OR=1.215), single parent (OR=7.751) , experienced trauma (OR=2.214), social isolation (OR=8.313), body bully (OR=3.116), mobile phone overused (OR=4.199), committed suicide (OR=9.276), and before/after pandemic (OR=5.421) were significantly associated with NSSI. When comparing the differences in influencing factors between the pre-pandemic and the post-pandemic group, the results showed that experiencing trauma and suffering body bullying played less role in the appearance of NSSI, while the family constitution, relationship with parents, mobile phone use, and stressful learning have become the important factors. Conclusions: : The pandemic has increased the risk of NSSI among adolescents and changed the influencing factors of this behavior. Tailored intervention gearing toward the changed risk factors should be formulated.

14.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325195

ABSTRACT

Background: COVID-19 is a globally emerging infectious disease. As the global epidemic continues to spread, the risk of COVID-19 transmission and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia from Wuhan. Methods: : Patients with COVID-19 pneumonia admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models. Results: : 106 (61.3%) of the patients were female. The mean age of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension (24.9%). The most common symptoms on admission were fever (67.6%) and cough (60.1%), digestive symptoms (22.0%) was also very common. Older age (OR: 3.420;95%Cl: 1.415-8.266;P=0.006), diarrhea (OR: 0.143;95%Cl: 0.033-0.611;P=0.009) and lymphopenia (OR: 4.769;95%Cl: 2.019-11.266;P=0.000) were associated with severe illness on admission;the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918;P=0.000). Older age (OR: 0.309;95%Cl: 0.142-0.674;P=0.003), leucopenia (OR: 0.165;95%Cl: 0.034-0.793;P=0.025), increased lactic dehydrogenase (OR: 0.257;95%Cl: 0.100-0.659;P=0.005) and interleukins-6 levels (OR: 0.294;95%Cl: 0.099-0.872;P=0.027) were associated with poor in-hospital outcome;AUC of predictive model were 0.752 (95%CI: 0.681-0.824;P=0.000). Conclusion: Older patients with diarrhea and lymphopenia need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome. Trial registration: ChiCTR2000029549

15.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323885

ABSTRACT

Objective: To conduct a meta-analysis of current studies that examined sex differences in severity and mortality in patients with COVID-19, and identify potential mechanisms underpinning these differences. Methods: We performed a systematic review to collate data from observational studies examining associations of sex differences with clinical outcomes of COVID-19. PubMed, Web of Science and four preprint servers were searched for relevant studies. Data were extracted and analyzed using meta-analysis where possible, with summary data presented otherwise. Publicly available bulk RNA sequencing (RNA-seq), single-cell RNA sequencing (scRNA-seq), and chromatin immunoprecipitation sequencing (ChIP-seq) data were analyzed to explore the potential mechanisms underlying the observed association. Results: 39 studies met inclusion criteria, representing 77932 patients, of which 41510 (53.3%) were males. Men were at a markedly increased risk of developing severe cases compared with women. Furthermore, the pooled odds ratio (OR) of mortality for male group compared with the female group indicated significant higher mortality rate for male. Data from scRNA-seq suggest that men have a higher amount of ACE2-expressing pulmonary alveolar type II cells than women. Sex-based immunological differences exist. The expression of androgen receptor (AR) is positively correlated with ACE2, and there is evidence that AR may directly regulate the expression of ACE2. Conclusions: This meta-analysis detected an increased severity and mortality rate in the male populations with COVID-19, which might be attributable to the sex-based differences in cellular compositions and immunological microenvironments of the lung. The host cell receptor ACE2 is likely regulated by AR signaling pathway, which is identified as a potential target for prevention and treatment of SARS-Cov-2 infections in men.

16.
MMWR Morb Mortal Wkly Rep ; 71(6): 206-211, 2022 02 11.
Article in English | MEDLINE | ID: covidwho-1687588

ABSTRACT

Genomic surveillance is a critical tool for tracking emerging variants of SARS-CoV-2 (the virus that causes COVID-19), which can exhibit characteristics that potentially affect public health and clinical interventions, including increased transmissibility, illness severity, and capacity for immune escape. During June 2021-January 2022, CDC expanded genomic surveillance data sources to incorporate sequence data from public repositories to produce weighted estimates of variant proportions at the jurisdiction level and refined analytic methods to enhance the timeliness and accuracy of national and regional variant proportion estimates. These changes also allowed for more comprehensive variant proportion estimation at the jurisdictional level (i.e., U.S. state, district, territory, and freely associated state). The data in this report are a summary of findings of recent proportions of circulating variants that are updated weekly on CDC's COVID Data Tracker website to enable timely public health action.† The SARS-CoV-2 Delta (B.1.617.2 and AY sublineages) variant rose from 1% to >50% of viral lineages circulating nationally during 8 weeks, from May 1-June 26, 2021. Delta-associated infections remained predominant until being rapidly overtaken by infections associated with the Omicron (B.1.1.529 and BA sublineages) variant in December 2021, when Omicron increased from 1% to >50% of circulating viral lineages during a 2-week period. As of the week ending January 22, 2022, Omicron was estimated to account for 99.2% (95% CI = 99.0%-99.5%) of SARS-CoV-2 infections nationwide, and Delta for 0.7% (95% CI = 0.5%-1.0%). The dynamic landscape of SARS-CoV-2 variants in 2021, including Delta- and Omicron-driven resurgences of SARS-CoV-2 transmission across the United States, underscores the importance of robust genomic surveillance efforts to inform public health planning and practice.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , SARS-CoV-2/genetics , Centers for Disease Control and Prevention, U.S. , Genomics , Humans , Prevalence , Public Health Surveillance/methods , United States/epidemiology
17.
J Control Release ; 342: 241-279, 2022 02.
Article in English | MEDLINE | ID: covidwho-1639249

ABSTRACT

RNA-based therapy is a promising and potential strategy for disease treatment by introducing exogenous nucleic acids such as messenger RNA (mRNA), small interfering RNA (siRNA), microRNA (miRNA) or antisense oligonucleotides (ASO) to modulate gene expression in specific cells. It is exciting that mRNA encoding the spike protein of COVID-19 (coronavirus disease 2019) delivered by lipid nanoparticles (LNPs) exhibits the efficient protection of lungs infection against the virus. In this review, we introduce the biological barriers to RNA delivery in vivo and discuss recent advances in non-viral delivery systems, such as lipid-based nanoparticles, polymeric nanoparticles, N-acetylgalactosamine (GalNAc)-siRNA conjugate, and biomimetic nanovectors, which can protect RNAs against degradation by ribonucleases, accumulate in specific tissue, facilitate cell internalization, and allow for the controlled release of the encapsulated therapeutics.


Subject(s)
COVID-19 , Nanoparticles , Humans , Liposomes , RNA, Small Interfering , SARS-CoV-2
18.
Fam Pract ; 2022 Jan 12.
Article in English | MEDLINE | ID: covidwho-1621601
19.
Genes Dis ; 2021 Dec 03.
Article in English | MEDLINE | ID: covidwho-1616497

ABSTRACT

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The Spike protein that mediates coronavirus entry into host cells is a major target for COVID-19 vaccines and antibody therapeutics. However, multiple variants of SARS-CoV-2 have emerged, which may potentially compromise vaccine effectiveness. Using a pseudovirus-based assay, we evaluated SARS-CoV-2 cell entry mediated by the viral Spike B.1.617 and B.1.1.7 variants. We also compared the neutralization ability of monoclonal antibodies from convalescent sera and neutralizing antibodies (NAbs) elicited by CoronaVac (inactivated vaccine) and ZF2001 (RBD-subunit vaccine) against B.1.617 and B.1.1.7 variants. Our results showed that, compared to D614G and B.1.1.7 variants, B.1.617 shows enhanced viral entry and membrane fusion, as well as more resistant to antibody neutralization. These findings have important implications for understanding viral infectivity and for immunization policy against SARS-CoV-2 variants.

20.
Sensors and Actuators B: Chemical ; : 131385, 2022.
Article in English | ScienceDirect | ID: covidwho-1612012

ABSTRACT

Rapid nucleic acid isothermal amplification techniques with minimal demand for laboratory instruments are desirable for early screening and mitigation of communicable diseases (e.g., COVID-19). However, most of the current techniques available employ non-specific signal generation strategies which increase the chance of false positives. Others require a two-step amplification-detection process, in which the tube is opened after amplification, prior to the detection step. This promotes cross-contamination that would lead to unreliable results. Here, we developed a one-pot loop probe-mediated isothermal amplification scheme (oLAMP) coupled with a concurrent target-specific detection readout. We have shown that the said scheme is compatible with crude sample preparation methods and is readily integrated with either fluorescence or electrochemical readouts. The entire process would take 30-40minutes, and we show that our scheme could detect 0.5 or 1 copy/μL of the SARS-CoV-2 N gene using fluorescence or electrochemical readouts, respectively. Moreover, we demonstrate that the scheme is robust across different biological matrices and other interfering substances. We further show that our method can detect the presence of Salmonella drug resistance gene in crude food samples. Thus, our platform offers a readily scalable and highly specific diagnostic pathway for rapid and decentralized detection of communicable diseases.

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