Association Between Severe SARS-CoV-2 Infection and De Novo HLA Donor Specific Antibody Production in Lung Transplant Recipients: Single-center study

Objectives: The COVID-19 pandemic has led to significant morbidity and mortality in lung transplant recipients (LTR). Respiratory viral infections may be associated with de-novo HLA donor-specific antibody (DSA) production and impact lung transplant outcome. Since one of the immunomodulation strategies post-SARS-CoV-2 infection in LTR include decreasing or holding anti-metabolites, concerns have been raised for higher incidence of de-novo DSA production in LTR. Method(s): We performed a retrospective chart review of 80 consecutive LTR diagnosed with COVID-19 to investigate this concern. COVID-19 disease severity was divided into 3 groups: mild, moderate, and severe. Mild disease was defined as patients with COVID-19 diagnosis who were stable enough to be treated as out-patients. Moderate disease was defined as patients who required admission to the hospital and were on less than 10 liters of oxygen at rest. Severe disease was identified as patients who required hospitalization and were on more than 10 liters of oxygen with or without mechanical ventilation or extra corporal membrane oxygenation (ECMO). Groups were compared using the Kruskal-Wallis test. Result(s): A total of 23, 47, and 10 LTR were diagnosed with mild, moderate, and severe COVID-19 respectively. De-novo HLA DSAwere detected in 0/23 (0%), 3/47 (6.3%), and 4/10 (40%) LTR with mild, moderate, and severe COVID-19 respectively (p = 0.0007) within 6 months post-COVID-19 diagnosis. Conclusion(s): Severe COVID-19 may be associated with increased risk of de novo HLA DSA production resulting in allograft dysfunction.Copyright © 2023 Elsevier Inc.

Heterogeneous influence of individuals' behavior on mask efficacy in gathering environments

Wearing masks is an easy way to operate and popular measure for preventing epidemics. Although masks can slow down the spread of viruses, their efficacy in gathering environments involving heterogeneous person-to-person contacts remains unknown. Therefore, we aim to investigate the epidemic prevention effect of masks in different real-life gathering environments. This study uses four real interpersonal contact datasets to construct four empirical networks to represent four gathering environments. The transmission of COVID-19 is simulated using the Monte Carlo simulation method. The heterogeneity of individuals can cause mask efficacy in a specific gathering environment to be different from the baseline efficacy in general society. Furthermore, the heterogeneity of gathering environments causes the epidemic prevention effect of masks to differ. Wearing masks can greatly reduce the probability of clustered epidemics and the infection scale in primary schools, high schools, and hospitals. However, the use of masks alone in primary schools and hospitals cannot control outbreaks. In high schools with social distancing between classes and in workplaces where the interpersonal contact is relatively sparse, masks can meet the need for prevention. Given the heterogeneity of individual behavior, if individuals who are more active in terms of interpersonal contact are prioritized for mask-wearing, the epidemic prevention effect of masks can be improved. Finally, asymptomatic infection has varying effects on the prevention effect of masks in different environments. The effect can be weakened or eliminated by increasing the usage rate of masks in high schools and workplaces. However, the effect on primary schools and hospitals cannot be weakened. This study contributes to the accurate evaluation of mask efficacy in various gathering environments to provide scientific guidance for epidemic prevention. © 2022, Higher Education Press.

Prediction of upcoming global infection burden of influenza seasons after relaxation of public health and social measures during the COVID-19 pandemic: a modelling study

Background The transmission dynamics of influenza were affected by public health and social measures (PHSMs) implemented globally since early 2020 to mitigate the COVID-19 pandemic. We aimed to assess the effect of COVID-19 PHSMs on the transmissibility of influenza viruses and to predict upcoming influenza epidemics. Methods For this modelling study, we used surveillance data on influenza virus activity for 11 different locations and countries in 2017-22. We implemented a data-driven mechanistic predictive modelling framework to predict future influenza seasons on the basis of pre-COVID-19 dynamics and the effect of PHSMs during the COVID-19 pandemic. We simulated the potential excess burden of upcoming influenza epidemics in terms of fold rise in peak magnitude and epidemic size compared with pre-COVID-19 levels. We also examined how a proactive influenza vaccination programme could mitigate this effect. Findings We estimated that COVID-19 PHSMs reduced influenza transmissibility by a maximum of 17.3% (95% CI 13.3-21.4) to 40.6% (35.2-45.9) and attack rate by 5.1% (1.5-7.2) to 24.8% (20.8-27.5) in the 2019-20 influenza season. We estimated a 10-60% increase in the population susceptibility for influenza, which might lead to a maximum of 1-5-fold rise in peak magnitude and 1-4-fold rise in epidemic size for the upcoming 2022-23 influenza season across locations, with a significantly higher fold rise in Singapore and Taiwan. The infection burden could be mitigated by additional proactive one-off influenza vaccination programmes. Interpretation Our results suggest the potential for substantial increases in infection burden in upcoming influenza seasons across the globe. Strengthening influenza vaccination programmes is the best preventive measure to reduce the effect of influenza virus infections in the community. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.

Network pharmacology research of mechanism of Maxing Shigan Decoction in treating COVID-19

Background: The COVID-19 has a huge negative impact on people's health. Traditional Chinese Medicine (TCM) has a good effect on viral pneumonia. It is of great practical significance to study its pharmacology. Methods: The ingredients and targets of each herb in Maxing Shigan Decoction which obtained from Traditional Chinese Medicine Systems Pharmacology (TCMSP) database, and the related targets of COVID-19 were screened by GeneCards database based on the network pharmacology. Venn was used to analyze the intersection target between active ingredients and diseases. Cytoscape software was used to construct an active ingredient-disease target network. The protein-protein interaction network was constructed by STRING database and Cytohubba was used to screen out the key targets. Gene Ontology (GO) functional enrichment analysis and KEGG pathway analysis were performed by DAVID database. Results: In this study, a total of 134 active ingredients and 229 related targets, 198 targets of COVID-19 and 48 common targets of drug-disease were chosen. Enrichment items and pathways were obtained through GO and KEGG pathway analysis. The predicted active ingredients were quercetin, kaempferol, luteolin, naringenin, glycyrol, and the key targets involved IL6, MAPK3, MAPK8, CASP3, IL10, etc. The results showed that the active ingredients of Maxing Shigan Decoction acted on multiple targets which played roles in the treatment of COVID-19 by regulating inflammation, immune system and other pathways. Conclusions: The main contribution of this paper is to use data to mine the principles of the treatment of COVID-19 from the pharmacology of these prescriptions, and the results can be provided theoretical reference for medical workers. © The Author (s) 2023. Published by Higher Education Press.

Effect of COVID-19 Pandemic on Acute Coronary Syndrome Clinical Practice Patterns: Findings from a Multicenter Clinician Survey in China

Background: The coronavirus disease 2019 (COVID-19) pandemic has severely affected healthcare systems around the world. This study aimed to investigate the perceptions of cardiologists regarding how the COVID-19 pandemic has affected the clinical practice patterns for acute coronary syndrome (ACS). Method(s): A multicenter clinician survey was sent to 300 cardiologists working in 22 provinces in China. The survey collected demographic information and inquired about their perceptions of how the COVID-19 pandemic has affected ACS clinical practice patterns. Result(s): The survey was completed by 211 (70.3%) cardiologists, 82.5% of whom were employed in tertiary hospitals, and 52.1% reported more than 10 years of clinical cardiology practice. Most respondents observed a reduction in ACS inpatients and outpatients in their hospitals during the pandemic. Only 29.9% of the respondents had access to a dedicated catheter room for the treatment of COVID-19-positive ACS patients. Most respondents stated that the COVID-19 pandemic had varying degrees of effect on the treatment of acute ST-segment elevation myocardial infarction (STEMI), acute non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. Compared with the assumed non-pandemic period, in the designed clinical questions, the selection of coronary interventional therapy for STEMI, NSTEMI, and unstable angina during the COVID-19 pandemic was significantly decreased (all p < 0.05), and the selection of pharmacotherapy was increased (all p < 0.05). The selection of fibrinolytic therapy for STEMI during the pandemic was higher than in the assumed non-pandemic period (p < 0.05). Conclusion(s): The COVID-19 pandemic has profoundly affected ACS clinical practice patterns. The use of invasive therapies significantly decreased during the pandemic period, whereas pharmacotherapy was more often prescribed by the cardiologists. Copyright: © 2022 The Author(s).

Analysis of regional differences and decomposition of carbon emissions in China based on generalized divisia index method

The achievement of China's carbon dioxide (CO2) emission reduction target is of great significance in the face of global climate change. Accurate identification of key factors that affect CO2 emissions can provide theoretical support to policymakers when designing related policies. Compared to the traditional method, the generalized Divisia index method (GDIM) can capture the influence of multiple scale factors on carbon emissions, providing new tools for studying the decomposition of carbon emissions. The article proposed a GDIM-based decomposition method to analyze the drivers that influence CO2 emissions in China from 2000 to 2017. The results indicate that investment activity is the primary element in promoting China's carbon emissions, followed by energy use and economic activities. On the contrary, investment carbon intensity is the vital inhibitory factor, followed by GDP carbon intensity. Specifically, the positive driving force of investment and energy use is gradually weakening, while the contribution of economic activities is continuously strengthening. The effectiveness of carbon emission reduction in the Northeast, East, and Southwest is actively promoting China's carbon emission reduction, while the effectiveness of CO2 emission reduction in the Northwest is not performing well. The findings provide support and reference for carbon emission control in China. (C) 2022 Elsevier Ltd. All rights reserved.

Turnover intention and associated factors among public health workers during the fight against COVID-19 in Guangdong Province

Objective To realize the current situation and influencing factors of turnover intention among public health workers fighting against COVID-19 in Guangdong Province, explore the moderating effect of social support, and provide evidence for improving the stability of epidemic prevention team. Methods A self-constructed online questionnaire was used to investigate the personnel of Centres for Disease Control and Prevention and primary health care institutes in Guangdong Province. Hierarchical regression analysis was conducted to examine the associated factors of turnover intention and the moderating role of social support. Results A total of 2 168 participants were collected, of which 632(29.15%) had turnover intention. Anti-epidemic public health workers with senior title, working in CDC, having a fixed establishment, sleeping ≥ 6 h, showing more job satisfaction and reporting higher leadership/colleague/relative support had lower turnover intention, while those working overnight and working overtime on rest days were more likely to report turnover intention. The interaction term "job satisfaction × family support" had a negative moderating effect on the relationship between job satisfaction and turnover intention. Conclusions A relatively high turnover intention is reported among public health workers during the fight against COVID-19 in Guangdong Province. Improving the incentive mechanism, increasing job satisfaction and providing more support to primary health workers may reduce their turnover intention. © 2022, Publication Centre of Anhui Medical University. All rights reserved.

Insight into mobility patterns under COVID-19: A time-sequence-based approach

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

Local Surveillance of the COVID-19 Outbreak

Given the worldwide pandemic of the novel coronavirus disease 2019 (COVID-19) and its continuing threat brought by the emergence of virus variants, there are great demands for accurate surveillance and monitoring of outbreaks. A valuable metric for assessing the current risk posed by an outbreak is the time-varying reproduction number ((Formula presented.)). Several methods have been proposed to estimate (Formula presented.) using different types of data. We developed a new tool that integrated two commonly used approaches into a unified and user-friendly platform for the estimation of time-varying reproduction numbers. This tool allows users to perform simulations and yield real-time tracking of local epidemic of COVID-19 with an R package. Copyright © 2022 Liu, Xu, Bai, Xu, Lau, Cowling and Du.

RiskEstim: A Software Package to Quantify COVID-19 Importation Risk

We present an R package developed to quantify coronavirus disease 2019 (COVID-19) importation risk. Quantifying and visualizing the importation risk of COVID-19 from inbound travelers is urgent and imperative to trigger public health responses, especially in the early stages of the COVID-19 pandemic and emergence of new SARS-CoV-2 variants. We provide a general modeling framework to estimate COVID-19 importation risk using estimated pre-symptomatic prevalence of infection and air traffic data from the multi-origin places. We use Hong Kong as a case study to illustrate how our modeling framework can estimate the COVID-19 importation risk into Hong Kong from cities in Mainland China in real time. This R package can be used as a complementary component of the pandemic surveillance system to monitor spread in the next pandemic.

Survey Research on the Setting and Utilization of the Fever Clinic at Primary Healthcare Institutions

Background: During the prevention and control of the COVID-19, the setting of fever clinic in primary healthcare institutions is an important experience summary and pilot practice. At present, the pilot sentinel surveillance has been carried out for more than one year, and it is necessary to analyze its operation situation. Objective: To investigate the setting and utilization of fever clinic in primary healthcare institutions, summarize experience and put forward corresponding suggestions. Methods: From 2021-02-22 to 2021-03-02, a multi-stage sampling method was adopted to select primary healthcare institutions(community healthcare centers/township health centers) who participated in the prevention and control of the COVID-19 epidemic to conduct a questionnaire survey(including fever sentinel surveillance clinics set up during epidemic prevention and fever clinics set up before epidemic prevention), cumulative use time, cumulative number of visits, cumulative referral rate, and cumulative number of diagnoses. Results: 718 valid responses from 408 primary healthcare institutions were totally obtained. Among them, 208 institutions(51.0%) set up fever sentinel surveillance clinic during the prevention and control of the COVID-19 epidemic, 91 institutions(22.3%) had set up before the prevention and control of the COVID-19 epidemic, and 109 institutions(26.7%) had not set up. 271 subjects participated in the work of the fever sentinel surveillance clinic. According to the 271 questionnaires: as the end of January 2021, the median cumulative use time of the fever sentinel surveillance clinic is 12(10) months;188 cases(69.4%) of the respondents indicated that the cumulative number of visits was <300, and 45 cases(16.6%) indicated that the cumulative number of visits was >1 000;184(67.9%) respondents indicated that the cumulative referral rate was <3%, and 35(12.9%) respondents indicated that the cumulative referral rate was >70%;238(87.8%) of the respondents indicated that the number of patients who were finally diagnosed with novel coronavirus pneumonia was 0 out of all the patients admitted. The test results of χ2 showed that the cumulative number of visits between the setting of the fever clinic during the prevention and control of the novel coronavirus pneumonia epidemic and the setting of the fever clinic before the epidemic prevention and control is statistically significant(P<0.05);However, there is no statistically significant difference in the cumulative number of visits, the cumulative referral rate, and the cumulative number of diagnoses in fever clinic in different regions(including economic zone, geographical location within the city, and the highest risk level during the epidemic period of the region). The results of Spearman rank correlation analysis showed that the setting time of fever clinics was significantly positively correlated with cumulative use time and cumulative visits(rs values were 0.37, 0.18, P<0.05), and the region(east, central, and western) was significantly positively correlated with cumulative diagnoses(rs=0.13, P<0.05). Conclusion: According to the survey, more than two thirds of primary healthcare institutions in China have set up fever sentinel surveillance clinics/fever clinics, and of which no difference were indicated in the cumulative visit number of febrile patients, cumulative referral rate and cumulative number of confirmed COVID-19 infections based on the different economic zones, geographical locations and regions with different highest risk level. The higher cumulative number of visits to fever clinics than fever sentinel surveillance clinics demonstrated the potential capacity of managing patients with fever during the pandemic of infectious diseases. Copyright © 2021 by the Chinese General Practice.

[Epidemiological characteristics of local outbreak of COVID-19 caused by SARS-CoV-2 Delta variant in Liwan district, Guangzhou].

Objective: To analyze the epidemiological characteristics of a local outbreak of COVID-19 caused by SARS-CoV-2 B.1.617.2(Delta) variant in Liwan district, Guangzhou, and provide evidence for the further prevention and control of the Delta variant of COVID-19. Methods: From May 21 to June 18, 2021, the incidence data of COVID-19 caused by Delta variant were obtained from National Notifiable Disease Report System of Chinese Disease Prevention and Control Information System and Liwan District Center for Disease Control and Prevention of Guangzhou.Frequency analysis (proportions), histograms, and percentage stacked area plots were used to describe the epidemiological characteristics of the outbreaks. The incubation period and time-varying reproduction numbers (Rt) estimations were used for the further analysis. Results: By June 18, 2021, a total of 127 COVID-19 cases caused by Delta variant was reported in Liwan district. The youngest case was aged 2 years and the oldest was aged 85 years. There were 18.9% (24/127) aged <18 years, 43.3% (55/127) aged 18-59 years, and 37.8% (48/127) aged ≥60 years, the male to female ratio of the cases was 1∶1.35 (54∶73). The cases were mainly retired people (32.3%, 41/127), the jobless or unemployed (18.1%, 23/127), and students (16.5%, 21/127). The infections mainly occurred in Baihedong (70.1%, 89/127) and Zhongnan street (23.6%, 30/127) communities in the southern area of Liwan district. The median incubation period of the Delta variant infection was 6 days (range: 1-15 days). The clinical classification were mainly common type (64.6%, 82/127). The basic reproduction number (R0) was 5.1, Rt which once increased to 7.3. The transmissions mainly occurred in confined spaces, such as home (26.8%), restaurant (29.1%), neighborhood (3.9%), and market (3.1%), the household clustering was predominant. Close contacts tracing (66.1%) and community screening (33.1%) were the main ways to find the infections. Conclusion: The COVID-19 outbreak caused by Delta variant in Liwan district of Guangzhou was highly contagious, with the obvious characteristics of household clustering and high proportions of cases in adults aged 18-59 years and elderly people aged ≥60 years.

COVID-19 Importation Risk From Olympic Athletes Prior to the Tokyo 2020 Olympics

The COVID-19 pandemic delayed the Tokyo 2020 Olympics for 1 year and sparked an unprecedented outbreak in Japan in early July 2021 due to the relaxation of social distancing measures for foreign arrivals. Approximately 11,000 athletes from 205 countries would gather at the Tokyo Olympics held from July 23 through August 8, 2021. Based on the prevalence of infection in different source locations and athlete numbers, we estimated that seven countries would introduce least one infection of COVID-19 to Tokyo and at most eleven unidentified infections after the three requested COVID-19 tests.</p>

Repositioning Molecules of Chinese Medicine to Targets of SARS-Cov-2 by Deep Learning Method

Traditional Chinese medicine has been used to treat and prevent infectious diseases for thousands of years, and has accumulated a large number of effective prescriptions. Deep learning methods provide powerful applications in calculating interactions between drugs and targets. In this study, we try to use the method of deep learning to reposition molecules of Chinese medicines (CMs) and the targets of syndrome coronavirus 2 (SARS-CoV-2). A deep convolution neural network with residual module (DCNN-Res) is constructed and trained on KIBA dataset. The accuracy of predicting the binding affinity of drug-target pairs is 85.33%. By ranking binding affinity scores of 433 molecules in 35 CMs to 6 targets of SARS-Cov-2, DCNN-Res recommends 30 possible repositioning molecules. The consistency between our result and the latest research is 0.827. The molecules in Gancao and Huangqin have a strong binding affinity to targets of SARS-CoV-2, which is also consistent with the latest research.

Analysis of the Current Status and Development Trend of Medical Protective Clothing Standards

With the spread of COVID-19 in the world, the medical protective clothing has becoming more and more important. However, there have been few reports on the analysis of the current protective clothing standards. This paper summarizes the current standards of medical protective clothing at home and abroad systematically. Furthermore, the main standards of medical protective clothing (GB19082-2009, ISO 16603-2004, ISO 16604-2004, NFPA1999-2018, EN14126-2003) are compared. Through the analysis, the protection requirements of various standards are compared in detail, the shortcomings of the standards of surgical clothing are pointed out, and lastly suggestions for improvement are put forward.

Research on Standard Analysis and Test Performance of Protective Masks

With the further spread of COVID-19, the market trend the protective mask industry presents new changes, which is both an opportunity and a challenge for the development of China's textile industry. This paper reviews the origin and development of masks and expounds the internal structure and protective mechanism of masks. Masks are an important line of defense against respiratory infections and can reduce the risk of novel coronavirus infection. Masks can not only prevent the patient from spraying droplets, reduce the amount and speed of droplets, but also block the virus containing droplets nucleus, preventing the wearer from inhaling. There are many types of face masks on the market, and different types of face masks have different application ranges. Different types of face masks follow different standards. The author investigated the application scope and relevant standards of masks in various countries, sorted out the classification, standards and evaluation indicators, etc., in order to provide help for medical personnel and the public. Through analysis, the new surgical mask with high antibacterial, high viral resistance and comfortable wearing is an important development direction in the future.

Standards for Setting up a Fever Sentinel Surveillance Clinic in Primary Healthcare Institutions: Findings of a Qualitative Delphi Study

Background: Many countries have carried out sentinel surveillance programs to monitor infectious diseases. As containing COVID-19 has become normalized, the Department of Primary Health of the National Health Commission of the People's Republic of China recommends primary healthcare institutions to set up a fever sentinel surveillance clinic. Objective: To develop a set of nationwide used standards for the establishment of a fever sentinel surveillance clinic in primary healthcare institutions with regional differences in healthcare level and medical resources taken into account, to surveil and contain possible regional epidemiology of COVID-19 and other infectious diseases in autumn and winter in China. Methods: We designed and carried out a two-round Delphi survey. The first round of survey was conducted with primary care experts selected from Shanghai's various institutions by purposive sampling to discuss setting up a fever sentinel surveillance clinic in primary care in Shanghai. And the second round of survey was implemented with a purposive sample of primary care experts from various healthcare institutions in different regions of China to improve the results of the first survey based on relevant national and regional government policy documents and the reviewing of relevant studies to draw up Draft Guiding Principles for Setting up a Fever Sentinel Surveillance Clinic in Primary Healthcare Institutions. Results: The developed standards include six domains: principles of setting up a fever sentinel surveillance clinic, functions of a fever sentinel surveillance clinic(items: daily functions and anti-epidemic functions), architectural and equipment specifications of a fever sentinel surveillance clinic(items: room, equipment and logo), staffing profile of a fever sentinel surveillance clinic(items: appropriate allocation of physicians, nurses, administrative workers, and handymen), working procedure of a fever sentinel surveillance clinic(fever pre-screening and triage, reception, management and health education and propaganda), profile of services delivered by a fever sentinel surveillance clinic(items: reception, preventive care, management, training, disinfection, supervision and support). Conclusion: The construction of a fever sentinel surveillance clinic in primary healthcare institutions is a reflection of the capacity of such institutions. The functions of this clinic shall contain fever pre-screening and triage, reception and screening of fever patients, timely reporting suspected patients and proving supports for transferring the patients, and effective prevention of nosocomial infection. The detailed architectural and equipment specifications as well as staffing for the clinic can be settled according to the conditions of the institutions. Copyright © 2021 by the Chinese General Practice.