Effect of Azovudine on Hepatic and Renal Function in Patients with COVID-19：a Case Series Study

Background Azovudine is a widely used antiviral drug for COVID-19 in China，but published trials on its effect on hepaticand renal function are extremely scarce. Objective To explore the changes of in hepatic and renal function in patients with COVID-19 infection after using Azovudine，so as to provide a reference for thesafe use of Azovudine in patients with renal insufficiency. Methods Inpatients ina tertiary general hospitalwho used Azovudine for COVID-19 from December 26，2022 to December 31，2022 were consecutively included in the retrospective study and divided into the normal group，mild injury group，moderate injury group，severe injury group，and end-stage groupaccording to estimated glomerularrate（eGFR）levels. The changes of biochemical parametersof liver and kidney including alanine aminotransferase（ALT），aspartate aminotransferase（AST），alkaline phosphatase （ALP），albumin（ALB），total bilirubin（TB），serum creatinine （Scr），eGFR were observed in each group；the formula D_FR=D_NL×［1-F_k （1-K_f）］ was used to correct the maintenance dose of Azivudine in patients with eGFR<60 mL·min-1·（1.73 m2）-1. The patients were divided into the corrected group and uncorrected group according to whether they were administered according to this formula，the biochemical parameters of liver and kidney were compared between the two groups. Results Among 322 patients who used Azovudine，190 patients met the inclusion and exclusion criteria. After grouping by the level of eGFR，there were statistically significant differences in the distribution of age，COVID-19 severity，peak procalcitonin（PCT）values，antihypertensive drugs，loop diuretics and Azovudine maintenance dose in each group（P<0.05）；there were 73 cases（38.4%） with elevated ALT level after Azovudine treatment，and 68 cases（93.2%） with elevated ALT level within one time of the upper normal limit；eGFR decreased in 58 cases（30.5%），of which 7 cases（12.1%） dropped to the next renal function grade；regardless of the grade of renal injury，there were no deterioration in eGFR，ALT，AST，TB，ALP and albumin after the use of conventional dose or corrected dose of Azivudine（P>0.05）；because the patients with moderate and severe renal injury were dose-corrected with Azivudine，the safety of this population was not compared if the dose was not corrected. Conclusion The use of Azivudine is prone to cause the elevation of ALT level and the decrease of eGFR，but the injury with clinical significance is 2.6% and 3.7%，respectively；there was no aggravation of liver and kidney injury in patients with moderate and severe kidney injury after using the corrected dose of Azivudine，however，this conclusion needs to be confirmed in a multicenter randomized controlled study with a large sample. © 2023 Chinese General Practice. All rights reserved.

The times make a hero: Street-level policy entrepreneurship in major crisis responses in China

Street-level bureaucrats are often grassroots officials, and they are regarded as passive practitioners of policy with no authority to change policy or innovate, while policy entrepreneurs are usually high-level officials. Based on observations of China's responses to two national crises, this study found that the times do make a hero. When acting as innovative frontline technocrats, major transboundary crisis practitioners, and management savvy operators within the top-down bureaucracy, street-level bureaucrats can become policy entrepreneurs. To innovate and drive policy change, street-level policy entrepreneurs will adopt innovative strategies. They will make efficient use of their expertise and discretion, integrate various resources, strive for attention from superiors, consolidate their achievements, and expand their influence. © 2023 Policy Studies Organization.

Research on the Construction Scheme of Wuhan Emergency Logistics System Under the Background of Public Health Emergencies

In order to improve the emergency logistics support capacity of Wuhan city and build a transportation power pilot, based on the background of public health emergencies and on the basis of comprehensively summarizing the experience, practices and prominent problems of emergency logistics support work of COVID-19 in Wuhan City, this paper studies from the aspects of development foundation, overall thinking and main tasks, Put forward the systematic framework and specific implementation path of emergency logistics system construction of "building three guarantee systems of reserve facilities, transportation capacity and command and dispatching, and building an information platform”. At the same time, in the construction of emergency logistics command and coordination information platform, K-means clustering method is adopted to achieve scientific matching and efficient connection between emergency materials transit stations and demand points. For other cities It is of practical significance to improve the regional emergency logistics system. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Reflections on the Pain Points of Elderly Care during the Epidemic Prevention and Control Stage from Two Cases of Disease Narration

The COVID-19 has had a profound impact on human society, the elderly, as a vulnerable group, are the most affected. Based on two cases of disease narrative collected by the department of neurology of a hospital in Guiyang, this paper analyzed the shortcomings of elderly care in the context of epidemic prevention and control. The overall health information literacy of the elderly was low, which made it difficult to obtain correct epidemic related information. The lifestyle of the elderly has changed during the epidemic prevention and control stag. The long time isolation at home has reduced their constitution and made them prone to illness, thus affecting the quality of healthy elderly care. In this stage, the psychological burden of the middle-aged and elderly people has been increasing, which reduced the life satisfaction and subjective well-being of the elderly, and increased the risk of depression. In view of these outstanding problems, this paper proposed corresponding measures, aiming to improve the quality of life and physical and mental health of the elderly during the epidemic prevention and control stage, and provide reference for realizing healthy aging in China. © 2023, Editorial department of Chinese Medical Ethics. All rights reserved.

Reflections on the Pain Points of Elderly Care during the Epidemic Prevention and Control Stage from Two Cases of Disease Narration

The COVID-19 has had a profound impact on human society, the elderly, as a vulnerable group, are the most affected. Based on two cases of disease narrative collected by the department of neurology of a hospital in Guiyang, this paper analyzed the shortcomings of elderly care in the context of epidemic prevention and control. The overall health information literacy of the elderly was low, which made it difficult to obtain correct epidemic related information. The lifestyle of the elderly has changed during the epidemic prevention and control stag. The long time isolation at home has reduced their constitution and made them prone to illness, thus affecting the quality of healthy elderly care. In this stage, the psychological burden of the middle-aged and elderly people has been increasing, which reduced the life satisfaction and subjective well-being of the elderly, and increased the risk of depression. In view of these outstanding problems, this paper proposed corresponding measures, aiming to improve the quality of life and physical and mental health of the elderly during the epidemic prevention and control stage, and provide reference for realizing healthy aging in China. © 2023, Editorial department of Chinese Medical Ethics. All rights reserved.

How Dialogic Vaccine Communication in the Workplace Facilitates Employee Advocacy for COVID-19 Vaccine Uptake

Encouraging employees' vaccine uptake and motivating their vaccine advocacy are crucial steps to secure workplace health and safety during the current pandemic. Yet, how to achieve those steps remains challenging. To address this challenge, this study examines whether and how companies' vaccine communication efforts with employees, particularly dialogic communication, can motivate employees' advocacy behaviors for COVID-19 vaccine uptake. Specifically, by drawing insights from public relations, management, psychology, and health communication research, we predict that organizations' dialogic communication will enhance employees' perceptions of organizational support for vaccination, which will further increase employees' positive emotions while decreasing their negative emotions toward the vaccines. These emotional states will ultimately contribute to employees' vaccine advocacy. An online survey among 505 full-time U.S. employees supported our predictions. Our study advances public relations, organizational communication, and workplace health scholarships and practice by revealing the under-explored role of workplace communication in promoting public health. © 2022 Taylor & Francis Group, LLC.

Reflections on the Pain Points of Elderly Care during the Epidemic Prevention and Control Stage from Two Cases of Disease Narration

The COVID-19 has had a profound impact on human society, the elderly, as a vulnerable group, are the most affected. Based on two cases of disease narrative collected by the department of neurology of a hospital in Guiyang, this paper analyzed the shortcomings of elderly care in the context of epidemic prevention and control. The overall health information literacy of the elderly was low, which made it difficult to obtain correct epidemic related information. The lifestyle of the elderly has changed during the epidemic prevention and control stag. The long time isolation at home has reduced their constitution and made them prone to illness, thus affecting the quality of healthy elderly care. In this stage, the psychological burden of the middle-aged and elderly people has been increasing, which reduced the life satisfaction and subjective well-being of the elderly, and increased the risk of depression. In view of these outstanding problems, this paper proposed corresponding measures, aiming to improve the quality of life and physical and mental health of the elderly during the epidemic prevention and control stage, and provide reference for realizing healthy aging in China. © 2023, Editorial department of Chinese Medical Ethics. All rights reserved.

Resilience Evaluation on Air Transportation System Based on Bayesian Network

In order to accurately describe the security capability of the air transportation system，the concept of resilience is introduced to evaluate its risk resistance and recovery level. First，a hierarchical Bayesian network model is established，and the factors that affect the normal operation of the air transportation system are analyzed. Second，the system resilience is evaluated，and the resilience and changing trends of China's air transportation system from 2010 to 2019 are quantitatively analyzed. Third，the impact of factors on the overall resilience level is analyzed，and the change of the underlying nodes during the COVID-19 epidemic is taken as an example. Then，the overall resilience level of the system is evaluated through adjusting each node of the model. The research results show that the overall resilience evaluation value of the air transportation system is between 54% and 60.2%，and it exhibits a fluctuating upward trend with the continuous social and economic development. Under the influence of the COVID-19 epidemic，the service level of the system has been greatly affected，but the overall system can still maintain a certain degree of resilience. The Bayesian network model can better quantify the resilience of the air transportation system，and help improve the resilience of the system. This method provides effective control strategies and theoretical methods for the sustainable development and resistance to shocks of the air transportation industry. © 2022 Nanjing University of Aeronautics an Astronautics. All rights reserved.

Resilience Evaluation on Air Transportation System Based on Bayesian Network

In order to accurately describe the security capability of the air transportation system，the concept of resilience is introduced to evaluate its risk resistance and recovery level. First，a hierarchical Bayesian network model is established，and the factors that affect the normal operation of the air transportation system are analyzed. Second，the system resilience is evaluated，and the resilience and changing trends of China's air transportation system from 2010 to 2019 are quantitatively analyzed. Third，the impact of factors on the overall resilience level is analyzed，and the change of the underlying nodes during the COVID-19 epidemic is taken as an example. Then，the overall resilience level of the system is evaluated through adjusting each node of the model. The research results show that the overall resilience evaluation value of the air transportation system is between 54% and 60.2%，and it exhibits a fluctuating upward trend with the continuous social and economic development. Under the influence of the COVID-19 epidemic，the service level of the system has been greatly affected，but the overall system can still maintain a certain degree of resilience. The Bayesian network model can better quantify the resilience of the air transportation system，and help improve the resilience of the system. This method provides effective control strategies and theoretical methods for the sustainable development and resistance to shocks of the air transportation industry. © 2022 Nanjing University of Aeronautics an Astronautics. All rights reserved.

Health, Concerns, and Finance: News Framing of Wearing Masks in China From 2001 to 2020

Since the COVID-19 outbreaks, masks have become one of the most controversial topics throughout the world. However, the pro-mask atmosphere seems to be formed smoothly in China, at least in the beginning and peak of epidemic. To understand the social construction of masks in China, this study examines the media framing of masks from 2001 to 2020 in two important newspapers, the People's Daily and the Southern Metropolis Daily. We found that pro-mask discourse portrayed wearing masks first as an emergent and undesired health strategy;later, as an inevitable measure against constant crises;and lastly, part of the new normality. The legalization of wearing masks lies in the severity of a certain health crisis, the effectiveness that masks can protect citizens from such crisis, a comparatively low cost that to exchange for normal lives under a crisis, and the fact that it could overall benefit China's national image and interests. Moreover, masks have been constructed as a financially promising business and a trendy fashion, which further justifies their existence. The counterdiscourses against masks appeared when the conditions that justified masks were questioned. © 2023 (Zhifei Mao, Huaxin Peng, Di Wang, Mengfan He, and Kun Zhou). Licensed under the Creative Commons Attribution Non-commercial No Derivatives (by-nc-nd). Available at http://ijoc.org.

[Kinetics of SARS-CoV-2-specific antibodies among inactivated COVID-19 vaccine recipients, SARS-CoV-2 natural infection cases, and breakthrough cases].

Between August and September, 2021, this study included 605 SARS-CoV-2 natural infection cases and 589 SARS-CoV-2 breakthrough cases from Nanjing and Yangzhou, as well as 690 inactivated COVID-19 vaccine recipients from Changzhou, China. In SARS-CoV-2 natural infection cases, the age range was 19-91 years (median age: 66 year), and the medians(Q1,Q3) of IgG titers were 0.19 (0.06-1.31), 3.70 (0.76-69.48), 15.31 (2.59-82.16), 4.41 (0.99-31.74), 2.31 (0.75-13.83), 2.28 (0.68-9.94) and 2.80 (1.00-9.53) at one to seven weeks after SARS-CoV-2 infection, respectively. In SARS-CoV-2 breakthrough cases, the age range was 18-76 years (median age: 45 year), and the medians(Q1,Q3)of IgG titers were 1.93 (0.34-26.67), 38.87 (7.90-121.0), 75.09 (11.85-123.70), 21.97 (5.20-95.58), 13.97 (3.47-46.82), 9.56 (2.48-33.38) and 4.38 (1.87-11.00) at one to seven weeks after SARS-CoV-2 infection, respectively. In inactivated COVID-19 vaccine recipients, the age range was 18-87 years (median age: 47 years), and the medians(Q1,Q3)of IgG titers were 16.22 (15.84-33.42), 5.35 (2.96-13.23), 3.30 (2.18-6.18), 3.14 (1.16-5.70), 2.77 (1.50-4.52), 2.72 (1.76-4.36), 2.01 (1.27-3.51) and 1.94 (1.35-3.09) at one to eight months after SARS-CoV-2 infection, respectively. The results suggested that IgG antibodies increased gradually within two weeks after SARS-CoV-2 infection, then declined gradually at three to seven weeks in SARS-CoV-2 natural infection cases. In SARS-CoV-2 breakthrough cases, IgG antibodies increased rapidly within two weeks, then declined gradually at three to seven weeks after SARS-CoV-2 infection. Additionally, IgG antibodies decreased rapidly within three months, then decreased gradually and remained at a low level within three months after immunization.

Intelligent Monitoring Model for Aggregated Infection Risk 计Against the Background of COVID-19 Epidemic

The Corona Virus Disease 2019（COVID-19）epidemic is a serious threat to people’s lives.Supervision of the density of clustered people and wearing of masks is key to controlling the virus.Public places are characterized by a dense flow of people and high mobility.Manual monitoring can easily increase the risk of infection，and existing mask detection algorithms based on deep learning suffer from the limitation of having a single function and can be applied to only a single type of scenes；as such，they cannot achieve multi-category detection across multiple scenes. Furthermore，their accuracy needs to be improved. The Cascade-Attention R-CNN target detection algorithm is proposed for realizing the automatic detection of aggregations in areas，pedestrians，and face masks. Aiming to solve the problem that the target scale changes too significantly during the task，a high-precision two-stage Cascade R-CNN target detection algorithm is selected as the basic detection framework. By designing multiple cascaded candidate classification regression networks and adding a spatial attention mechanism，we highlight the important features of the candidate region features and suppress noise features to improve the detection accuracy. Based on this，an intelligent monitoring model for aggregated infection risk is constructed，and the infection risk level is determined by combining the outputs of the proposed algorithm. The experimental results show that the model has high accuracy and robustness for multi-category target images with different scenes and perspectives. The average accuracy of the Cascade Attention R-CNN algorithm reaches 89.4%， which is 2.6 percentage points higher than that of the original Cascade R-CNN algorithm，and 10.1 and 8.4 percentage points higher than those of the classic two-stage target detection algorithm，Faster R-CNN and the single-stage target detection framework，RetinaNet，respectively. © 2022, Editorial Office of Computer Engineering. All rights reserved.

A delayed modulation of solar ultraviolet radiation on the COVID-19 transmission reflects an incubation period

Laboratory experiments have revealed the meteorological sensitivity of the coronavirus disease 2019 (COVID-19) virus. However, no consensus has been reached about how outdoor meteorological conditions modulate the virus transmission as it is also constrained by non-meteorological conditions. Here, we identify the outbreak's evolution stage, constrained least by non-meteorological conditions, by searching the maximum correlation coefficient between the ultraviolet flux and the growth rate of cumulative confirmed cases at the country level. At this least-constrained stage, the cumulative cases count around 1300-3200, and the count's daily growth rate correlates with the ultraviolet flux and temperature significantly (correlation coefficients r = -0.54 +/- 0.09 and -0.39 +/- 0.10 at p<0.01$$ p, respectively), but not with precipitation, humidity, and wind. The ultraviolet correlation exhibits a delay of about 7 days, providing a meteorological measure of the incubation period. Our work reveals a seasonality of COVID-19 and a high risk of a pandemic resurgence in winter, implying a need for seasonal adaption in public policies.

Spatial-temporal characteristics and pollutant assessment in the early stage of COVID-19 outbreak in China

To explore the early stage spatial-temporal characteristics and to assess the factors of atmospheric pollution that may affect the development of coronavirus disease 2019（COVID-19）outbreak in the Chinese Mainland in 2020，we collected the daily new cases of COVID-19 in the Municipalities and Provinces from the websites of National and Provincial Health Commission of China. The spatiotemporal characteristics of COVID-19 epidemic were studied using autocorrelation analysis and trend analysis. The Spearman's correlation coefficient for ranked data and generalized additive model were used for risk assessment of air pollutants affecting the COVID-19 epidemic of Hubei Province. Daily new cases of COVID-19 in the Chinese Mainland totaled 39 877 from January 20th to February 9th of 2020. The global Moran index values of these three weeks were 0.249，0.307 and 0.297（P<0.01），respectively. There was a significant clustering phenomenon. The high incidence regions included Hunan Province，Guangdong Province，Jiangxi Province，Zhejiang Province，Anhui Province and Jiangsu Province. The epidemic hot spots were basically distributed in the area from 108° 47'-123° 10' E to 25° 31'-35° 20' N. Daily new cases of COVID-19 in Hubei Province was positively correlated with daily average concentrations of PM10，NO2 and O3 pollutants（ρ =0.515，0.579 and 0.536，P<0.05）. The lag effects of air pollutions were existed. The relative risk（RR）values of PM2.5and PM10 reached to maximum with lag0，the RR value of NO2 reached to maximum with lag4，and the RR value of O3 reached to maximum with lag 0~1. We estimated that a 10 μg/m3 increase in day-before NO2 daily average concentration was associated with a 32.745% （95% Confidence Interval（CI）：11.586%-57.916%）excess risk（ER）of daily new cases of COVID-19. And NO2 had a significant impact on daily new cases of COVID-19. When NO2 was introduced to PM2.5and PM10 separately，for every 10 μg/m3 rise in NO2 daily average concentration，the ER of daily new cases of COVID-19 was 23.929%（95% CI：4.705%-46.682%）and 24.672%（95% CI：5.379%-47.496%），respectively. The study showed that the southeast was the main spread direction in the early stage of COVID-19 outbreak in the Chinese Mainland in 2020. Reducing the atmospheric concentration of nitrogen dioxide in epidemic hot spots has a positive effect on epidemic prevention and control. © 2022 Journal of Zhongshan University. All rights reserved.

Understanding residents' continued usage intention of community sharing platforms in smart communities in a post-COVID era: evidence from China

A community sharing platform has demonstrated its significant role in prevention and control of COVID-19 pandemic in communities throughout China. Despite its increasing popularity, the widespread adoption and continued usage intention of smart community sharing platforms by the residents is still far underexplored. Thus, this study applied the technology acceptance model (TAM) as the research framework to empirically investigate the factors influencing residents' continued intention to use community sharing platforms in the post-COVID era. Empirical results show that perceived ease of use, perceived usefulness and sharing attitude significantly impact residents' continued intention to use smart community sharing platforms and that residents' education level significantly moderates the relationships between the three kinds of antecedents and continued usage intention. This study contributes to the literature in the field of smart communities and provides practical implications for governments and platform operators to achieve sustainable development of community sharing platforms. © 2022 Inderscience Enterprises Ltd.

Understanding the Necessity and Economic Benefits of Lockdown Measures to Contain COVID-19

Since the outbreak of the coronavirus disease 2019 (COVID-19), the issue of how to maintain economic development while containing the epidemic has become a significant concern for decision-makers. Though lockdown measures are verified to be very effective in containing the epidemic, its economic costs and other influences have not been fully explored. As a result, decision-makers in many countries are still hesitant to include the lockdown measure in an intervention strategy in response to COVID-19. To address this issue, we propose a universal computational experiment approach for policy evaluation and adjustment based on the Artificial societies, Computational experiments, Parallel execution (ACP) concept. First, we innovatively construct a model via observable CO<inline-formula> <tex-math notation="LaTeX">$_2$</tex-math> </inline-formula> emissions, which is able to estimate the economic costs affected by nonpharmaceutical interventions. Furthermore, based on the population movement data, a risk source model is proposed to estimate the local transmission risk for any prefectures outside the epicenter. Finally, we integrate the data models in a high-resolution agent-based artificial society and carry out large-scale computational experiments supported by the Tianhe supercomputer. Policy adjustments and evaluations are carried out in four cities: Wenzhou, Guangzhou, Beijing, and Wuhan. Our research findings show important implications for policy-making: 1) the local transmission of a city can be almost contained if lockdowns are adopted immediately when the risk index is larger than 1.645, 1.960, or 2.576 at the 90%, 95%, or 99% confidence interval, respectively;2) if lockdowns are required, in-advance lockdown measures facilitate mitigation efficacy and reduce economic loss;and 3) lockdowns lasting for 7–14 days in a prefecture would be effective in controlling the spread of the epidemic. The duration of the measure should be prolonged with the increment of the initial transmission risk. IEEE

Teaching of Human Parasitology During the COVID-19 Pandemic in China

Since the coronavirus disease 2019 (COVID-19) pandemic, human parasitology education has been exceedingly disrupted. To deliver human parasitology knowledge, medical universities in China have employed multiple measures, some of which have had positive outcomes that have not yet been summarized. The objective of this review is to share the Chinese experience as the human parasitology teaching methods were transformed. In general, we adopted a fully online teaching model under urgent pandemic control measures based on a well-structured teaching model that integrated the course preview, live lecture, review, and assessment. Combinations were attempted of COVID-19 and parasitology teaching contents. Some active learning models, such as case-based e-learning and flipped classrooms, were proposed for offline and online blended teaching during the normalization stage of the pandemic. Meanwhile, we discuss both the strengths and flaws of online and blended teaching. Some useful assessment tools are presented for reference purposes. In conclusion, this transition to online and online-offline blended human parasitology teaching in China has boosted innovative teaching activities and may continue to catalyze the transformation of medical education.

A Case of an 83 Year Old Male with Acute Disseminated Encephalomyelitis-like Presentation Post COVID-19 Vaccination

Objective: NA Background: A variety of neurologic disorders have been described in patients after receiving the COVID-19 vaccines. Acute disseminated encephalomyelitis (ADEM) have been reported especially in the younger population following any vaccination, including the Covid-19 vaccines. Reports of ADEM in the elderly patients are scarce. Design/Methods: An 83 year old male with history of hypertension, presented with suddenonset of progressive multifocal neurological deficits including blurry vision, upper extremity weakness, numbness and clumsiness with imbalance resulting in multiple falls. A few days later, he reported dysphagia, intermittent expressive aphasia and confusion. Thirteen days prior, he received his second dose of Moderna vaccine. Examination showed mild bilateral upper motor neuron and cerebellar signs. Laboratory tests were unremarkable except for elevated ESR (72), low Vitamins-B12 (311 pg/mL), and D (14.9 ng/mL) levels, and iron deficiency anemia. MRI brain with gadolinium revealed non-enhancing multifocal and confluent supra/infratentorial T2/FLAIR hyperintensity lesions. Cerebrospinal fluid (CSF) analysis showed pleocytosis (whitecell count 13 with 60% lymphocytes), elevated protein (54), and glucose (80), suggestive of underlying inflammation. CSF cytology, meningoencephalitis panel, VDRL, JC-virus PCR, India-ink, acid-fast, bacterial and fungus cultures were negative. HIV antibody was negative. Intravenous Ceftriaxone was initiated until CSF cultures returned negative. Serum anti-MOG and anti-NMO were negative. Repeat imaging within a week showed decreased confluent T2 hyperintensities, but also demonstrated new areas of patchy involvement. The patient received intravenous methylprednisolone 1000 mg daily for 5 days. In the following weeks, his symptoms improved remarkably. Results: NA Conclusions: This 83 year old patient presented with multiple neurologic symptoms, confluent T2-Flair white matter hyperintensities on imaging studies, 13 days post Covid-19 vaccination. Workup for other inflammatory and infectious etiologies was unrevealing. Symptoms improved after intravenous corticosteroids treatment. ADEM is a consideration. Theoretical and actual concerns of vaccine-related neurologic diseases exist, timely recognition and treatment can alter the course and disease progression.