Understanding the Impact Mechanism of User Behavior Pattern toward Real Estate APP Platforms in the Post-COVID Era: A Quantitative Analysis

While technology factors are the main driver of the booming real estate APP platforms with important implications for user behavior pattern during and post-pandemic contexts, there is a lack of adequate research. In response, this study explores the user behavior pattern of real estate APP platforms to promote user mental health by taking the real estate APP platforms users as the participants based on theory of technology readiness and acceptance model. Data collected from offline surveys are analyzed using PLS-SEM. The results reveal the technology readiness index positively affects individuals' perceived usefulness and satisfaction, ultimately positively affects individuals' continuance intention with real estate APP platforms;satisfaction with real estate APP platforms mediated the relationship between technology readiness index, perceived ease of use, perceived usefulness, and individuals' continuance intention with real estate APP platforms. However, the group comparison finds no significant difference in user behavior patterns by gender. The contribution of this study is to reveal the influence mechanisms of digital technology on users' behavioral patterns toward real estate APP platforms, which can help guide the sustainable development of real estate APP platforms and promote user mental health and wellbeing in the post-COVID era.

COVID-19 responses and coping in young Malaysians from low-income families.

Introduction: This study aimed to shed light on how young people from low-income families were responding to COVID-19. Methods: This cross-sectional study recruited young people aged between 18 and 24 years from the low-income-group communities. A convenience sampling approach was used. Google Surveys were used to gather data from the survey. The questionnaire consisted of an assessment of demographic characteristics, lifestyle factors, parent-youth conflict (Parental Environment Questionnaire, PEQ), resilient coping (Brief Resilient Coping Scale, BRCS), and psychological distress (Depression, Anxiety, and Stress Scale-short form, DASS-21). Results: A total of 561 complete responses were received. The results showed a low level of parent-child conflict in the overall study population, with a median PEQ of 48.0 [interquartile range (IQR) 36-48]. Higher parent-child conflicts were found in females than in males (OR = 1.75, 95% CI 1.19-2.57) and in youth from households with an income below MYR 2000 than those earning MYR 3,001-5,000 (OR = 4.39, 95% CI 2.40-8.03). A low prevalence of depression (12.5%), anxiety (15.2%), and stress (6.4%) was found. Parent-child conflict remains the strongest significant predictor for higher levels of depression (OR = 10.90, 95% CI 4.31-27.57), anxiety (OR = 11.92, 95% CI 5.05-28.14), and stress (OR = 4.79, 95% CI 1.41-16.33) symptoms. Poor resilient coping was the second strongest predictor for depression and anxiety symptoms. Regarding lifestyle factors, a lower level of physical exercise was associated with higher symptoms of depression. By demographics, females reported more severe symptoms of depression and anxiety than males. Young people from low-income households reported greater severity in symptoms of depression, anxiety, and stress than those from high-income households. Young people who are employed also reported greater severity of anxiety symptoms than those who are unemployed. Discussion: The COVID-19 pandemic continues to have an unpredictable impact on the lives of vulnerable youth in low-income families that warrants attention in future advocacy efforts.

Safety and immunogenicity of SCB-2019, an adjuvanted, recombinant SARS-CoV-2 trimeric S-protein subunit COVID-19 vaccine in healthy 12-17 year-old adolescents.

We previously demonstrated the efficacy of the COVID-19 vaccine candidate, SCB-2019, in adults in the SPECTRA phase 2/3 efficacy study. We extended the study to include 1278 healthy 12-17-year-old adolescents in Belgium, Colombia, and the Philippines who received either two doses of SCB-2019 or placebo 21 days apart, to assess immunogenicity as neutralizing antibodies against prototype SARS-CoV-2 and variants of concern, and safety and reactogenicity as solicited and unsolicited adverse events with a comparator group of young adults (18-25 years). In participants with no evidence of prior SARS-CoV-2 infection SCB-2019 immunogenicity in adolescents was non-inferior to that in young adults; respective geometric mean neutralizing titers (GMT) against prototype SARS-CoV-2 14 days after the second vaccination were 271 IU/mL (95% CI: 211-348) and 144 IU/mL (116-178). Most adolescents (1077, 84.3%) had serologic evidence of prior SAR-CoV-2 exposure at baseline; in these seropositive adolescents neutralizing GMTs increased from 173 IU/mL (135-122) to 982 IU/mL (881-1094) after the second dose. Neutralizing titers against Delta and Omicron BA SARS-CoV-2 variants were also increased, most notably in those with prior exposure. SCB-2019 vaccine was well tolerated with generally mild or moderate, transient solicited and unsolicited adverse events that were comparable in adolescent vaccine and placebo groups except for injection site pain - reported after 20% of SCB-2019 and 7.3% of placebo injections. SCB-2019 vaccine was highly immunogenic against SARS-CoV-2 prototype and variants in adolescents, especially in those with evidence of prior exposure, with comparable immunogenicity to young adults. Clinical trial registration: EudraCT 2020-004272-17; ClinicalTrials.gov NCT04672395.

Four new eudesmane-type and one new eremophilane-type sesquiterpenes from the whole plant of Carpesium abrotanoides L.

The extract of the whole plant of Carpesium abrotanoides L. yielded five new sesquiterpenes including four eudesmanes (1-4) and one eremophilane (5). The new compounds were characterized by spectroscopic analysis especially 1D and 2D NMR spectroscopy and HRESIMS data. Structurally, both compounds 1 and 2 were sesquiterpene epoxides and 2 owned an epoxy group at C-4/C-15 position to form a spiro skeleton. Compounds 4 and 5 were two sesquiterpenes without lactones and 5 possessed a carboxy group in the molecule. Additionally, all the isolated compounds were preliminarily evaluated for the inhibitory activity against SARS-CoV-2 main protease. As a result, compound 2 showed moderate activity with an IC50 value of 18.79 µM, while other compounds were devoid of noticeable activity (IC50 > 50 µM).

Pilot genome-wide association study of antibody response to inactivated SARS-CoV-2 vaccines.

Vaccines are a key weapon against the COVID-19 pandemic caused by SARS-CoV-2. However, there are inter-individual differences in immune response to SARS-CoV-2 vaccines and genetic contributions to these differences have barely been investigated. Here, we performed genome-wide association study (GWAS) of antibody levels in 168 inactivated SARS-CoV-2 vaccine recipients. A total of 177 SNPs, corresponding to 41 independent loci, were identified to be associated with IgG, total antibodies or neutral antibodies. Specifically, the rs4543780, the intronic variant of FAM89A gene, was associated with total antibodies level and was annotated as a potential regulatory variant affecting gene expression of FAM89A, a biomarker differentiating bacterial from viral infections in febrile children. These findings might advance our knowledge of the molecular mechanisms driving immunity to SARS-CoV-2 vaccine.

Parent-child relationships and psychological distress: survey of parents from low-income families after the COVID-19 pandemic.

Introduction: This study aims to shed light on parent-child relationships and the psychological health of parents from low-income families after the easing of the COVID-19 pandemic restrictions. Methods: This cross-sectional study recruited 553 parents of children aged 13-24 years in low-income community settings. The Parent-Child Conflict scale of the Parental Environment Questionnaire (PEQ) was used to measure parent-child conflict. Psychological distress was assessed using the Depression, Anxiety, and Stress Scale short form (DASS-21). Results: The study revealed a low level of parent-child conflict in the overall study population, with a median PEQ of 48.0 (interquartile range [IQR] 36 to 48). Concerning demographics, married parents reported a likelihood of having a higher level of parent-child conflict over 3 times higher than single parents (OR = 3.18 95%, CI 1.30-7.75). More parent-child conflicts were also found in parents aged 60-72 years old who were unemployed, retired, or housewives and from lower-income groups. In regard to lifestyle factors, a higher level of physical activity and having enough sleep were associated with lower levels of parent-child conflict. Only approximately 1% of the participants reported symptoms of depression, anxiety, or stress. Discussion: Low risk exists for parent-child conflict and psychological sequelae following the easing of the COVID-19 pandemic restrictions, which could be due to various support measures implemented by the government. Vulnerable parents identified as being at risk of parent-child conflict warrant attention in future advocacy efforts.

Preschoolers' screen time in China before and during COVID-19 lockdown: a parental survey.

OBJECTIVES: Since COVID-19 first appeared in Wuhan, China, in December 2019, the disease has spread rapidly across the country. To reduce the spread of infection, schools including kindergartens were closed. Prolonged home confinement can affect children's behaviour. Therefore, we investigated the change of preschoolers' total daily screen time during the COVID-19 lockdown in China. DESIGN, SETTING AND PARTICIPANTS: In the parental survey, 1121 preschoolers, whose parents or grandparents completed an online survey from 1 June 2020 to 5 June 2020, were enrolled. PRIMARY OUTCOME: Total daily screen time. Multivariable modelling was performed to identify factors associated with increased screen time. RESULTS: The results showed that preschoolers' total daily screen time during lockdown(median 2.5 hours, IQR 2.5 hours) was significantly longer than it was before lockdown (median 1.5 hours, IQR 1.0 hour). Older age (OR 1.26, 95% CI 1.07 to 1.48), higher annual household income (OR 1.18, 95% CI 1.04 to 1.34),and decrease of moderate-vigorous physical activity (OR 1.41, 95% CI 1.20 to 1.66) were independently associated with increased screen time. CONCLUSIONS: Preschoolers' total daily screen time significantly increased during lockdown.

Nirmatrelvir/ritonavir for patients with SARS-CoV-2 infection and impaired kidney function during the Omicron surge.

Background: Nirmatrelvir/ritonavir has demonstrated effectiveness in high-risk patients with coronavirus disease 2019 (COVID-19). However, investigations on the efficacy and safety of nirmatrelvir/ritonavir in patients with kidney dysfunction are limited. Methods: Data were collected from the patients admitted to a COVID-19 referral center in Shanghai, China. Patients were at least 18 years of age and had a baseline estimated glomerular filtration rate (eGFR) of <60 ml/min/1·73 m2. The primary endpoint was a composite of all-cause mortality, intensive care unit admission, or cardiovascular events. The secondary endpoint was viral shedding. Results: Among the 195 participants, 73 received nirmatrelvir/ritonavir. A lower risk of the primary endpoint was observed in nirmatrelvir/ritonavir recipients compared with non-recipients [adjusted HR 0.56 (95% CI: 0.32-0.96); p = 0.035]. Nirmatrelvir/ritonavir recipients experienced a shorter duration of viral shedding [adjusted HR 3·70 (95%CI: 2.60-5.28); p < 0.001) and faster viral load clearance versus non-recipients. Among the nirmatrelvir/ritonavir users, earlier initiation of nirmatrelvir/ritonavir within 5 days since COVID-19 diagnosis was related with shorter viral shedding time (adjusted HR 7.84 [95% CI: 3.28-18.76]; p < 0.001) compared to late initiation. No patients reported serious adverse events during treatment. Conclusion: Our findings support the early initiation of nirmatrelvir/ritonavir for high-risk patients with impaired kidney function. This could improve patient outcomes and shorten the viral shedding period.

Conduct of body donation and cadaveric dissection training during the COVID-19 pandemic: challenges, impacts and mitigation.

The new coronavirus disease 2019 (COVID-19) has had a substantial impact on the Silent Mentor Programme (SMP), a programme in which members of the public may pledge their bodies to be used for medical training and research after their death. This study aimed to explore the conduct of body donations and simulation surgery training during the COVID-19 pandemic from the viewpoints of the committee members of the SMP and the next-of-kin of body donor pledgers. This study utilised a qualitative exploration method to seek an in-depth understanding of this phenomenon. In-depth individual interviews were carried out. Thematic analysis was used to identify patterns of themes. The COVID-19 polymerase chain reaction (RT-PCR) test is compulsory before accepting a body donation, and this resulted in the turning down of several donations. Being a donor is the final wish of pledgers and this turning down led to a negative emotional remorseful feeling in the next-of-kin of pledgers. From the perspective of students, it is feared that the conduct of the programme, particularly the home visit session being held online, has impeded teaching of humanistic values, compassion, and empathy, which is the prime philosophy of the programme. Previous to the pandemic, the programme ceremonies were well-attended, denoting the utmost respect and recognition of the mentors; however, travel restrictions due to the pandemic limiting in-person attendance resulted in ceremonies becoming less impactful. Continuous postponements of cadaveric dissection training also resulted in students missing training opportunities, hence potentially impairing their professional practice and humanistic values in the medical profession. Counselling interventions should be directed at easing the negative psychological impact on the next-of-kin of pledgers. As the COVID-19 pandemic may pose a significant impediment to achieving the educational outcomes of cadaveric dissection training, efforts to make up for these gaps are essential.

COVID-19 Anti-Vaccine Sentiments in Malaysia: Narratives of Comments from Facebook Post.

The anti-vaccination movement was an ongoing issue in Malaysia, a Muslim-majority country, even before the COVID-19 pandemic. It is unclear whether the introduction of new COVID-19 vaccines would similarly provoke anti-vaccine sentiments. This study analyzed COVID-19 anti-vaccine sentiments in the Malaysian community. Anti-vaccine comments from Facebook page posts were extracted. The qualitative software QSR-NVivo 10 was used to manage, code and analyze the data. The fast-track COVID-19 vaccine evoked the fear of unknown long-term effects, safety, effectiveness and the duration of protection. The halal status of the COVID-19 vaccines is important. Although it is permissible to use vaccines that are not certified halal under the state of darurah (emergency), there was doubt that the current state has reached the stage of darurah that warrants the use of vaccines. COVID-19 vaccine microchip conspiracy theories were raised. COVID-19 is viewed as only severe for vulnerable populations, and hence vaccination is not needed for the healthy. There were opinions that coronavirus treatments would be more beneficial than vaccination. The anti-COVID-19 vaccine sentiments uncovered in this study provide important insights for the formulation of public health messages to instill confidence in new COVID-19 vaccines. Despite the pandemic being nearly over and many people worldwide having received COVID-19 vaccines, the findings provide important insight into potential issues regarding the introduction of new vaccines in the event of future pandemics.

Oridonin inhibits inflammation of epithelial cells via dual-targeting of CD31 Keap1 to ameliorate acute lung injury.

Introdcution: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are major causes of COVID-19 mortality. However, drug delivery to lung tissues is impeded by endothelial cell barriers, limiting the efficacy of existing treatments. A prompt and aggressive treatment strategy is therefore necessary. Methods: We assessed the ability of anti-CD31-ORI-NPs to penetrate endothelial cell barriers and specifically accumulate in lung tissues using an animal model. We also compared the efficacy of anti-CD31-ORI-NPs to that of free oridonin in ameliorating acute lung injury and evaluated the cytotoxicity of both treatments on endothelial cells. Results: Compared to free ORI, the amount of anti-CD31-ORI-NPs accumulated in lung tissues increase at least three times. Accordingly, anti-CD31-ORI-NPs improve the efficacy three times on suppressing IL-6 and TNF-a secretion, ROS production, eventually ameliorating acute lung injury in animal model. Importantly, anti-CD31-ORI-NPs significantly decrease the cytotoxicity at least two times than free oridonin on endothelial cells. Discussion: Our results from this study will not only offer a novel therapeutic strategy with high efficacy and low toxicity, but also provide the rational design of nanomaterials of a potential drug for acute lung injury therapy.

Homologous and Heterologous Boosting of the Chadox1-S1-S COVID-19 Vaccine With the SCB-2019 Vaccine Candidate: A Randomized, Controlled, Phase 2 Study.

Background: Ongoing outbreaks of coronavirus disease 2019 (COVID-19) are driven by waning immunity following primary immunizations and emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants that escape vaccine-induced neutralizing antibodies. It has been suggested that heterologous boosters could enhance and potentially maintain population immunity. Methods: We assessed the immunogenicity and reactogenicity of booster doses of different formulations of aluminium hydroxide-adjuvanted SCB-2019 vaccine (9 µg of SCB-2019, with or without CpG-1018 adjuvant, or 30 µg of SCB-2019 with CpG-1018) in Brazilian adults primed with ChAdOx1-S vector vaccine. S-protein antibodies and ACE2-binding inhibition were measured by enzyme-linked immunosorbent assay (ELISA) on days 1, 15, and 29. Participants self-reported solicited adverse events and reactions. Results: All SCB-2019 formulations increased S-protein ELISA antibodies and ACE2 binding inhibition to a greater extent than ChAdOx1-S. After 30 µg of SCB-2019 + CpG + aluminium hydroxide, titers against wild-type S-protein were significantly higher than after ChAdOx1-S on days 15 and 29, as were titers of neutralizing antibodies against the wild-type strain and Beta, Gamma, Delta, and Omicron variants. Boosting with SCB-2019 or ChAdOx1-S was well tolerated, with no vaccine-related serious or severe adverse events. Conclusions: Boosting ChAdOx1-S-primed adults with SCB-2019 induced higher levels of antibodies against a wild-type strain and SARS-CoV-2 variants than a homologous ChAdOx1-S booster, with the highest responses being with the 30-µg SCB-2019 + CpG + aluminium hydroxide formulation. Clinical Trials Registration: NCT05087368.

Multiple detection of 13 kinds of viruses in 500 children with acute respiratory tract infection in Hami of Xinjiang province

OBJECTIVE: To investigate and analyze multiple detection of 13 kinds of viruses in 500 children with acute respiratory tract infection in Hami of Xinjiang. METHODS: A total of 500 children with acute respiratory tract infection treated in the hospital between Jan 2018 and Jan 2021 were enrolled. Thirteen kinds of respiratory infection viruses including human respiratory syncytial virus(RSV), human rhinovirus(hRV), respiratory adenovirus(AdV), influenza A and B viruses(Inf A, Inf B), parainfluenza virus(PIV 1/2/3), human enterovirus(hEV), human metapneumovirus(hMPV), human coronavirus(hCoV 229E/OC43) and human Boca virus(hBoV) were detected by multiple reverse transcription polymerase chain reaction(RT-PCR) amplification and capillary electrophoresis. And the results were compared with those by direct sequencing method. RESULTS: Of the 500 samples, 379 samples were positive(75.80%), and the top three detection rates were RSV(19.40%), hRV(16.00%) and Inf B(12.60%). The differences in positive rates of the respiratory virus among <1 year group, 1-3 years group and >3 years group were significant(84.97%, 77.47%, 65.45%)(P<0.05). The detection rate of RSV was the highest in <1 year group, and the detection rates of Inf A and Inf B were the highest in >3 years group. The differences in positive rates of respiratory viruses among the spring group, summer group, autumn group and winter group were significant(74.05%, 63.73%, 77.24%, 84.03%)(P<0.05). The detection rates of RSV, PIV 3, and hMPV were the highest in the winter group, and detection rate of AdV was the highest in spring group. CONCLUSION: RSV is the main infection virus in children with acute respiratory infection in Hami of Xinjiang. The distribution of respiratory viruses is related to age and onset season in children.

Bioinformatics Analysis of Candidate Genes and Pathways Related to Hepatocellular Carcinoma in China: A Study Based on Public Databases.

Background and Objective: Hepatocellular carcinoma (HCC) is a highly aggressive malignant tumor of the digestive system worldwide. Chronic hepatitis B virus (HBV) infection and aflatoxin exposure are predominant causes of HCC in China, whereas hepatitis C virus (HCV) infection and alcohol intake are likely the main risk factors in other countries. It is an unmet need to recognize the underlying molecular mechanisms of HCC in China. Methods: In this study, microarray datasets (GSE84005, GSE84402, GSE101685, and GSE115018) derived from Gene Expression Omnibus (GEO) database were analyzed to obtain the common differentially expressed genes (DEGs) by R software. Moreover, the gene ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed by using Database for Annotation, Visualization and Integrated Discovery (DAVID). Furthermore, the protein-protein interaction (PPI) network was constructed, and hub genes were identified by the Search Tool for the Retrieval of Interacting Genes (STRING) and Cytoscape, respectively. The hub genes were verified using Gene Expression Profiling Interactive Analysis (GEPIA), UALCAN, and Kaplan-Meier Plotter online databases were performed on the TCGA HCC dataset. Moreover, the Human Protein Atlas (HPA) database was used to verify candidate genes' protein expression levels. Results: A total of 293 common DEGs were screened, including 103 up-regulated genes and 190 down-regulated genes. Moreover, GO analysis implied that common DEGs were mainly involved in the oxidation-reduction process, cytosol, and protein binding. KEGG pathway enrichment analysis presented that common DEGs were mainly enriched in metabolic pathways, complement and coagulation cascades, cell cycle, p53 signaling pathway, and tryptophan metabolism. In the PPI network, three subnetworks with high scores were detected using the Molecular Complex Detection (MCODE) plugin. The top 10 hub genes identified were CDK1, CCNB1, AURKA, CCNA2, KIF11, BUB1B, TOP2A, TPX2, HMMR and CDC45. The other public databases confirmed that high expression of the aforementioned genes related to poor overall survival among patients with HCC. Conclusion: This study primarily identified candidate genes and pathways involved in the underlying mechanisms of Chinese HCC, which is supposed to provide new targets for the diagnosis and treatment of HCC in China.

Administration of macrolide antibiotics increases cardiovascular risk.

Background: The increased risk of cardiovascular events in patients prescribed macrolides has been subject to debate for decades. Methods: Medline, EMBASE databases and ClinicalTrials.gov were searched from inception until August 31, 2022 for studies investigating the link between macrolides and cardiovascular risk. A meta-analysis was performed using a random-effects model. Results: A total of 80 studies involving 39,374,874 patients were included. No association was found between macrolides and all-cause death. However, compared with the non-macrolide group, macrolides were associated with a significantly increased risk of ventricular arrhythmia or sudden cardiac death (VA or SCD) (azithromycin, relative ratio [RR]: 1.53; 95% confidence interval [CI]: 1.19 to 1.97; clarithromycin, RR: 1.52; 95% CI: 1.07 to 2.16). Besides, administration of macrolides was associated with a higher risk of cardiovascular disease (CVD) death (azithromycin, RR: 1.63; 95% CI: 1.17 to 2.27) and a slightly increased risk of myocardial infarction (MI) (azithromycin, RR: 1.08; 95% CI: 1.02 to 1.15). Interestingly, no association was observed between roxithromycin and adverse cardiac outcomes. Increased risk of VA or SCD was observed for recent or current use of macrolides, MI for former use, and CVD death for current use. Conclusion: Administration of macrolide antibiotics and timing of macrolide use are associated with increased risk for SCD or VTA and cardiovascular death, but not all-cause death.

DIA-based technology explores hub pathways and biomarkers of neurological recovery in ischemic stroke after rehabilitation.

Objective: Ischemic stroke (IS) is a common disease that causes severe and long-term neurological disability in people worldwide. Although rehabilitation is indispensable to promote neurological recovery in ischemic stroke, it is limited to providing a timely and efficient reference for developing and adjusting treatment strategies because neurological assessment after stroke treatment is mostly performed using scales and imaging. Therefore, there is an urgent need to find biomarkers that can help us evaluate and optimize the treatment plan. Methods: We used data-independent acquisition (DIA) technology to screen differentially expressed proteins (DEPs) before and after ischemic stroke rehabilitation treatment, and then performed Gene Ontology (GO) and pathway enrichment analysis of DEPs using bioinformatics tools such as KEGG pathway and Reactome. In addition, the protein-protein interaction (PPI) network and modularity analysis of DEPs were integrated to identify the hub proteins (genes) and hub signaling pathways for neurological recovery in ischemic stroke. PRM-targeted proteomics was also used to validate some of the screened proteins of interest. Results: Analyzing the serum protein expression profiles before and after rehabilitation, we identified 22 DEPs that were upregulated and downregulated each. Through GO and pathway enrichment analysis and subsequent PPI network analysis constructed using STRING data and subsequent Cytoscape MCODE analysis, we identified that complement-related pathways, lipoprotein-related functions and effects, thrombosis and hemostasis, coronavirus disease (COVID-19), and inflammatory and immune pathways are the major pathways involved in the improvement of neurological function after stroke rehabilitation. Conclusion: Complement-related pathways, lipoprotein-related functions and effects, thrombosis and hemostasis, coronavirus disease (COVID-19), and inflammation and immunity pathways are not only key pathways in the pathogenesis of ischemic stroke but also the main pathways of action of rehabilitation therapy. In addition, IGHA1, LRG1, IGHV3-64D, and CP are upregulated in patients with ischemic stroke and downregulated after rehabilitation, which may be used as biomarkers to monitor neurological impairment and recovery after stroke.

5G-Based Telerobotic Ultrasound System Improves Access to Breast Examination in Rural and Remote Areas: A Prospective and Two-Scenario Study.

OBJECTIVE: Ultrasound (US) plays an important role in the diagnosis and management of breast diseases; however, effective breast US screening is lacking in rural and remote areas. To alleviate this issue, we prospectively evaluated the clinical availability of 5G-based telerobotic US technology for breast examinations in rural and remote areas. METHODS: Between September 2020 and March 2021, 63 patients underwent conventional and telerobotic US examinations in a rural island (Scenario A), while 20 patients underwent telerobotic US examination in a mobile car located in a remote county (Scenario B) in May 2021. The safety, duration, US image quality, consistency, and acceptability of the 5G-based telerobotic US were assessed. RESULTS: In Scenario A, the average duration of the telerobotic US procedure was longer than that of conventional US (10.3 ± 3.3 min vs. 7.6 ± 3.0 min, p = 0.017), but their average imaging scores were similar (4.86 vs. 4.90, p = 0.159). Two cases of gynecomastia, one of lactation mastitis, and one of postoperative breast effusion were diagnosed and 32 nodules were detected using the two US methods. There was good interobserver agreement between the US features and BI-RADS categories of the identical nodules (ICC = 0.795-1.000). In Scenario B, breast nodules were detected in 65% of the patients using telerobotic US. Its average duration was 10.1 ± 2.3 min, and the average imaging score was 4.85. Overall, 90.4% of the patients were willing to choose telerobotic US in the future, and tele-sonologists were satisfied with 85.5% of the examinations. CONCLUSION: The 5G-based telerobotic US system is feasible for providing effective breast examinations in rural and remote areas.

Targeted screening of genetic associations with COVID-19 susceptibility and severity.

The COVID-19 pandemic has resulted in great morbidity and mortality worldwide and human genetic factors have been implicated in the susceptibility and severity of COVID-19. However, few replicate researches have been performed, and studies on associated genes mainly focused on genic regions while regulatory regions were a lack of in-depth dissection. Here, based on previously reported associated variants and genes, we designed a capture panel covering 1,238 candidate variants and 25 regulatory regions of 19 candidate genes and targeted-sequenced 96 mild and 145 severe COVID-19 patients. Genetic association analysis was conducted between mild and severe COVID-19 patients, between all COVID-19 patients and general population, or between severe COVID-19 patients and general population. A total of 49 variants were confirmed to be associated with susceptibility or severity of COVID-19 (p < 0.05), corresponding to 18 independent loci. Specifically, rs1799964 in the promoter of inflammation-related gene TNF, rs9975538 in the intron of interferon receptor gene IFNAR2, rs429358 in the exon of APOE, rs1886814 in the intron of FOXP4-AS1 and a list of variants in the widely reported 3p21.31 and ABO gene were confirmed. It is worth noting that, for the confirmed variants, the phenotypes of the cases and controls were highly consistent between our study and previous reports, and the confirmed variants identified between mild and severe patients were quite different from those identified between patients and general population, suggesting the genetic basis of susceptibility and severity of SARS-CoV-2 infection might be quite different. Moreover, we newly identified 67 significant associated variants in the 12 regulatory regions of 11 candidate genes (p < 0.05). Further annotation by RegulomeDB database and GTEx eQTL data filtered out two variants (rs11246060 and rs28655829) in the enhancer of broad-spectrum antiviral gene IFITM3 that might affect disease severity by regulating the gene expression. Collectively, we confirmed a list of previously reported variants and identified novel regulatory variants associated with susceptibility and severity of COVID-19, which might provide biological and clinical insights into COVID-19 pathogenesis and treatment.