Solidarity and strife after the Atlanta spa shootings: A mixed methods study characterizing Twitter discussions by qualitative analysis and machine learning.

Background: On March 16, 2021, a white man shot and killed eight victims, six of whom were Asian women at Atlanta-area spa and massage parlors. The aims of the study were to: (1) qualitatively summarize themes of tweets related to race, ethnicity, and racism immediately following the Atlanta spa shootings, and (2) examine temporal trends in expressions hate speech and solidarity before and after the Atlanta spa shootings using a new methodology for hate speech analysis. Methods: A random 1% sample of publicly available tweets was collected from January to April 2021. The analytic sample included 708,933 tweets using race-related keywords. This sample was analyzed for hate speech using a newly developed method for combining faceted item response theory with deep learning to measure a continuum of hate speech, from solidarity race-related speech to use of violent, racist language. A qualitative content analysis was conducted on random samples of 1,000 tweets referencing Asians before the Atlanta spa shootings from January to March 15, 2021 and 2,000 tweets referencing Asians after the shooting from March 17 to 28 to capture the immediate reactions and discussions following the shootings. Results: Qualitative themes that emerged included solidarity (4% before the shootings vs. 17% after), condemnation of the shootings (9% after), racism (10% before vs. 18% after), role of racist language during the pandemic (2 vs. 6%), intersectional vulnerabilities (4 vs. 6%), relationship between Asian and Black struggles against racism (5 vs. 7%), and discussions not related (74 vs. 37%). The quantitative hate speech model showed a decrease in the proportion of tweets referencing Asians that expressed racism (from 1.4% 7 days prior to the event from to 1.0% in the 3 days after). The percent of tweets referencing Asians that expressed solidarity speech increased by 20% (from 22.7 to 27.2% during the same time period) (p < 0.001) and returned to its earlier rate within about 2 weeks. Discussion: Our analysis highlights some complexities of discrimination and the importance of nuanced evaluation of online speech. Findings suggest the importance of tracking hate and solidarity speech. By understanding the conversations emerging from social media, we may learn about possible ways to produce solidarity promoting messages and dampen hate messages.

Factors Associated with Community Awareness on COVID-19 in a Developing Country: Implications for Optimal Risk Communication.

Purpose: New COVID-19 variants pose great challenges in protecting the success of vaccination programs. Awareness of community becomes an important component to prevent the spread of COVID-19. This study aims to analyze people's awareness of COVID-19 and identify the implications for optimal risk communication in Vietnam. Study Methods and Materials: A total of 341 individuals participated in an online cross-sectional study. Community awareness on COVID-19 was examined by using a structured questionnaire. Multivariable Tobit regression was used to examine associated factors with community awareness. Results: Our results indicated high levels of awareness of local COVID-19 situation, transmission risks, and preventive behavioral practices during the first week of social isolation. Higher awareness of local pandemic situation was associated with female respondents (Coef.: 6.19; 95% CI: 0.51; 11.87) and larger family sizes of above 5 people (Coef.: 9.00; -1.00; 19.00). Respondents between 35-44 years old were shown to be less aware of preventive behavioral practices than other age groups, including the group of participants above 44 years old (Coef.: -0.34; 95% CI: -0.67; -0.02). Lastly, participants who were "fairly satisfied" with information resources had awareness levels of preventive behavioral practices lower than that of "unsatisfied" respondents (Coef.: -0.45; 95% CI: 0.74; -0.16). Conclusion: This study offers crucial insights into the pandemic awareness of citizens and risk communication effectiveness during COVID-19 in Vietnam. The study findings shall serve the development of policies and interventions aimed at empowering individuals in the local and global fight against coronavirus.

Balancing the aquatic export supply chain strategy- A case study of the Vietnam pangasius industry

COVID-19 has called more attention to the importance of supply chains (SCs) in the global food market. The supply chain for Vietnamese pangasius is expanding at a rapid rate, and export shares are changing in the EU, the US, China, and ASEAN markets. Increased international competition in the whitefish market and other emerging Asian markets have forced the Vietnam pangasius industry to re-examine its SC strategy. The questions raised are: Should the pangasius industry employ a responsive SC, where aquatic products achieve international certificates and respond to consumer demand, or embrace a cost-efficient supply chain with large export volumes, low selling prices, and increased stakeholder profits? Based on the concepts of cost responsiveness and efficient frontier, using time series data for 2010–2019, we attempted to identify and describe the factors influencing Vietnamese pangasius strategic balance along this frontier. Vietnam's pangasius strategic balance is between a responsive supply chain and a cost-effective SC with greater emphasis on responsive supply chain management. However, there is insufficient attention to changing consumer trends and demands, and although the laws directing each node of the supply chain are numerous, there is inadequate enforcement and oversight of their implementation. The strategy of cost minimization is facing many challenges: the market share is declining in some major markets, profits have tightened due to low selling prices, there is competition with other whitefish species, and distribution channels have improved but remain inefficient. The recommendation requires the adoption of a supply chain strategy that balances between a cost-efficient and a responsive chain for the pangasius industry to remain competitive. • Vietnam's pangasius strategic balance is between responsive and cost-effective supply chain. • A need exists for enforcement and oversight of regulation of trends in consumer demand. • The strategy for a lower price fish improves sales as consumer income increases. • Constant tweakingof the supply chain is necessary to balance between a cost-efficient chain and a responsive chain. [ FROM AUTHOR]

Balancing the aquatic export supply chain strategy- A case study of the Vietnam pangasius industry

COVID-19 has called more attention to the importance of supply chains (SCs) in the global food market. The supply chain for Vietnamese pangasius is expanding at a rapid rate, and export shares are changing in the EU, the US, China, and ASEAN markets. Increased international competition in the whitefish market and other emerging Asian markets have forced the Vietnam pangasius industry to re-examine its SC strategy. The questions raised are: Should the pangasius industry employ a responsive SC, where aquatic products achieve international certificates and respond to consumer demand, or embrace a cost-efficient supply chain with large export volumes, low selling prices, and increased stakeholder profits? Based on the concepts of cost responsiveness and efficient frontier, using time series data for 2010–2019, we attempted to identify and describe the factors influencing Vietnamese pangasius strategic balance along this frontier. Vietnam's pangasius strategic balance is between a responsive supply chain and a cost-effective SC with greater emphasis on responsive supply chain management. However, there is insufficient attention to changing consumer trends and demands, and although the laws directing each node of the supply chain are numerous, there is inadequate enforcement and oversight of their implementation. The strategy of cost minimization is facing many challenges: the market share is declining in some major markets, profits have tightened due to low selling prices, there is competition with other whitefish species, and distribution channels have improved but remain inefficient. The recommendation requires the adoption of a supply chain strategy that balances between a cost-efficient and a responsive chain for the pangasius industry to remain competitive.

Leveraging 13 million responses to the U.S. COVID-19 Trends and Impact Survey to examine vaccine hesitancy, vaccination, and mask wearing, January 2021-February 2022.

BACKGROUND: The urgency of the COVID-19 pandemic called upon the joint efforts from the scientific and private sectors to work together to track vaccine acceptance and prevention behaviors. METHODS: Our study utilized individual responses to the Delphi Group at Carnegie Mellon University U.S. COVID-19 Trends and Impact Survey, in partnership with Facebook. We retrieved survey data from January 2021 to February 2022 (n = 13,426,245) to examine contextual and individual-level predictors of COVID-19 vaccine hesitancy, vaccination, and mask wearing in the United States. Adjusted logistic regression models were developed to examine individual and ZIP code predictors of COVID-19 vaccine hesitancy and vaccination status. Given the COVID-19 vaccine was rolled out in phases in the U.S. we conducted analyses stratified by time, January 2021-May 2021 (Time 1) and June 2021-February 2022 (Time 2). RESULTS: In January 2021 only 9% of U.S. Facebook respondents reported receiving the COVID-19 vaccine, and 45% were vaccine hesitant. By February 2022, 80% of U.S. Facebook respondents were vaccinated and only 18% were vaccine hesitant. Individuals who were older, held higher educational degrees, worked in white collar jobs, wore a mask most or all the time, and identified as white and Asian had higher COVID-19 vaccination rates and lower vaccine hesitancy across Time 1 and Time 2. Essential workers and blue-collar occupations had lower COVID vaccinations and higher vaccine hesitancy. By Time 2, all adults were eligible for the COVID-19 vaccine, but blacks and multiracial individuals had lower vaccination and higher vaccine hesitancy compared to whites. Those 55 years and older and females had higher odds of wearing masks most or all the time. Protective service, construction, and installation and repair occupations had lower odds of wearing masks. ZIP Code level percentage of the population with a bachelors' which was associated with mask wearing, higher vaccination, and lower vaccine hesitancy. CONCLUSION: Associations found in earlier phases of the pandemic were generally found to also be present later in the pandemic, indicating stability in inequities. Additionally, inequities in these important outcomes suggests more work is needed to bridge gaps to ensure that the burden of COVID-19 risk does not disproportionately fall upon subgroups of the population.

Neutralizing-antibody response to SARS-CoV-2 for 12 months after the COVID-19 workplace outbreaks in Japan.

This study aimed to elucidate the 12-month durability of neutralizing antibodies (NAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients infected during the 2020 workplace outbreaks of coronavirus disease 2019 (COVID-19) in Japan. We followed 33 Japanese patients infected with SARS-CoV-2 in April 2020 for 12 months (12M). Patients were tested for NAbs and for antibodies against the SARS-CoV-2 nucleocapsid (anti-NC-Ab) and antibodies against the spike receptor-binding domain (anti-RBD-Ab). Tests were performed at 2M, 6M, and 12M after the primary infection (api) with commercially available test kits. In 90.9% (30/33) of patients, NAbs persisted for 12M api, though the median titers significantly declined from 78.7% (interquartile range [IQR]: 73.0-85.0%) at 2M, to 59.8% (IQR: 51.2-77.9) at 6M (P = 0.008), and to 56.2% (IQR: 39.6-74.4) at 12M (P<0.001). An exponential decay model showed that the NAb level reached undetectable concentrations at 35.5 months api (95% confidence interval: 26.5-48.0 months). Additionally, NAb titers were significantly related to anti-RBD-Ab titers (rho = 0.736, P<0.001), but not to anti-NC-Ab titers. In most patients convalescing from COVID-19, NAbs persisted for 12M api. This result suggested that patients need a booster vaccination within one year api, even though NAbs could be detected for over two years api. Anti-RBD-Ab titers could be used as a surrogate marker for predicting residual NAb levels.

Social Network Analysis on the Mobility of Three Vulnerable Population Subgroups: Domestic Workers, Flight Crews, and Sailors during the COVID-19 Pandemic in Hong Kong.

BACKGROUND: Domestic workers, flight crews, and sailors are three vulnerable population subgroups who were required to travel due to occupational demand in Hong Kong during the COVID-19 pandemic. OBJECTIVE: The aim of this study was to explore the social networks among three vulnerable population subgroups and capture temporal changes in their probability of being exposed to SARS-CoV-2 via mobility. METHODS: We included 652 COVID-19 cases and utilized Exponential Random Graph Models to build six social networks: one for the cross-sectional cohort, and five for the temporal wave cohorts, respectively. Vertices were the three vulnerable population subgroups. Edges were shared scenarios where vertices were exposed to SARS-CoV-2. RESULTS: The probability of being exposed to a COVID-19 case in Hong Kong among the three vulnerable population subgroups increased from 3.38% in early 2020 to 5.78% in early 2022. While domestic workers were less mobile intercontinentally compared to flight crews and sailors, domestic workers were 1.81-times in general more likely to be exposed to SARS-CoV-2. CONCLUSIONS: Vulnerable populations with similar ages and occupations, especially younger domestic workers and flight crew members, were more likely to be exposed to SARS-CoV-2. Social network analysis can be used to provide critical information on the health risks of infectious diseases to vulnerable populations.

Social Network Analysis on the Mobility of Three Vulnerable Population Subgroups: Domestic Workers, Flight Crews, and Sailors during the COVID-19 Pandemic in Hong Kong

Background: Domestic workers, flight crews, and sailors are three vulnerable population subgroups who were required to travel due to occupational demand in Hong Kong during the COVID-19 pandemic. Objective: The aim of this study was to explore the social networks among three vulnerable population subgroups and capture temporal changes in their probability of being exposed to SARS-CoV-2 via mobility. Methods: We included 652 COVID-19 cases and utilized Exponential Random Graph Models to build six social networks: one for the cross-sectional cohort, and five for the temporal wave cohorts, respectively. Vertices were the three vulnerable population subgroups. Edges were shared scenarios where vertices were exposed to SARS-CoV-2. Results: The probability of being exposed to a COVID-19 case in Hong Kong among the three vulnerable population subgroups increased from 3.38% in early 2020 to 5.78% in early 2022. While domestic workers were less mobile intercontinentally compared to flight crews and sailors, domestic workers were 1.81-times in general more likely to be exposed to SARS-CoV-2. Conclusions: Vulnerable populations with similar ages and occupations, especially younger domestic workers and flight crew members, were more likely to be exposed to SARS-CoV-2. Social network analysis can be used to provide critical information on the health risks of infectious diseases to vulnerable populations.

Diet during the COVID-19 pandemic: An analysis of Twitter data.

In this study, we measured the association between county characteristics and changes in healthy-food, fast-food, and alcohol tweets during the COVID-19 pandemic in the United States. Our analytic dataset consisted of 1,282,316 geotagged tweets that referenced food consumption posted before (63.2%) and during (36.8%) the pandemic and included all US states. We found the share of healthy-food tweets increased by 20.5% during the pandemic compared with pre-pandemic, while fast-food and alcohol tweets decreased by 9.4% and 11.4%, respectively. We also observed that time spent at home and more grocery stores per capita were associated with increased odds of healthy-food tweets and decreased odds of fast-food tweets. More liquor stores per capita was associated with increased odds of alcohol tweets. Our results highlight the potential impact of the pandemic on nutrition and alcohol consumption and the association between the built environment and health behaviors.

Effects of demolishing abandoned buildings on firearm violence: a moderation analysis using aerial imagery and deep learning.

PURPOSE: Demolishing abandoned buildings has been found to reduce nearby firearm violence. However, these effects might vary within cities and across time scales. We aimed to identify potential moderators of the effects of demolitions on firearm violence using a novel approach that combined machine learning and aerial imagery. METHODS: Outcomes were annual counts of fatal and non-fatal shootings in Rochester, New York, from 2000 to 2020. Treatment was demolitions conducted from 2009 to 2019. Units of analysis were 152×152 m grid squares. We used a difference-in-differences approach to test effects: (A) the year after each demolition and (B) as demolitions accumulated over time. As moderators, we used a built environment typology generated by extracting information from aerial imagery using convolutional neural networks, a deep learning approach, combined with k-means clustering. We stratified our main models by built environment cluster to test for moderation. RESULTS: One demolition was associated with a 14% shootings reduction (incident rate ratio (IRR)=0.86, 95% CI 0.83 to 0.90, p<0.001) the following year. Demolitions were also associated with a long-term, 2% reduction in shootings per year for each cumulative demolition (IRR=0.98, 95% CI 0.95 to 1.00, p=0.02). In the stratified models, densely built areas with higher street connectivity displayed following-year effects, but not long-term effects. Areas with lower density and larger parcels displayed long-term effects but not following-year effects. CONCLUSIONS: The built environment might influence the magnitude and duration of the effects of demolitions on firearm violence. Policymakers may consider complementary programmes to help sustain these effects in high-density areas.

Impact of the COVID-19 pandemic on provision of HIV/AIDS services for key populations.

The COVID-19 pandemic has aggravated the obstacles for HIV/AIDS programs in limited-resource countries like Vietnam to achieve the HIV/AIDS-related Sustainable Development target. The paper aims to evaluate the impact of the COVID-19 pandemic on the provision of HIV/AIDS services-a pathway to achieving universal health coverage for key populations (KPs). Employing mix-methods, we conducted a desk study, one focus group discussion, and ten in-depth interviews with participants from the Ministry of Health, Provincial Centres for Disease Control, and HIV/AIDS-related facilities. The results showed the reduced coverage of KPs with access to prevention (i.e., harm-reduction services, counselling), testing, and treatment services (i.e., antiretroviral therapy, isoniazid preventive therapy). It also showed the reduced coverage of quality essential services, mainly in skipping consultation and testing, delaying un-emergency services, and redirecting KPs to non-HIV-specialised facilities. There was a gap in providing support for mental health, violence/abuse, and reproductive health. Financial risk protection for KPs was reduced due to uncertain local budget allocation; decreasing their ability to pay for HIV/AIDS-related services and social health insurance premiums; and increased out-of-pocket payments to comply with the COVID-19 control measures. This paper provides recommendations for strategic planning to ensure universal health coverage for KPs in the post COVID-19 era, especially for limited-resource countries like Vietnam.

Safety and immunogenicity of Nanocovax, a SARS-CoV-2 recombinant spike protein vaccine: Interim results of a double-blind, randomised controlled phase 1 and 2 trial.

Background: Nanocovax is a recombinant severe acute respiratory syndrome coronavirus 2 subunit vaccine composed of full-length prefusion stabilized recombinant SARS-CoV-2 spike glycoproteins (S-2P) and aluminium hydroxide adjuvant. Methods: We conducted a dose-escalation, open label trial (phase 1) and a randomized, double-blind, placebo-controlled trial (phase 2) to evaluate the safety and immunogenicity of the Nanocovax vaccine (in 25 mcg, 50 mcg, and 75 mcg doses, aluminium hydroxide adjuvanted (0·5 mg/dose) in 2-dose regime, 28 days apart (ClinicalTrials.gov number, NCT04683484). In phase 1, 60 participants received two intramuscular injection of the vaccine following dose-escalation procedure. The primary outcomes were reactogenicity and laboratory tests to evaluate the vaccine safety. In phase 2, 560 healthy adults received either vaccine doses similar in phase 1 (25 or 50 or 75 mcg S antigen in 0·5 mg aluminium per dose) or adjuvant (0·5 mg aluminium) in a ratio of 2:2:2:1. One primary outcome was the vaccine safety, including solicited adverse events for 7 day and unsolicited adverse events for 28 days after each injection as well as serious adverse event or adverse events of special interest throughout the study period. Another primary outcome was anti-S IgG antibody response (Index unit/ml). Secondary outcomes were surrogate virus neutralisation (inhibition percentage), wild-type SARS-CoV-2 neutralisation (dilution fold), and T-cell responses by intracellular staining for interferon gamma (IFNg). Anti-S IgG and neutralising antibody levels were compared with convalescent serum samples from symptomatic Covid-19 patients. Findings: For phase 1 study, no serious adverse events were observed for all 60 participants. Most adverse events were grade 1 and disappeared shortly after injection. For phase 2 study, after randomisation, 480 participants were assigned to receive the vaccine with adjuvant, and 80 participants were assigned to receive the placebo (adjuvant only). Reactogenicity was absent or mild in the majority of participants and of short duration (mean ≤3 days). Unsolicited adverse events were mild in most participants. There were no serious adverse events related to Nanocovax. Regarding the immunogenicity, Nanocovax induced robust anti-S antibody responses. In general, there humoral responses were similar among vaccine groups which reached their peaks at day 42 and declined afterward. At day 42, IgG levels of vaccine groups were 60·48 [CI95%: 51·12-71·55], 49·11 [41·26-58·46], 57·18 [48·4-67·5] compared to 7·10 [6·32-13·92] of convalescent samples. IgG levels reported here can be converted to WHO international standard binding antibody unit (BAU/ml) by multiplying them to a conversion factor of 21·8. Neutralising antibody titre of vaccine groups at day 42 were 89·2 [52·2-152·3], 80·0 [50·8-125.9] and 95·1 [63·1-143·6], compared to 55·1 [33·4-91·0] of the convalescent group. Interpretation: Up to day 90, Nanocovax was found to be safe, well tolerated, and induced robust immune responses. Funding: This work was funded by the Coalition for Epidemic Preparedness Innovations (CEPI), the Ministry of Science and Technology of Vietnam, and Nanogen Pharmaceutical Biotechnology JSC.

Semi-nested RT-PCR enables sensitive and high-throughput detection of SARS-CoV-2 based on melting analysis.

BACKGROUND: Asymptomatic transmission was found to be the Achilles' heel of the symptom-based screening strategy, necessitating the implementation of mass testing to efficiently contain the transmission of COVID-19 pandemic. However, the global shortage of molecular reagents and the low throughput of available realtime PCR facilities were major limiting factors. METHODS: A novel semi-nested and heptaplex (7-plex) RT-PCR assay with melting analysis for detection of SARS-CoV-2 RNA has been established for either individual testing or 96-sample pooled testing. The complex melting spectrum collected from the heptaplex RT-PCR amplicons was interpreted with the support of an artificial intelligence algorithm for the detection of SARS-CoV-2 RNA. The analytical and clinical performance of the semi-nested RT-PCR assay was evaluated using RNAs synthesized in-vitro and those isolated from nasopharyngeal samples. RESULTS: The LOD of the assay for individual testing was estimated to be 7.2 copies/reaction. Clinical performance evaluation indicated a sensitivity of 100% (95% CI: 97.83-100) and a specificity of 99.87% (95% CI: 99.55-99.98). More importantly, the assay supports a breakthrough sample pooling method, which makes possible parallel screening of up to 96 samples in one real-time PCR well without loss of sensitivity. As a result, up to 8,820 individual pre-amplified samples could be screened for SARS-CoV-2 within each 96-well plate of realtime PCR using the pooled testing procedure. CONCLUSION: The novel semi-nested RT-PCR assay provides a solution for highly multiplex (7-plex) detection of SARS-CoV-2 and enables 96-sample pooled detection for increase of testing capacity. .

Structure-based 3D-Pharmacophore modeling to discover novel interleukin 6 inhibitors: An in silico screening, molecular dynamics simulations and binding free energy calculations.

Interleukin 6 (IL-6) is a cytokine with various biological functions in immune regulation, hematopoiesis, and inflammation. Elevated IL-6 levels have been identified in several severe disorders such as sepsis, acute respiratory distress syndrome (ARDS), and most recently, COVID-19. The biological activity of IL-6 relies on interactions with its specific receptor, IL-6Rα, including the membrane-bound IL-6 receptor (mIL-6R) and the soluble IL-6 receptor (sIL-6R). Thus, inhibition of the interaction between these two proteins would be a potential treatment for IL-6 related diseases. To date, no orally available small-molecule drug has been approved. This study focuses on finding potential small molecules that can inhibit protein-protein interactions between IL-6 and its receptor IL-6Rα using its crystal structure (PDB ID: 5FUC). First, two pharmacophore models were constructed based on the interactions between key residues of IL-6 (Phe74, Phe78, Leu178, Arg179, Arg182) and IL-6Rα (Phe229, Tyr230, Glu277, Glu278, Phe279). A database of approximately 22 million compounds was screened using 3D-pharmacophore models, molecular docking models, and ADMET properties. By analyzing the interactive capability of successfully docked compounds with important amino acids, 12 potential ligands were selected for further analysis via molecular dynamics simulations. Based on the stability of the complexes, the high interactions rate of each ligand with the key residues of IL-6/IL-6Rα, and the low binding free energy calculation, two compounds ZINC83804241 and ZINC02997430, were identified as the most potential IL-6 inhibitor candidates. These results will pave the way for the design and optimization of more specific compounds to combat cytokine storm in severe coronavirus patients.

Quality of Life and Factors Affecting It: A Study Among People Living Near a Solid Waste Management Facility.

Background: The amount of waste generated has been increasing over the years. Meanwhile, the capacity of solid waste management facilities (SWMFs) for waste disposal does not meet the needs, resulting in adverse consequences on the natural environment and health of residents living near these plants, which can significantly degrade their quality of life (QoL). This study aims to evaluate the QoL of residents living near an SWMF and the potential impacts it has on the residents. Methods: A cross-sectional descriptive study was conducted involving 801 subjects, aged 18 and above, who live near the SWMF of Hue City, Vietnam. The QoL of the subjects was quantitatively assessed using the WHO QoL assessment scale (WHOQOL-BREF). The general, health, and environmental factors influencing QoL were identified using bivariate and multivariate logistic regression analyses. Results: About 22.6% of the subjects had a good QoL. In particular, the proportions for good psychological health (6.9%) and environment (13.6%) were low, indicating an influence of the SWMF. Significant factors that degraded the QoL of residents were less education defined by not graduating from high school (odds ratio, OR = 2.78; 95% CI = 1.09-7.06), poor health status (OR = 2.50; 95% CI: 1.56-4.01), dissatisfaction with water quality (OR = 2.41; 95% CI: 1.10-5.25), and unacceptance of the SWMF presence (OR = 1.70; 95% CI: 1.11-2.60). Moreover, subjects living within 2 km of the plant had dermatological diseases and digestive disorders more frequently than those who lived away from the plant. They also reported more complaints regarding water, air, and soil quality, which were likely due to the operation of the SWMF. Conclusions: Burying and disposing of solid waste at the SWMF might lead to the degradation of the surrounding water and soil environments, and its collection and transportation are considered to cause odor and dust. The efforts of responsible authorities to strictly supervise and inspect these activities at the SWMF are essential, not only to protect the surrounding environment but also to improve the QoL of those who live nearby these plants.

Patient, physician, and policy factors underlying variation in use of telemedicine for radiation oncology cancer care.

BACKGROUND: Oncology telemedicine was implemented rapidly after COVID-19. We examined multilevel correlates and outcomes of telemedicine use for patients undergoing radiotherapy (RT) for cancer. METHODS: Upon implementation of a telemedicine platform at a comprehensive cancer center, we analyzed 468 consecutive patient RT courses from March 16, 2020 to June 1, 2020. Patients were categorized as using telemedicine during ≥1 weekly oncologist visits versus in-person oncologist management only. Temporal trends were evaluated with Cochran-Armitage tests; chi-squared test and multilevel multivariable logistic models identified correlates of use and outcomes. RESULTS: Overall, 33% used telemedicine versus 67% in-person only oncologist management. Temporal trends (ptrend  < 0.001) correlated with policy changes: uptake was rapid after local social-distancing restrictions, reaching peak use (35% of visits) within 4 weeks of implementation. Use declined to 15% after national "Opening Up America Again" guidelines. In the multilevel model, patients more likely to use telemedicine were White non-Hispanic versus Black or Hispanic (odds ratio [OR] = 2.20, 95% confidence interval [CI] 1.03-4.72; p = 0.04) or receiving ≥6 fractions of RT versus 1-5 fractions (OR = 4.49, 95% CI 2.29-8.80; p < 0.001). Model intraclass correlation coefficient demonstrated 43% utilization variation was physician-level driven. Treatment toxicities and 30-day emergency visits or unplanned hospitalizations did not differ for patients using versus not using telemedicine (p > 0.05, all comparisons). CONCLUSION: Though toxicities were similar with telemedicine oncology management, there remained lower uptake among non-White patients. Continuing strategies for oncology telemedicine implementation should address multilevel patient, physician, and policy factors to optimize telemedicine's potential to surmount-and not exacerbate-barriers to quality cancer care.

Factors Associated with Community Awareness on COVID-19 in a Developing Country: Implications for Optimal Risk Communication

Purpose New COVID-19 variants pose great challenges in protecting the success of vaccination programs. Awareness of community becomes an important component to prevent the spread of COVID-19. This study aims to analyze people’s awareness of COVID-19 and identify the implications for optimal risk communication in Vietnam. Study Methods and Materials A total of 341 individuals participated in an online cross-sectional study. Community awareness on COVID-19 was examined by using a structured questionnaire. Multivariable Tobit regression was used to examine associated factors with community awareness. Results Our results indicated high levels of awareness of local COVID-19 situation, transmission risks, and preventive behavioral practices during the first week of social isolation. Higher awareness of local pandemic situation was associated with female respondents (Coef.: 6.19;95% CI: 0.51;11.87) and larger family sizes of above 5 people (Coef.: 9.00;−1.00;19.00). Respondents between 35–44 years old were shown to be less aware of preventive behavioral practices than other age groups, including the group of participants above 44 years old (Coef.: −0.34;95% CI: −0.67;−0.02). Lastly, participants who were “fairly satisfied” with information resources had awareness levels of preventive behavioral practices lower than that of “unsatisfied” respondents (Coef.: −0.45;95% CI: 0.74;−0.16). Conclusion This study offers crucial insights into the pandemic awareness of citizens and risk communication effectiveness during COVID-19 in Vietnam. The study findings shall serve the development of policies and interventions aimed at empowering individuals in the local and global fight against coronavirus.

Knowledge and Self-Protective Practices Against COVID-19 Among Healthcare Workers in Vietnam.

Background: In middle-income countries such as Vietnam, where healthcare resources are already constrained, protecting healthcare workers (HCWs) is essential for ensuring the sustainability of COVID-19 response in Vietnam. This study was conducted to assess the knowledge and practices regarding the prevention of the COVID-19 among the HCWs in Vietnam to identify the ways of disseminating information to maximize the safety of these essential workers. Methods: An online cross-sectional study, using respondent-driven sampling, was conducted in Vietnam with 742 participants within 2 weeks. The validity of the questionnaire was examined by exploratory factor analysis. Descriptive statistics were used to identify the level of knowledge and practices among the HCWs to prevent the COVID-19. Inferential statistics and regression modeling were used to identify the associated factors with results. Results: Vietnamese HCWs had a high level of knowledge with more than 75% of the participants demonstrating awareness of all the modes of transmission aside from air. The mean knowledge score was 3.7 ± 0.8 (range 1-5). Nearly all the participants relied on the Ministry of Health (98.3%) and the internet (95.5%) for information regarding the COVID-19. The participants endorsed a moderately high level of self-protective practices with mean scores of 4.2 and 3.6 (band score 1-5) for the precautionary and psychological measures, respectively. Nurses were more likely to practice the precautionary measures than doctors and the HCWs at the central level were more likely to practice the psychological measures than those at the district level. Conclusion: Future education initiatives should consolidate the latest literature in an accessible format, focusing initially on the gaps of knowledge regarding aerosol transmission. These initiatives should primarily focus on the doctors, especially those in emergency and intensive care departments.