Effect of the capsid assembly modulator (CAM) ALG-000184 on HBsAg Levels in subjects with HBeAg positive chronic hepatitis B (CHB)

Background: ALG-000184 is a prodrug of ALG-001075, a novel, potent, pan-genotypic Class II CAM. CAMs are thought to have two mechanisms of action (MoA). The primary MoA affects pgRNA encapsidation resulting in inhibition of HBV DNA/RNA replication, as confirmed in CHB subjects receiving ALG-000184. The secondary MoA, which occurs at higher concentrations, regulates the establishment and replenishment of cccDNA, resulting in lowering of HBsAg, an effect that has not been reported to date with ALG- 000184. Method(s): ALG-000184-201 is a multi-part, multicenter, doubleblind, randomized, placebo-controlled study. In healthy volunteers (HVs), single doses up to 500 mg and multiple doses up to 250 mg were well tolerated with linear PK (Gane E., HBV TAG and APASL 2021). In treatment naive (TN) subjects with CHB, daily oral doses of 10-100 mg ALG-000184 for 28 days were well tolerated with linear PK and were associated with profound reductions of DNA/RNA regardless of HBeAg status or dose (Yuen MF, EASL 2022). Plasma exposures required to engage the secondary MoA are expected to be achieved at the 300 mg dose level. Data from a 300 mg cohort treated for 28 days are described here. Data from another ongoing cohort treated with 300 mg for 12 weeks will be presented at the conference. Result(s): Ten subjects were randomized to 300 mg ALG-000184 for 28 days and two to placebo. Two subjects randomized to ALG- 000184 were replaced due to missing data due to Covid-19 lockdown. Subjects were Asian, HBeAg positive, and genotype B or C. Mean baseline HBV DNA and RNA levels were 8.4 log10 IU/mL and 7.3 log10 copies/mL, respectively. One subject experienced a serious adverse event (AE) of pneumothorax>8 weeks after last dose which was considered unlikely related to study drug. No subjects prematurely discontinued study drug. All treatment emergent AEs were Grade <= 2 except for 4 Grade >= 3 alanine aminotransferase (ALT) elevations, which an independent ALT Flare Committee assessed as not related to study drug toxicity. PK was similar to HBeAg negative and HV cohorts following body weight adjustment. Subjects dosed with 300 mg ALG-000184 experienced mean declines of 4.0 log10 IU/mL and 2.6 log10 copies/mL in HBV DNA and RNA levels, respectively, at Day 28. Three of 7 evaluable subjects who received ALG-000184 had HBsAg declines>0.2 log10 IU/mL (0.23-0.78 log10 IU/mL). One subject receiving ALG-000184 had unquantifiable HBsAg throughout the study. Additionally, one HBeAg positive subject in a prior 100 mg cohort had plasma exposures equivalent to the 300 mg dose level and experienced a 0.5 log10 IU/mL HBsAg decline. Conclusion(s): In TN HBeAg positive CHB subjects, 300 mg ALG- 000184 for 28 days was well tolerated, exhibited predictable PK and resulted in rapid and substantial declines in HBV DNA and RNA. Notably, 3 of 7 evaluable subjects from this cohort experienced HBsAg declines of up to 0.78 log10 IU/mL. These data suggest that ALG-000184 can engage the secondary MoA of CAM II. Cohorts evaluating 300 mg over longer durations are planned or ongoing.

Multiplex and Ultrasensitive Detection of Severe Acute Respiratory Syndrome Coronavirus 2 and Influenza A/B Nucleocapsid Proteins Based on Nanometer-Sized Core-Shell Superparamagnetic Antifouling Probes

Infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A (Flu A), and influenza B (Flu B) show similar clinical symptoms, such as cough, fever, and dyspnea, but patients infected by these viruses should be treated differently. The rapid and accurate diagnosis of infections caused by SARS-CoV-2, Flu A or Flu B is critical during the influenza season. Herein, we synthesized core-shell magnetic particles (MNPs) with excellent antifouling properties and applied them in the MNP-based immunochromatographic test (MICT) for simultaneous detection of SARS-CoV-2, Flu A, and Flu B nucleocapsid(N) proteins in 20 min. Two kinds of carboxyl -modified MNPs, MNP@pMBAA and MNP@Si-SA, were prepared and evaluated as probes in the MICT. Among them, the MNP@ pMBAA showed lower nonspecific adsorption of proteins and low background noise in the application in MICTs. Particularly, the MNP@pMBAA50 bead-based MICT strip exhibited the highest signal-to-noise ratio for SARS-CoV-2 N protein detection with a limit of detection (LOD) of 0.072 ng/mL. Moreover, the proposed MICT strip demonstrated a minimal cross-reactivity and a broad linear dynamic detection range under a magnetic assay reader in the simultaneous detection of SARS-CoV-2, Flu A, and Flu B N proteins with relative LOD values of 0.0086, 0.012, and 0.018 ng/mL, respectively. The results demonstrated that the synthesized MNPs showed great potential for use as MICT probes for sensitive and multiplex detection of biomarkers in the development of point-of-care testing systems.

Multiplex and Ultrasensitive Detection of Severe Acute Respiratory Syndrome Coronavirus 2 and Influenza A/B Nucleocapsid Proteins Based on Nanometer-Sized Core-Shell Superparamagnetic Antifouling Probes

Infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A (Flu A), and influenza B (Flu B) show similar clinical symptoms, such as cough, fever, and dyspnea, but patients infected by these viruses should be treated differently. The rapid and accurate diagnosis of infections caused by SARS-CoV-2, Flu A or Flu B is critical during the influenza season. Herein, we synthesized core-shell magnetic particles (MNPs) with excellent antifouling properties and applied them in the MNP-based immunochromatographic test (MICT) for simultaneous detection of SARS-CoV-2, Flu A, and Flu B nucleocapsid(N) proteins in 20 min. Two kinds of carboxyl-modified MNPs, MNP@pMBAA and MNP@Si-SA, were prepared and evaluated as probes in the MICT. Among them, the MNP@pMBAA showed lower nonspecific adsorption of proteins and low background noise in the application in MICTs. Particularly, the MNP@pMBAA50 bead-based MICT strip exhibited the highest signal-to-noise ratio for SARS-CoV-2 N protein detection with a limit of detection (LOD) of 0.072 ng/mL. Moreover, the proposed MICT strip demonstrated a minimal cross-reactivity and a broad linear dynamic detection range under a magnetic assay reader in the simultaneous detection of SARS-CoV-2, Flu A, and Flu B N proteins with relative LOD values of 0.0086, 0.012, and 0.018 ng/mL, respectively. The results demonstrated that the synthesized MNPs showed great potential for use as MICT probes for sensitive and multiplex detection of biomarkers in the development of point-of-care testing systems. © 2023 American Chemical Society.

Novel research methods on evaluating the nexus between environment and energy use: evaluating the role of tourism in the pre-COVID period

Since the fossil fuels are the principal energy sources across the globe, it is considered as the major reason for environmental degradation. Although, the fossil fuel consumption contributes to maintain industrial production, which is a key factor of economic growth, yet tourism is also among the key sources of revenue for China in the pre-Covid-19 pandemic. However, after the emergence of this novel pandemic, both fossil fuel consumption and tourism are severely affected that slowdowns China's economic progress and could have influence on environmental quality. This study investigates the impact of traditional fossil fuel, economic growth, and tourism on carbon emissions level in China over the period 1995–2020. Using time series estimating approaches, all the variables are found stationary at first difference. Due to irregular distribution of data, this study employed the novel Quantile-on-Quantile regression. The estimated results reveal that consumption of fossil fuel significantly enhances the level of carbon emissions in China. Whereas the impact of economic growth and tourism on carbon emission is mixed. The influence of both the variables is found positive in the lower and medium quantiles, while negative in the upper quantiles. This study also employed the pairwise Granger causality test, that validates two-way causal nexus between fossil fuel consumption—carbon emission and economic growth—carbon emissions. While one way causality from tourism to carbon emissions is evident in the empirical results. This study suggests lowering of fossil fuel consumption by using the alternative energy sources and increase tourism stringent environmental regulations for environmentally destructive tourism activities. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

A Population-Based Propensity Score-Matched Study of COVID-19 Vaccination on Clinical Outcomes in Hospitalized Adult Patients with COVID-19

Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause significant morbidity and mortality in hospitalized patients. We aimed to evaluate the impact of 2-dose COVID-19 vaccination on ICU admissions and inhospital deaths in adult patients with COVID-19. Methods. Laboratory-confirmed COVID-19 adult patients hospitalized at Memorial Healthcare System, Hollywood, Florida, between June 01, 2021 and September 20, 2021, were retrospectively reviewed. We used 1:1 propensity score matching for demographic characteristics and underlying diseases to construct an unvaccinated cohort similar to the vaccinated cohort. "Fully vaccinated" was defined as a patient who received 2-dose vaccines. Risk of in-hospital mortality or ICU admission was estimated using logistic regression models adjusting for age, gender, race/ethnicity, body mass index, and comorbidities. Results. 3067 unvaccinated and 284 fully vaccinated patients were included. The propensity score-matched cohort included 262 unvaccinated and 262 fully vaccinated patients. The median age was 71.0 (IQR, 60-81) years, 51.3% were men, and 36.2% were white participants. The most common comorbidities were hypertension (452;86.3%), diabetes (236;45.0%), and chronic kidney disease (163;31.1%). At the study closeout of Oct 18, 2021, 70 (13.4%) patients required ICU admission, and 81 (15.5%) patients died. In multivariable-adjusted models, fully vaccinated patients had lower risks of ICU admission and in-hospital mortality compared to unvaccinated patients (Figure 1). Patients who received the Pfizer BioNTech vaccines had comparable risks of ICU admission (adjusted odds ratio [aOR], 0.80;95% CI, 0.23-2.79;p=0.731) and in-hospital mortality (aOR, 2.99;95% CI, 0.59-15.3;p=0.187) compared to those received the Moderna vaccines (Figure 2). No difference in hospital length of stay or in ICU length of stay were noted between fully vaccinated and unvaccinated patients. Conclusion. Fully vaccinated patients hospitalized with COVID-19 have lower risks of ICU admission and in-hospital mortality than unvaccinated patients. No significant differences were noted in ICU admission and in-hospital mortality between patients who received Moderna vaccines and those received Pfizer BioNTech vaccines.

Characteristics and Outcomes in Hospitalized Adult Patients Infected with the SARS-CoV-2 Omicron Variant at a Large Healthcare System in South Florida, January 1 -14, 2022

Background. The SARS-CoV-2 Omicron variant has been rapidly spreading worldwide. We aimed to characterize Omicron severity by assessing in-hospital deaths and intensive care admissions in a large healthcare system in South Florida during an Omicron predominant surge. Methods. Laboratory-confirmed COVID-19 adult patients hospitalized during January 1 -14, 2022 were retrospectively reviewed. Risks of in-hospital mortality and intensive care admission were estimated using logistic regression models. Analyses were stratified by age >= 65 years and vaccination status, and further adjusted for sex, comorbidities, and history of a previous COVID-19 infection. Results. 500 consecutively hospitalized COVID-19 Omicron patients were included. The median age was 69 (IQR, 53-80) years, and 271 (54.2%) were women. The most common comorbidities were hypertension (65.5%), diabetes (32%), and chronic kidney disease (24%). 260 (52%) patients were fully vaccinated (defined as a patient who received 2-dose vaccines), and 32 (6.4%) were previously infected with COVID-19. 252 (50.4%) patients required supplemental oxygen, 54 (10.8%) required intensive care unit (ICU) admission, and 44 (8.8%) patients required mechanical ventilation. At study closeout of March 7, 2022, case fatality rates among patients aged 18 -29 years, 30 -39 years, 40-49 years, 50-59 years, 60-69 years, 70-79 years, and >= 80 years were 0%, 2.2%, 6.4%, 5.3%, 8.0%, 5.7%, and 15.4% respectively ( p < 0.001), with the median time from hospital admission to death being 13 days (IQR, 6.5-20.5) (Figure 1). Patients aged >= 65 years had 2.6 times higher rates for in-hospital mortality (OR, 2.63;95% CI, 1.29-5.33;p =0.007) than those aged < 65 years, but were comparable for ICU admission (OR, 0.85;95% CI, 0.49-1.52;p =0.586). Past vaccination offered no protection against in-hospital mortality (OR, 1.18;95% CI, 0.64-2.19;p =0.599) or ICU admission (OR, 1.16;95% CI, 0.66-2.06;p =0.6) (Figure 2). In multivariable-adjusted models, patients aged >= 65 years had a higher in-hospital mortality than those aged < 65 years (Figure 2). Conclusion. This case series provides characteristics and outcomes of hospitalized adult patients with COVID-19 Omicron variant. Past COVID-19 vaccination did not impact ICU admission rate nor in-hospital mortality.

Clinical Presentations of Hospitalized Adult Patients Infected with SARS-CoV-2 during the Omicron Variant Surge in South Florida

Background. Patients infected with COVID-19 Omicron variant, may be hospitalized for reasons other than COVID-19 pneumonia. We describe the clinical presentations of hospitalized adult patients with COVID-19 Omicron variant in a large healthcare system in South Florida. Methods. Laboratory-confirmed COVID-19 adult patients hospitalized during January 1-14, 2022 were retrospectively reviewed. Clinical presentations were divided into one of three admission groups: COVID-19 pneumonia or respiratory infection (Group 1), severe extrapulmonary manifestations of COVID-19 (Group 2), and completely incidental diagnosis of COVID-19 (Group 3). Risks of in-hospital mortality and intensive care admission were estimated using logistic regression models. Results. Among 500 consecutively hospitalized COVID-19 Omicron patients, the median age was 69 (IQR, 53-80) years, and 271 (54.2%) were women. The most common comorbidities were hypertension (326;65.5%), diabetes (160;32%), and chronic kidney disease (120;24%). 260 (52%) patients were fully vaccinated (defined as a patient who received 2-dose vaccines), and 32 (6.4%) were previously infected with COVID-19. 257(51.4%) patients were classified as Group 1, 82 (16.4%) in Group 2, and 161 (32.2%) in Group 3 (Figure 1). Compared to Group 3, patients in Group 1 and Group 2 had a higher risk for ICU admission, with odds ratios (ORs) of 7.45 (95% CI, 2.62-21.23;p< 0.001) and 4.84 (95% CI, 1.44-16.23;p=0.011), and for in-hospital mortality, with ORs of 27.76 (95% CI, 3.78-204.3;p=0.001) and 12.63 (95% CI, 1.49-106.78;p=0.020), respectively (Figure 2). In multivariable-adjusted models, patients in Group 1 remained at higher risk for ICU admission and in-hospital mortality compared to Group 3, while patients in Group 2 remained at a higher risk for ICU admission, but with no difference in in-hospital mortality compared to Group 3 (Figure 2). Figure 1. Clinical characteristics of consecutively hospitalized patients stratified by clinical presentations at admission. Figure 2. Crude (Upper panel) and multivariable-adjusted (Lower panel) odds ratios for ICU admission and in-hospital mortality from logistic regression models. Group 3 represents patients with a completely incidental diagnosis of COVID-19. The variables included in the final multivariable models were age, gender, history of hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease, malignancy, transplantation, HIV, vaccination status, and previous SARS-CoV-2 infection. Conclusion. This case series illustrates the clinical presentations of hospitalized adult patients infected with the COVID-19 Omicron variant. Significant differences in in-hospital mortality and ICU admission exist when comparing patients admitted for a COVID-19 related respiratory infection to those admitted with a completely incidental COVID-19 diagnosis.

[Clinical update in non-invasive positive pressure ventilation for respiratory failure in 2022].

In this article, we searched the research literatures related to clinical investigation of non-invasive positive pressure ventilation (NPPV) in acute respiratory failure(ARF)/chronic respiratory failure(CRF) between 1st October 2021 and 30th September 2022 through Medline, and reviewed the important advances. Three prospective randomized controlled studies related to the efficacy and safety of NPPV and/or high-flow nasal cannula oxygen therapy (HFNC) on patients with COVID-19 with ARF were reported, showing that NPPV (including continuous positive airway pressure and bilevel positive airway pressure) was able to reduce the intubation rate, but the efficacy of HFNC was contradictory. In addition, progress has been made in outcome prediction models for ARF treated with NPPV, NPPV-related cardiac arrest, and the impact of human-machine interface on NPPV treatment outcomes. The effects of NPPV as preoxygenation method before intubation was reported to be able to reduce severe desaturation during intubation, especially in obese population. The use of NPPV in extubated patients resulting in reduced reintubation rate was also studied. With regard to long-term home application of NPPV, five indicators of successful initiation were proposed, but the success rate was low in clinical practice. Some reports showed that psychological support could improve the adherence to NPPV. The results of these studies contributed to the rational selection and optimal application of NPPV in clinical practice.

Network Pharmacology Discussion on the Mechanism of Shufeng Jiedu Granules in Treating Corona Virus Disease 2019

Objective: To study the mechanism of Shufeng jiedu granules in treating Corona Virus Disease 2019(COVID-19)based on network pharmacology. Method(s): TCMSP database was used to search and screen the active components of Shufeng jiedu granules, GeneGards database was used to predict and screen disease targets, the common targets of the above two were input into the STRING database to obtain the target protein interaction network, the PPI network and the "traditional Chinese medicines-components-targets-diseases" network were constructed by using Cytoscape 3.7.2 software, and the GO function enrichment analysis and KEGG pathway enrichment analysis were carried out by using Cytoscape 3.7.2 software, R software and the corresponding program package. Result(s): A total of 207 active components and 1 006 traditional Chinese medicine component targets were screened, and 350 COVID-19-related targets were identified, so as to obtain 49 common drug-disease targets.GO functional enrichment analysis resulted in 1 575 items(P<0.05), KEGG enrichment analysis resulted in 120 related signaling pathways(P<0.05), mainly involving IL-17 signaling pathway, TNF signaling pathway, etc. Conclusion(s): Shufeng jiedu granules may achieve the therapeutic effect of COVID-19 through multi-targets, multi-pathways to regulate virus and inflammation-related pathways. Copyright © 2021, Central Station of Chinese Medicinal Materials Information, National Medical Products Administration. All right reserved.

Mortality and prognostic factors in hospitalized COVID-19 patients with cancer: An analysis from a large healthcare system in the United States

Background: Coronavirus 19 (COVID-19) is a severe global pandemic and a public health challenge. Patients with COVID-19 and cancer are at an increased risk of poor clinical outcomes. Data is lacking in evaluating outcomes in patients with different cancers, races and ages;particularly in Florida with high proportion of elderly and the largest racial/ethnic disparities. We evaluated the in-hospital mortality of COVID-19 positive cancer patients. Methods: We used retrospective data of COVID-19 patients hospitalized at the Memorial Healthcare System between March 1, 2020 and January 18, 2021. Over 4,870 patients with COVID-19 were evaluated, of which 265 (5.4%) had cancer. The primary endpoint was in-hospital mortality in patients with cancer and COVID-19. Mortality was analyzed in COVID- 19 patients with/without a cancer history. We used descriptive statistics to synthesize outcomes and characteristics from the study population. Univariate and multivariate logistic analysis were performed to define baseline clinical characteristics potentially associated with mortality in cancer patients with COVID-19. Results: 4,870 patients with COVID-19 were evaluated and 265 had malignancy. The study included all different races including Non-Hispanic Whites (NHW) 816 (16.8%), Hispanics 2,271 (46.6%), African-Americans (AA) 1,534 (31.5%) and other minorities 248 (5.1%). Of cancer patients, 24.1% NHW, 43% Hispanic, 28.7% AA and 4.2% other minorities. Amongst races, NHW with cancer accounted for the highest number of COVID-related deaths representing 37.5%, while Hispanics and AA accounted for 18.4% and 19.7% respectfully. Amid cancer subtypes, 24.6% of hematological cancers resulted in mortality and 23.5% of solid cancers resulted in mortality, but no statistical significance was seen. Additionally, after adjusting for age, gender, and race, cancer was linked to an increased in-hospital mortality. Lastly, older age (> 65), elevated creatinine levels (Cr) and elevated C-reactive protein (CRP) were associated with increased risk of death. Conclusions: Patients with COVID-19 and cancer had worse outcomes. Cancer subtypes included hematological and solid cancers, with similar in-hospital mortalities. Although NHW were the smallest group, they had the highest rate of in-hospital deaths amongst cancer patients with COVID-19, in comparison to Hispanics, the largest group in the study, had the least amount of in-hospital deaths. Additionally, factors such as advanced age, elevated Cr and CRP were associated with increased risk of COVID-related deaths. The findings indicate the need for close surveillance and monitoring of these patients as they are more likely to have complications such as mortality from COVID-19.

Experience of Overseas Research on Electronic Health Literacy and Its Enlightenment to China in Public Health Emergencie

The Internet has become an important carrier of medical information.Good electronic health literacy can enhance the public’s ability to obtain correct medical and health information with the help of electronic resources,which is helpful for the public to use health information to prevent diseases,avoid drug abuse,reduce the waste of medical resources and strengthen the self-management of chronic diseases. The improvement of electronic health literacy is of great value to the healthy development of citizens’ health literacy and healthy behavior.In view of the late start and slow development in the field of electronic health literacy in China,by combing the theoretical and practical research experience of electronic health literacy outside the region and combining with the COVID-19,this paper put forward new thinking on electronic health literacy in China,in order to provide useful reference for improving electronic health iteracy of Chinese citizens,realizing self-care,self-management and disease prevention. © 2022, Editorial department of Chinese Medical Ethics. All rights reserved.

[Course of disease and related epidemiological parameters of COVID-19: a prospective study based on contact tracing cohort].

Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.

Racial and/or Ethnic Disparity in Multisystem Inflammatory Syndrome in Children (MIS-C) in the State of Mississippi, USA, July 2020 to June 2021

Purpose: The racial composition of Mississippi is Caucasian (C) 58%, African American (AA) 38%, and others 4%, whereas the SARS-CoV-2 PCR positive rates are 16% in AA, 25% in Hispanics, and 6% in C children. We aimed to study the disparities of MIS-C in Mississippi and whether MIS-C follow the same racial distribution as SARS-CoV-2 infection? Methods: Retrospective study of consecutive MIS-C patients <18 years of age hospitalized at our center over 1 year. We compared demographics, clinical presentation, laboratory findings, and treatment of MIS-C by race/ethnicity. We compared the distribution of MIS-C cases with that of SARS-CoV-2 infection rates. Results: During the study period, 51 MIS-C patients hospitalized. Median age was 9 year, 58% male, 36(71%) were AA, 13(25%) were C, 1 was Asian, and 1 was Hispanic. We found a significant delay between onset of symptoms and hospitalization in AA than C children, 2.3±2.1 vs. 0.6±1.5 days (P=0.002). Cardiac symptoms were present in 24%, and 39% had Kawasaki's disease-like symptoms. Only absolute neutrophil count was associated with cardiac dysfunction (p= 0.01) on multivariate analysis. Creatinine and ferritin levels were associated with ICU admission;p= 0.01 and 0.03, respectively. Differences in inflammatory and cardiac biomarkers between AA and C races are summarized in Figure 1. AA children with MIS-C had increased length of hospitalization (8.1 vs 5.2 days;p=0.04), a higher trend of more admissions to ICU (38.9% vs 23.1%;p=0.3) and cardiac involvement (36.1% vs 23.1%;p=0.5) than C Children (Figure 2). Conclusion: In Mississippi, racial disparity in MIS-C exceeds the differences of SARS-CoV-2 infection rates in children. AA children had delayed hospitalization from the onset of symptoms, severe inflammation, longer length of stay, a higher trend for more cardiac dysfunction and ICU admissions than C children. Our findings could assist health professionals in devising appropriate strategies to target minority children.

Machine Learning Identification of Self-reported COVID-19 Symptoms from Tweets in Canada

Surveillance of open-source media, such as social media, has become an essential complement to traditional surveillance data for quickly detecting changes in the occurrence of diseases in time and space. We present our method for classifying Tweets into narratives about COVID-19 symptoms to produce a dataset for downstream surveillance applications. A dataset of 10,405 tweets has been manually classified as relevant or not to self-reported symptoms of COVID-19. Five machine learning classification algorithms, with different tokenization methods, were trained on the dataset and tested. The Support vector machine (SVM) algorithm, with a term frequency-inverse document frequency (TF-IDF) 3-4 n-grams on character as the tokenization method, was the classification algorithm with the highest F1-score of 0.70. However, the training dataset showed an imbalanced classification problem. To reduce the bias of the imbalance classes, the crowdsourcing website Mechanical Turk was used to add 133 relevant tweets. This addition improved the F1-score from 0.70 to 0.77. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Impact of COVID-19 Pandemic on an Emergency Department Opt-out HIV Screening Program: An Interrupted Time Series Analysis

Background. The coronavirus disease 2019 (COVID-19) pandemic has posed tremendous challenges to health care systems, including emergency department (ED) priorities and visits. We describe the impact of COVID-19 pandemic on ED-based "Opt-out" HIV testing at a public healthcare system in South Florida. Methods. The programmatic data of ED-based HIV testing from July 2018 to March 2021 at the Memorial Regional Hospital, Hollywood, Florida was retrospectively analyzed. Interrupted time series (ITS) analysis models were developed to evaluate the immediate and gradual effects of the pandemic on the monthly number of HIV tests over time, with an interruption point at March 2020. Results. 45,185 HIV tests were recorded between July 2018 and March 2021. A mean of 1,745 (SD, 266) HIV tests per month before the COVID-19 pandemic (July 2018 to Feb 2020) and a mean of 791 (SD, 187) HIV tests per month during the pandemic period (March 2020 to March 2021) was seen (p< 0.0001). As shown in Table 1, there was a slight decline trend in the number of monthly HIV test before the pandemic (estimate -10.29, p=0.541). We estimated a significant decrease in monthly HIV tests (estimate -678.48, p = 0.008), whereas the slope change after the pandemic was non-significant (estimate 4.84, p = 0.891). The number of monthly HIV tests declined significantly during the early phase of the pandemic, particularly between March 2020 and September 2020 (all p< 0.05), with an estimated 48.0% decrease in the March 2020 (estimate -678.48, p = 0.007), 43% in the April 2020 (estimate -673.65, p=0.007), and 50.7% in the May 2020 (estimate -668.83, p=0.009), compared with the same month of the pre-pandemic period (Figure 1). This decline in number of monthly HIV tests is consistent with the first wave of the COVID-19 pandemic in South Florida. Number of decreased monthly HIV tests from October 2020 through March 2021 was less pronounced (all p >0.05) and returned to pre-pandemic levels. Conclusion. The COVID-19 pandemic led to a significant and immediate decline in monthly number of ED-based HIV tests. Disruption of basic health services by the COVID-19 pandemic is a public health concern. Strategies to develop an infrastructure to meet the demands of HIV testing should be implemented to ensure the current HIV prevention during the COVID-19 period.

Prognostic Value of Absolute Lymphocyte Count for Disease Severity and Clinical Outcomes in Adult COVID-19 Inpatients

Background. Lymphopenia has been reported as a relatively frequent finding in patients with coronavirus disease 2019 (COVID-19). This study aimed to assess the use of absolute lymphocyte count (ALC) as a prognostic biomarker for disease severity and clinical outcomes. Methods. A cohort of adult patients with COVID-19 admitted to Memorial Healthcare System, Hollywood, Florida from March 7, 2020 to January 18, 2021 was retrospectively analyzed. An absolute lymphocyte count (ALC) < 1.1 × 109/L was used as cutoff point to define lymphopenia. Correlations of ALC upon admission with age and serum levels of C-reactive protein, interleukin-6, lactate dehydrogenase, and creatinine were analyzed. Univariate and multivariate regression models were developed to assess the association of lymphopenia with the risk of ICU admission and clinical outcomes. Results. 4,485 hospitalized patients were included in the final analyses. Median age was 61 (interquartile range, 47-73) years and 2,311 (51.5%) were men. Lymphopenia was more frequent in patients admitted to the ICU compared to those that were not admitted to the ICU, with an odds ratio of 2.14 (95% confidence interval [CI], 1.78-2.56, p < .0001) (Figure 1). The actual value of the ALC was negatively correlated with age and serum levels of C-reactive protein, interleukin-6, lactate dehydrogenase, and creatinine (all p < 0.005). Patients with lymphopenia (n=2,409) compared to those without lymphopenia (n=2,076) had multivariable-adjusted odds ratios of 1.85 (95% CI, 1.53-2.24) for ICU admission, 2.08 (95% CI, 1.67-2.58) for intubation, 1.98 (95% CI, 1.31-3.00) for development of acute kidney failure, and 2.23 (95% CI, 1.79-2.79) for in-hospital mortality (Table 1). Analyses were adjusted for age, gender, race, hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease, malignancy, obesity, and smoking. Conclusion. Lymphopenia in adult COVID -19 hospitalized patients was associated with increased risk of disease severity (as evidenced by need for ICU admission) and poor clinical outcomes. Absolute lymphocyte count may help with prognostication in individuals hospitalized with COVID-19.

Research on the Impact of Covid-19 on the chemistry industry in us stock market based on the fama-french five-factor model

The capital asset pricing model (CAPM) and the Fama-French model are of great significance to the study of all aspects of the capital market, which lays the foundation of modern finance. This paper analyzes both data before Covid-19 and after Covid-19, which are daily data with the same time length in the chemistry industry. It finds that Covid-19 makes a significant impact on the chemistry industry due to its negative influence on economics. The data were adopted from Kenneth R. French's database and fitted with the Fama-French five-factor model. After data processing, the T-value used for significant testing and five corresponding coefficients is obtained using multiple linear regression. The results indicated that Covid-19 causes an anomaly because the intercept is significant after the epidemic, a decrease of market sensitivity from changes of market factor, investors' more attention to the companies that have a good ability to gain profitability by analyzing RMW, and better returns for the companies with high book-to-market ratios due to HML. Besides, SMB and CMA factors are redundant. In conclusion, the influence made by Covid-19 on the chemistry industry is significant, and the investors are recommended to pay attention to companies with robust profitability and high book-to-market. © 2021 ACM.

Evaluating first responders for SARS-CoV-2 infection in broward county, Florida

Background: First responders (e.g., emergency medical technicians, firefighters and police) may be at higher risk of SARS-CoV-2 infection and potentially spreading it than the general population due to frequent and close exposure to others. Prevention of first responder infections is important for reducing secondary transmission and maintaining health system capacity. We aimed to evaluate the burden of SARS-CoV-2 infection on first responders, identify risk factors for infection, and to provide health services to help control the current outbreak. Methods: Memorial Healthcare System (MHS), a public healthcare system serving the South Broward Hospital District, together with the National Guard and Florida state governor, opened up a drive-through testing center for SARS-CoV-2 at C.B. Smith Park in Broward County, Florida. All first responders in Broward County, symptomatic or asymptomatic, were being tested. SARS-CoV-2 infection was made as a positive result of real time polymerase chain reaction (PCR) testing on at least one nasal or nasopharyngeal swab. All first responders who test positive for SARS-CoV-2 were informed by test site staff and self-quarantined to limit the spread of the disease. Results: A total of 3,375 individuals was tested during the period from April 1 to April 29, 2020. The median age was 42 years (IQR 33-52) and 1,464 (43%) were men. 473 (14%) were symptomatic and 2,902 (86%) were asymptomatic. 289 (8.5%) of 3,375 first responders were positive for SARS-CoV-2 infection. These included 54 of 473 symptomatic (11%) and 235 of 2,902 asymptomatic (8.1%) cases. The rates of SARS-CoV-2 infection were comparable in male vs female (8.1% vs 8.9%, p = 0.429) and in symptomatic vs asymptomatic (p = 0.173). There is no sex-, age-based differences in susceptibility to SARS-CoV-2 infection among the first responders tested (Figure 1). Laboratory confirmed SARS-CoV-2 among first responders between April 1 and April 30, 2020 in Broward County. Conclusion: First responders carry a significant burden from SARS-CoV-2 infection, with an infection rate of 8.5%, which was comparable in symptomatic and asymptomatic individuals. There is no sex-, age-based differences in susceptibility to SARS-CoV-2 infection in first responders. High priority testing for SARS-CoV-2 must expand to include first responders, particularly asymptomatic individuals.

Enlightenment of re-entry airflow: The path of the airflow and the airborne pollutants transmission in buildings.

Viable aerosols in the airflow may increase the risk of occupants contracting diseases. Natural ventilation is common in buildings and is accompanied by re-entry airflow during the ventilation process. If the re-entry airflow contains toxic or infectious species, it may cause potential harm to residents. One of the Covid-19 outbreaks occurred in a public residential building at Luk Chuen House (LC-House) in Hong Kong. It is highly suspected that the outbreak of the disease is related to the re-entry airflow. The study attempts to explain and discuss possible causes of the outbreak. In order to understand the impact of airflow on the outbreak, a public residential building similar to LC-House was used in the study. Two measurements M - I and M - II with the same settings were conducted for a sampling unit in the corridor under low and strong wind conditions respectively. The sampling unit and the tracer gas carbon dioxide (CO2) were used to simulate the index unit and infectious contaminated airflow respectively. The CO2 concentrations of the unit and corridor were measured simultaneously. Two models of Traditional Single-zone model (TSZ-model) and New Dual-zone model (NDZ-model) were used in the analysis. By comparing the ACH values obtained from the two models, it is indicated that the re-entry airflow of the unit is related to the corridor wind speeds and this provides a reasonable explanation for the outbreak in LC-House, and believes that the results can help understand the recent frequent cluster outbreaks in other residential buildings.

Transformation of distribution logistics management in the digitalization of the economy

A problem predicted by experts with the onset of the COVID-19 pandemic is that many markets, in particular, the restaurant market, the tourism market, and the entertainment market, will face long-term stagnation in the near future due to outflow of financial resources. On the other hand, even though the standards of social interactions have changed, the basic needs of modern society for nourishing and varied food, entertainment and experiences cannot disappear as a result of a pandemic. The goal of our study consisted of gaining insights into the new hybrid practices of logistics and customer services that business needs to master in the new environment, combining offline and online activities. We have found that success in the market is achieved by organizations that regularly generate new entrepreneurial, scientific and technical ideas and consolidate their own and attracted resources to create, develop and launch new products, services and technologies on the market. Employing analytical methods, we have characterized the drivers of the transformation of distribution logistics management in the context of the digitalization of the economy, concluding that this process primarily affects the management of distribution channels. The features of transformation in the management of international distribution channels are studied. The requirements for logistics management in this functional area of management are defined. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.