A Reagent and Virus Benchmarking Panel for a Uniform Analytical Performance Assessment of N Antigen-Based Diagnostic Tests for COVID-19.

Rapid diagnostic tests (RDTs) that detect antigen indicative of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can help in making quick health care decisions and regularly monitoring groups at risk of infection. With many RDT products entering the market, it is important to rapidly evaluate their relative performance. Comparison of clinical evaluation study results is challenged by protocol design variations and study populations. Laboratory assays were developed to quantify nucleocapsid (N) and spike (S) SARS-CoV-2 antigens. Quantification of the two antigens in nasal eluates confirmed higher abundance of N than S antigen. The median concentration of N antigen was 10 times greater than S per genome equivalent. The N antigen assay was used in combination with quantitative reverse transcription (RT)-PCR to qualify a panel composed of recombinant antigens, inactivated virus, and clinical specimen pools. This benchmarking panel was applied to evaluate the analytical performance of the SD Biosensor Standard Q COVID-19 antigen (Ag) test, Abbott Panbio COVID-19 Ag rapid test, Abbott BinaxNOW COVID-19 Ag test, and the LumiraDx SARS-CoV-2 Ag test. The four tests displayed different sensitivities toward the different panel members, but all performed best with the clinical specimen pool. The concentration for a 90% probability of detection across the four tests ranged from 21 to 102 pg/mL of N antigen in the extracted sample. Benchmarking panels provide a quick way to verify the baseline performance of a diagnostic and enable direct comparisons between diagnostic tests. IMPORTANCE This study reports the results for severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) nucleocapsid (N) and spike (S) antigen quantification assays and their performance against clinical reverse transcription (RT)-PCR results, thus describing an open-access quantification method for two important SARS-CoV-2 protein analytes. Characterized N antigen panels were used to evaluate the limits of detection of four different rapid tests for SARS-CoV-2 against multiple sources of nucleocapsid antigen, demonstrating proof-of-concept materials and methodology to evaluate SARS-CoV-2 rapid antigen detection tests. Quantification of N antigen was used to characterize the relationship between viral count and antigen concentration among clinical samples and panel members of both clinical sample and viral culture origin. This contributes to a deeper understanding of protein antigen and molecular analytes and presents analytical methods complementary to clinical evaluation for characterizing the performance of both laboratory-based and point-of-care rapid diagnostics for SARS-CoV-2.

The mediating impact of airlines' image in relation of corporate social responsibility and customers' loyalty: An empirical in Vietnam

Corporate social responsibility (CSR) towards sustainable development has been identified as a marketing philosophy that businesses in developed countries should pursue in the post-Covid-19 era as these practices deal with urgent global social and environmental challenges. Such efforts contributing to sustainable development will enhance corporate image and reinforce strong bonds with customers. In developing countries like Vietnam, how CSR affects consumer behaviour and the mechanism regulating the relationship between CSR and consumer behavior are the research gaps that have not been widely investigated. This study explores the relationship between CSR and customer loyalty, with the emphasis on the mediating role of corporate image. Focusing on the Vietnamese aviation industry, the author surveyed 514 passengers and analyzed them using structural equation modeling. Our findings show that CSR has a positive impact on corporate image and customer loyalty. In addition, CSR also affects customer loyalty through enhancing corporate image. Research results have provided research implications and management implications for the future. © 2023 The Author(s). This open access article is distributed under a Creative Commons Attribution (CC-BY) 4.0 license.

The Potential of Ameliorating COVID-19 and Sequelae From Andrographis paniculata via Bioinformatics.

The current coronavirus disease 2019 (COVID-19) outbreak is alarmingly escalating and raises challenges in finding efficient compounds for treatment. Repurposing phytochemicals in herbs is an ideal and economical approach for screening potential herbal components against COVID-19. Andrographis paniculata, also known as Chuan Xin Lian, has traditionally been used as an anti-inflammatory and antibacterial herb for centuries and has recently been classified as a promising herbal remedy for adjuvant therapy in treating respiratory diseases. This study aimed to screen Chuan Xin Lian's bioactive components and elicit the potential pharmacological mechanisms and plausible pathways for treating COVID-19 using network pharmacology combined with molecular docking. The results found terpenoid (andrographolide) and flavonoid (luteolin, quercetin, kaempferol, and wogonin) derivatives had remarkable potential against COVID-19 and sequelae owing to their high degrees in the component-target-pathway network and strong binding capacities in docking scores. In addition, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that the PI3K-AKT signaling pathway might be the most vital molecular pathway in the pathophysiology of COVID-19 and long-term sequelae whereby therapeutic strategies can intervene.

Ganoderma microsporum immunomodulatory protein acts as a multifunctional broad-spectrum antiviral against SARS-CoV-2 by interfering virus binding to the host cells and spike-mediated cell fusion.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible coronavirus that has caused over 6 million fatalities. SARS-CoV-2 variants with spike mutations are frequently endowed with a strong capability to escape vaccine-elicited protection. Due to this characteristic, a broad-spectrum inhibitor against SARS-CoV-2 infection is urgently demanded. Ganoderma microsporum immunomodulatory protein (GMI) was previously reported to alleviate infection of SARS-CoV-2 through ACE2 downregulation whereas the impact of GMI on virus itself was less understood. Our study aims to determine the effects of GMI on SARS-CoV-2 pseudovirus and the more detailed mechanisms of GMI inhibition against SARS-CoV-2 pseudovirus infection. METHODS: ACE2-overexpressing HEK293T cells (HEK293T/ACE2) and SARS-CoV-2 pseudoviruses carrying spike variants were used to study the effects of GMI in vitro. Infectivity was evaluated by fluorescence microscopy and flow cytometry. Fusion rate mediated by SARS-CoV-2 spike protein was examined with split fluorescent protein /luciferase systems. The interactions of GMI with SARS-CoV-2 pseudovirus and ACE2 were investigated by immunoprecipitation and immunoblotting. RESULTS: GMI broadly blocked SARS-CoV-2 infection in various cell lines. GMI effectively inhibited the infection of pseudotyped viruses carrying different emerged spike variants, including Delta and Omicron strains, on HEK293T/hACE2 cells. In cell-free virus infection, GMI dominantly impeded the binding of spike-bearing pseudotyped viruses to ACE2-expressing cells. In cell-to-cell fusion model, GMI could efficiently inhibit spike-mediated syncytium without the requirement of ACE2 downregulation. CONCLUSIONS: GMI, an FDA-approved dietary ingredient, acts as a multifunctional broad-spectrum antiviral against SARS-CoV-2 and could become a promising candidate for preventing or treating SARS-CoV-2 associated diseases.

Ganoderma microsporum immunomodulatory protein acts as a multifunctional broad-spectrum antiviral against SARS-CoV-2 by interfering virus binding to the host cells and spike-mediated cell fusion

Graphical illustration of the underlying mechanisms of GMI inhibitory effects against SARS-CoV-2

Translating extracellular vesicle packaging into therapeutic applications.

Extracellular vesicles (EVs) are membrane-bound particles released by cells in various (patho)physiological conditions. EVs can transfer effector molecules and elicit potent responses in recipient cells, making them attractive therapeutic agents and drug delivery platforms. In contrast to their tremendous potential, only a few EV-based therapies and drug delivery have been approved for clinical use, which is largely attributed to limited therapeutic loading technologies and efficiency. As EV cargo has major influence on their functionality, understanding and translating the biology underlying the packaging and transferring of biomolecule cargos (e.g. miRNAs, pathogen antigens, small molecule drugs) into EVs is key in harnessing their therapeutic potential. In this review, through recent insights into EVs' content packaging, we discuss different mechanisms utilized by EVs during cargo packaging, and how one might therapeutically exploit this process. Apart from the well-characterized EVs like exosomes and microvesicles, we also cover the less-studied and other EV subtypes like apoptotic bodies, large oncosomes, bacterial outer membrane vesicles, and migrasomes to highlight therapeutically-diverse opportunities of EV armoury.

Comparison of COVID-19 Resilience Index and Its Associated Factors across 29 Countries during the Delta and Omicron Variant Periods.

Our study aims to compare the pandemic resilience index and explore the associated factors during the Delta and Omicron variant periods. In addition, the study aims to identify the characteristics of countries that had good performances. We analyzed observation data among 29 countries over the first eight weeks during the two periods of Delta and Omicron variant dominance. Data were extracted from open public databases. The Omicron variant caused a lowered mortality rate per 100,000 COVID-19 patients; however, it is still imposing a colossal burden on health care systems. We found the percentage of the population fully vaccinated and high government indices were significantly associated with a better resilience index in both the Delta and Omicron periods. In contrast, the higher death rate of cancers and greater years lived with disability (YLD) caused by low bone density were linked with poor resilience index in the Omicron periods. Over two periods of Delta and Omicron, countries with good performance had a lower death rate from chronic diseases and lower YLD caused by nutrition deficiency and PM2.5. Our findings suggest that governments need to keep enhancing the vaccine coverage rates, developing interventions for populations with chronic diseases and nutrition deficiency to mitigate COVID-19 impacts on these targeted vulnerable cohorts.

GMI, a protein from Ganoderma microsporum, induces ACE2 degradation to alleviate infection of SARS-CoV-2 Spike-pseudotyped virus.

BACKGROUND: Severe Acute Respiratory Syndrome Coronavirus Type 2 (SARS-CoV-2) induces a global serious pandemic and is responsible for over 4 million human deaths. Currently, although various vaccines have been developed, humans can still get SARS-CoV-2 infection after being vaccinated. Therefore, the blocking of SARS-CoV-2 infection may be potential therapeutic strategies. Ganoderma microsporum immunomodulatory protein (GMI), a small fungal protein, is cloned from Ganoderma microsporum. It exhibits anti-cancer and immunomodulatory functions. Currently, it is still unclear whether GMI involves in interfering with viral infection. PURPOSE: This study aimed to examine the potential functions and mechanisms of GMI on inhibiting SARS-CoV-2 pseudovirus infection. METHODS: The effects of GMI were examined in vitro on ACE2 overexpressing HEK293T (HEK293T/ACE2) cells exposed to SARS-CoV-2 Spike lentiviral pseudovirus encoding a green fluorescent protein (GFP) gene. The infection efficacy was determined using fluorescence microscopy and flow cytometry. The protein level of ACE2 was verified by Western blot. The effects of GMI on cell viability of HEK293T/ACE2 and lung epithelial WI38-2RA cells were determined by MTT assay. Mice received GMI via nebulizer. RESULTS: GMI did not affect the cell viability of HEK293T/ACE2, WI38-2RA and macrophages. Functional studies showed that GMI inhibited GFP expressing SARS-CoV-2 pseudovirus from infecting HEK293T/ACE2 cells. GMI slightly interfered the interaction between ACE2 and Spike protein. GMI interacted with S2 domain of Spike protein. Specifically, GMI dramatically reduced ACE2 expression in HEK293T/ACE2 and WI38-2RA cells. Mechanistically, GMI induced ACE2 degradation via activating protein degradation system, including proteasome and lysosome. Abolishing proteasome and lysosome by MG132 and bafilomycin A1, respectively, rescued GMI-reduced ACE2 levels. In addition, GMI triggered dynamin and lipid raft-mediated ACE2 endocytosis. ACE2 levels were downregulated in the lung tissue after the mice inhaling GMI. CONCLUSIONS: GMI prevents SARS-CoV-2 pseudovirus infection via induction of ACE2 degradation in host cells. Our findings suggest that GMI will be a potential prevention agent to alleviate SARS-CoV-2 infection.

A Systematic Style-Based Blended Teaching for Competence Enhancement of Lecturers in the COVID-19 Pandemic Situation: A Case Study for Teaching in Higher Education

Currently, the global Covid-19 epidemic has been having an impact on the trend of the organization and implementation training activities of higher education. Blended teaching and building a systematic Style-Based Blended teaching model still have certain limitations for teachers. This study has surveyed and evaluated the results of implementing systematic Style-Based Blended teaching model with 135 lecturers from universities in Vietnam from the academic year 2019 - 2020. This study used a combination of qualitative and quantitative methods, the parameters of this research results were verified through evaluating the applied results before and after implementing systematic Style-Based Blended teaching model in teaching at experimental universities. Research results with this Blended teaching model present evidence in implementing and developing a systematic StyleBased Blended teaching model with effective effects on improving teaching performance of teachers, contributing to improve the quality of teaching in higher education._

A Systematic Style-Based Blended Teaching for Competence Enhancement of Lecturers in the COVID-19 Pandemic Situation: A Case Study for Teaching in Higher Education

Currently, the global Covid-19 epidemic has been having an impact on the trend of the organization and implementation training activities of higher education. Blended teaching and building a systematic Style-Based Blended teaching model still have certain limitations for teachers. This study has surveyed and evaluated the results of implementing systematic Style-Based Blended teaching model with 135 lecturers from universities in Vietnam from the academic year 2019 - 2020. This study used a combination of qualitative and quantitative methods, the parameters of this research results were verified through evaluating the applied results before and after implementing systematic Style-Based Blended teaching model in teaching at experimental universities. Research results with this Blended teaching model present evidence in implementing and developing a systematic Style-Based Blended teaching model with effective effects on improving teaching performance of teachers, contributing to improve the quality of teaching in higher education.

The Effects of Non-Pharmaceutical Interventions on COVID-19 Epidemic Growth Rate during Pre- and Post-Vaccination Period in Asian Countries.

There is little knowledge about how the influence of non-pharmaceutical interventions (NPIs) reduces the COVID-19 infection rate during the period of vaccine rollout. This study aimed to examine the effectiveness of NPIs on decreasing the epidemic growth of COVID-19 between before and after the vaccine rollout period among Asian countries. Our ecological study included observations from 30 Asian countries over the 20 weeks of the pre- and post-vaccination period. Data were extracted from the Oxford COVID-19 Government Response Tracker and other open databases. Longitudinal analysis was utilized to evaluate the impacts of public health responses and vaccines. The facial covering policy was the most effective intervention in the pre-vaccination period, followed by border control and testing policies. In the post-vaccination period, restrictions on gatherings and public transport closure both play a key role in reducing the epidemic growth rate. Vaccine coverage of 1-5%, 5-10%, 10-30%, and over 30% of the population was linked with an average reduction of 0.12%, 0.32%, 0.31%, and 0.59%, respectively. Our findings support the evidence that besides the vaccine increasingly contributing to pandemic control, the implementation of NPIs also plays a key role.

Stock market returns and liquidity during the COVID-19 outbreak: evidence from the financial services sector in Vietnam

PurposeThis paper aims to explore the influence of the COVID-19 outbreak and the Government's disease control measures on the stock returns and liquidity of Vietnam-listed companies in the financial services sector.Design/methodology/approachThe authors have conducted a panel data regression analysis using data from 50 banking, insurance and finance companies listed in Vietnam's two biggest stock exchanges (HNX and HOSE) within the period from January 30th, 2020 to May 15th, 2021.FindingsThe regression results indicate that the daily growth in the total number of confirmed cases caused by COVID-19 has significant negative effects on the stock market returns and liquidity. Nevertheless, the Government's imposition of lockdown yields significant and positive outcomes on stock performance. In addition, the study reveals remarkable differences in returns of large-cap and small-cap stocks under the impact of the COVID-19 pandemic.Research limitations/implicationsThe study indicates government and regulators should act more actively to limit the outbreak of the virus, improve investor confidence as well to support the financial services industry and deal with the outbreak of the pandemic later.Originality/valueThis is the first study to explore the influence of the COVID-19 outbreak and the Government's disease control measures on the stock returns and liquidity of Vietnam-listed companies in the financial services industry.

POLICY IMPLICATIONS IMPROVING THE BANKING SERVICE QUALITY IN VIETNAM

In particular, the growing trend of retail customer business is the "key" to banks' revenue and business efficiency. [...]this study objective proposed policy implications for improving the banking service quality in Vietnam. According to Barker & Kandampully (2017), if a service provider provides customers with quality products that satisfy their needs, that business will initially make customers satisfied. [...]to improve customer satisfaction, service providers must enhance the quality of service by Moyo (2018). [...]competition in the banking sector is also one factor promoting the expansion and development of banking services in the direction of diversification and modernization, according to Le Ngoc Nuong & Ha Thi Hoa (2020). From there, it can attract customers to use banking services. [...]it can be said that this is also a factor affecting the development of banking services by Tasnain & Abbas (2013).

Factor Associated With Teacher Satisfaction and Online Teaching Effectiveness Under Adversity Situations: A Case of Vietnamese Teachers During COVID-19.

How teachers perform and react to the world-wide pandemic and how the epidemic affects an education system may also be used as new conditions to consider the way to enhance SDG4 in developing countries. Regarding that concern, this study investigated 294 teachers' perspective on their teaching effectiveness and satisfaction during COVID-19. The findings underlined the significant roles of support from various stakeholders, school readiness toward digital transformation, and teachers' anxiety over teacher satisfaction. Notably, teachers' newly absorbed technological and pedagogical skills do elevate their teaching effectiveness but do not lead to higher satisfaction during the pandemic.

Stroke Care Trends During COVID-19 Pandemic in Zanjan Province, Iran. From the CASCADE Initiative: Statistical Analysis Plan and Preliminary Results.

BACKGROUND: The emergence of the COVID-19 pandemic has significantly impacted global healthcare systems and this may affect stroke care and outcomes. This study examines the changes in stroke epidemiology and care during the COVID-19 pandemic in Zanjan Province, Iran. METHODS: This study is part of the CASCADE international initiative. From February 18, 2019, to July 18, 2020, we followed ischemic and hemorrhagic stroke hospitalization rates and outcomes in Valiasr Hospital, Zanjan, Iran. We used a Bayesian hierarchical model and an interrupted time series analysis (ITS) to identify changes in stroke hospitalization rate, baseline stroke severity [measured by the National Institutes of Health Stroke Scale (NIHSS)], disability [measured by the modified Rankin Scale (mRS)], presentation time (last seen normal to hospital presentation), thrombolytic therapy rate, median door-to-needle time, length of hospital stay, and in-hospital mortality. We compared in-hospital mortality between study periods using Cox-regression model. RESULTS: During the study period, 1,026 stroke patients were hospitalized. Stroke hospitalization rates per 100,000 population decreased from 68.09 before the pandemic to 44.50 during the pandemic, with a significant decline in both Bayesian [Beta: -1.034; Standard Error (SE): 0.22, 95% CrI: -1.48, -0.59] and ITS analysis (estimate: -1.03, SE = 0.24, p < 0.0001). Furthermore, we observed lower admission rates for patients with mild (NIHSS < 5) ischemic stroke (p < 0.0001). Although, the presentation time and door-to-needle time did not change during the pandemic, a lower proportion of patients received thrombolysis (-10.1%; p = 0.004). We did not see significant changes in admission rate to the stroke unit and in-hospital mortality rate; however, disability at discharge increased (p < 0.0001). CONCLUSION: In Zanjan, Iran, the COVID-19 pandemic has significantly impacted stroke outcomes and altered the delivery of stroke care. Observed lower admission rates for milder stroke may possibly be due to fear of exposure related to COVID-19. The decrease in patients treated with thrombolysis and the increased disability at discharge may indicate changes in the delivery of stroke care and increased pressure on existing stroke acute and subacute services. The results of this research will contribute to a similar analysis of the larger CASCADE dataset in order to confirm findings at a global scale and improve measures to ensure the best quality of care for stroke patients during the COVID-19 pandemic.

An International Report on the Adaptations of Rapid Transient Ischaemic Attack Pathways During the COVID-19 Pandemic.

BACKGROUND: This report aims to describe changes that centres providing transient ischaemic attack (TIA) pathway services have made to stay operational in response to the SARS-CoV-2 pandemic. METHODS: An international cross-sectional description of the adaptions of TIA pathways between 30th March and 6th May 2020. Experience was reported from 18 centres with rapid TIA pathways in seven countries (Australia, France, UK, Canada, USA, New Zealand, Italy, Canada) from three continents. RESULTS: All pathways remained active (n = 18). Sixteen (89%) had TIA clinics. Six of these clinics (38%) continued to provide in-person assessment while the majority (63%) used telehealth exclusively. Of these, three reported PPE use and three did not. Five centres with clinics (31%) had adopted a different vascular imaging strategy. CONCLUSION: The COVID pandemic has led TIA clinics around the world to adapt and move to the use of telemedicine for outpatient clinic review and modified investigation pathways. Despite the pandemic, all have remained operational.

COVID-19 Pandemic and Burden of Non-Communicable Diseases: An Ecological Study on Data of 185 Countries.

BACKGROUND: The interaction between coronavirus disease 2019 (COVID-19) and non-communicable diseases may increase the global burden of disease. We assessed the association of COVID-19 with ageing and non-communicable diseases. METHODS: We extracted data regarding non-communicable disease, particularly cardiovascular disease, deaths, disability-adjusted life years (DALYs), and healthy life expectancy (HALE) from the Global Burden of Disease Study (GBD) 2017. We obtained data of confirmed COVID-19 cases, deaths, and tests from the Our World in Data database as of May 28, 2020. Potential confounders of pandemic outcomes analyzed include institutional lockdown delay, hemispheric geographical location, and number of tourists. We compared all countries according to GBD classification and World Bank income level. We assessed the correlation between independent variables associated with COVID-19 caseload and mortality using Spearman's rank correlation and adjusted mixed model analysis. FINDINGS: High-income had the highest, and the Southeast Asia, East Asia, and Oceania region had the least cases per million population (3050.60 vs. 63.86). Sub-saharan region has reported the lowest number of COVID-19 mortality (1.9). Median delay to lockdown initiation varied from one day following the first case in Latin America and Caribbean region, to 34 days in Southeast Asia, East Asia, and Oceania. Globally, non-communicable disease DALYs were correlated with COVID-19 cases (r = 0.32, p<0.001) and deaths (r = 0.37, p<0.001). HALE correlated with COVID-19 cases (r = 0.63, p<0.001) and deaths (r = 0.61, p<0.001). HALE was independently associated with COVID-19 case rate and the number of tourists was associated with COVID-19 mortality in the adjusted model. INTERPRETATION: Preventive measures against COVID-19 should protect the public from the dual burden of communicable and non-communicable diseases, particularly in the elderly. In addition to active COVID-19 surveillance, policymakers should utilize this evidence as a guide for prevention and coordination of health services. This model is timely, as many countries have begun to reduce social isolation.

Call to Action: SARS-CoV-2 and CerebrovAscular DisordErs (CASCADE).

BACKGROUND AND PURPOSE: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. METHODS: This is an international, multicenter, hospital-based study on stroke incidence and outcomes during the COVID-19 pandemic. We will describe patterns in stroke management, stroke hospitalization rate, and stroke severity, subtype (ischemic/hemorrhagic), and outcomes (including in-hospital mortality) in 2020 during COVID-19 pandemic, comparing them with the corresponding data from 2018 and 2019, and subsequently 2021. We will also use an interrupted time series (ITS) analysis to assess the change in stroke hospitalization rates before, during, and after COVID-19, in each participating center. CONCLUSION: The proposed study will potentially enable us to better understand the changes in stroke care protocols, differential hospitalization rate, and severity of stroke, as it pertains to the COVID-19 pandemic. Ultimately, this will help guide clinical-based policies surrounding COVID-19 and other similar global pandemics to ensure that management of cerebrovascular comorbidity is appropriately prioritized during the global crisis. It will also guide public health guidelines for at-risk populations to reduce risks of complications from such comorbidities.