Comparative analysis of epidemiological trends of COVID-19 in Shanghai and New York City

ObjectiveTo assess the effects of countermeasures against coronavirus disease 2019 (COVID-19) in Shanghai from March to May 2022 in comparison with epidemiological trend of COVID-19 in New York City. MethodsDaily confirmed cases, asymptomatic SARS-CoV-2 carriers, and daily deaths were obtained in the Shanghai Municipal Health Commission and the Center for Disease Control and Prevention (CDC) of the United States. Descriptive study was conducted by using these data. ResultsFrom March 1 to May 17, the number of daily asymptomatic SARS-CoV-2 infections in Shanghai was up to 58 times as large as that of daily confirmed cases;however, the number of daily confirmed cases in Shanghai was generally less than that in New York in the same time period. At the peak of the COVID-19 epidemic, the growth of daily attack rate in Shanghai was significantly lower than that in New York (P < 0.05). Moreover, the number of daily death was evidently less than that in New York. In addition, the vaccination rate in the elderly (aged 60 years) in Shanghai was evidently lower than that in New York (aged 65 years). ConclusionThe COVID-19 epidemics in Shanghai from March to May 2022 and in New York after December 2021 were both caused by the Omicron variant. Compared with the Delta variant, the Omicron variant has stronger replication ability and infectivity, resulting in challenges to the containment of the epidemic in metropolis such as Shanghai and New York City. The epidemic in New York City remained crucial due to absence of effective countermeasures, while that in Shanghai has been effectively contained with strict countermeasures. The prevention and control strategies may be adjusted along with the continual evolution of SARS-CoV-2 and increasing trend of imported COVID-19 cases.

Real-World COPD Management Over 3 Years at the Community Health Service Center of Shanghai During the COVID-19 Pandemic in China.

Objective: To evaluate the real-world situation for the management of chronic obstructive pulmonary disease (COPD) and poorly controlled disease risk factors in the Chinese community. Methods: This retrospective multicentre study analysed data from COPDMICand MICHC in Shanghai Songjiang District, Shanghai, China. The differences in COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) dyspnea scale, and the number of emergency cases, emergency visits, inpatient cases, and hospitalisations from January 2018 to December 2020 were analysed. The impact of coronavirus disease 2019 (COVID-19) on COPD management was also assessed. Results: For 2020 versus 2018, analysis of 468 COPD cases from COPDMIC matched with MICHC data showed significantly more patients with improved mMRC grades, significantly fewer emergency cases and emergency visits, and significantly fewer hospitalisation cases and hospitalisations. Differences in the number of emergency visits and hospitalisations per capita were statistically significant. Compared to GOLD 3-4, GOLD 1-2 patients showed significant improvements in CAT score, mMRC grade, the number of emergency visits and hospitalisations per capita. Treatment adherence from 2018 to 2020 was 25%, 29.1%, and 6.8%, and the proportion of medication regimens consistent with guidelines was 43.44%, 50.98%, and 71.87%, respectively. Higher treatment adherence resulted in significantly improved CAT scores and mMRC grades and fewer emergency department visits and hospitalisations per capita. Conclusion: Combined with remote management tools, patients with COPD achieved continuous improvement in symptoms and exacerbations over 3 years. In the context of COVID-19 prevention/control measures, improvements were significant for patients with GOLD 1-2 COPD but limited with GOLD 3-4. Pharmacologic treatment significantly improved clinical symptoms and reduced emergency visits and hospitalisations. Severe airflow limitation and poor adherence to pharmacologic treatment were important risk factors for lack of disease remission.

Adjustment of Immunosuppressants to Facilitate Anti-COVID-19 Antibody Production after mRNA Vaccination in Liver Transplant Recipients.

Liver transplant recipients are immunocompromised and have low immunogenicity to produce antibodies in anti-COVID-19 vaccination. Whether immunosuppressant adjustment could facilitate anti-COVID-19 antibody production in anti-COVID-19 mRNA vaccination is undetermined. Our patients were informed to temporarily suspend mycophenolate mofetil (MMF) or everolimus (EVR) for 2 weeks during both the 1st and 2nd doses of Moderna mRNA-1273 vaccine. A total of 183 recipients receiving two doses of Moderna mRNA-1273 vaccine were enrolled and grouped into tacrolimus monotherapy (MT, n = 41), and dual therapy with non-adjustment (NA, n = 23), single suspension (SS, n = 19) and double suspension (DS, n = 100) of MMF/EVR in two-dose mRNA vaccination. A total of 155 (84.7%) patients had a humoral response to vaccines in this study. The humoral response rates were 60.9%, 89.5%, 91.0% and 80.5% in NA, SS, DS, and MT group patients, respectively (p = 0.003). Multivariate analysis showed that favorable factors for humoral response were temporary suspension of MMF/EVR and monotherapy, and unfavorable factors were deceased donor liver transplantation, WBC count < 4000/uL, lymphocyte < 20% and tacrolimus trough level ≥ 6.8 ng/mL. In conclusion, temporary two-week suspension of anti-proliferation immunosuppressants could create a window to facilitate antibody production during anti-COVID-19 mRNA vaccination. This concept may be applied to other vaccinations in liver transplant recipients.

Critical Care Pharmacist Attitudes and Perceptions of Neuromuscular Blocker Infusions in ARDS.

BACKGROUND: Current critical care pharmacist (CCP) practices and perceptions related to neuromuscular infusion (NMBI) use for acute respiratory distress syndrome (ARDS) maybe different with the COVID-19 pandemic and the publication of 2020 NMBI practice guidelines. OBJECTIVE: To evaluate CCP practices and perceptions regarding NMBI use for patients with moderate-severe ARDS. METHODS: We developed, tested, and electronically administered a questionnaire (7 parent-, 42 sub-questions) to 409 American College of Clinical Pharmacy (ACCP) Critical Care Practice and Research Network members in 12 geographically diverse states. The questionnaire focused on adults with moderate-severe ARDS (PaO2:FiO2<150) whose causes of dyssynchrony were addressed. Two reminders were sent at 10-day intervals. RESULTS: Respondents [131/409 (32%)] primarily worked in a medical intensive care unit (ICU) 102 (78%). Compared to COVID-negative(-) ARDS patients, COVID positive(+) ARDS patients were twice as likely to receive a NMBI (34 ± 18 vs.16 ± 17%; P < 0.01). Respondents somewhat/strongly agreed a NMBI should be reserved until after trials of deep sedation (112, 86%) or proning (92, 81%) and that NMBI reduced barotrauma (88, 67%), dyssynchrony (87, 66%), and plateau pressure (79, 60%). Few respondents somewhat/strongly agreed that a NMBI should be initiated at ARDS onset (23, 18%) or that NMBI reduced 90-day mortality (12, 10%). Only 2/14 potential NMBI risks [paralysis awareness (101, 82%) and prolonged muscle weakness (84, 68%)] were frequently reported to be of high/very high concern. Multiple NMBI titration targets were assessed as very/extremely important including arterial pH (109, 88%), dyssynchrony (107, 86%), and PaO2: FiO2 ratio (82, 66%). Train-of-four (55, 44%) and BIS monitoring (36, 29%) were deemed less important. Preferred NMBI discontinuation criteria included absence of dysschrony (84, 69%) and use ≥48 hour (72, 59%). CONCLUSIONS AND RELEVANCE: Current critical care pharmacists believe NMBI for ARDS patients are best reserved until after trials of deep sedation or proning; unique considerations exist in COVID+ patients. Our results should be considered when ICU NMBI protocols are being developed and bedside decisions regarding NMBI use in ARDS are being formulated.

Differential renal proteomics analysis in a novel rat model of iodinated contrast-induced acute kidney injury.

Contrast-induced acute kidney injury (CI-AKI), which occurs after the use of iodinated contrast media, has become the third leading cause of hospital-acquired acute kidney injury (AKI). It is associated with prolonged hospitalization and increased risks of end-stage renal disease and mortality. The pathogenesis of CI-AKI is unclear and effective treatments are lacking. By comparing different post-nephrectomy times and dehydration times, we constructed a new, short-course CI-AKI model using dehydration for 24 h two weeks after unilateral nephrectomy. We found that the low-osmolality contrast media iohexol caused more severe renal function decline, renal morphological damage, and mitochondrial ultrastructural alterations compared to the iso-osmolality contrast media iodixanol. The shotgun proteomics based on Tandem Mass Tag (TMT) was used to conduct proteomics research on renal tissue in the new CI-AKI model, and 604 distinct proteins were identified, mainly involving complement and coagulation cascade, COVID-19, PPAR signalling pathway, mineral absorption, cholesterol metabolism, ferroptosis, staphylococcus aureus infection, systemic lupus erythematosus, folate biosynthesis, and proximal tubule bicarbonate reclamation. Then, using parallel reaction monitoring (PRM), we validate 16 candidate proteins, of which five were novel candidates (Serpina1, Apoa1, F2, Plg, Hrg) previously unrelated to AKI and associated with an acute response as well as fibrinolysis. The pathway analysis and 16 candidate proteins may help to discover new mechanisms in the pathogenesis of CI-AKI, allowing for early diagnosis and outcome prediction.

Clinically suspected lethal viral myocarditis combined with encephalitis: a COVID-19 vaccine complication.

This case study aimed to identify rare viral myocarditis combined with encephalitis as a COVID-19 vaccine complication. A 59-year-old male patient with a 2 day history of headache and rapidly progressive cognitive decline, who had received the third dose of COVID-19 vaccine 12 days before, was admitted to our hospital. The patient had no underlying systemic conditions, no prior medical history, and no prior history of COVID-19 infection. The patient was diagnosed with viral myocarditis and encephalitis by two neurologists and two cardiologists after laboratory examination, head computed tomography, and magnetic resonance imaging evaluation. The patient experienced cardiogenic shock and developed severe arrhythmia, resulting in his death 10 h after admission. Clinically suspected lethal viral myocarditis combined with encephalitis in the patient could be related to COVID-19 vaccination. Adverse effects of the Chinese COVID-19 vaccine, especially serious complications, have been uncommon. This case study highlights a rare complication after COVID-19 vaccination that needs high attention.

Lineage-mosaic and mutation-patched spike proteins for broad-spectrum COVID-19 vaccine.

SARS-CoV-2 spread in humans results in continuous emergence of new variants, highlighting the need for vaccines with broad-spectrum antigenic coverage. Using inter-lineage chimera and mutation-patch strategies, we engineered a recombinant monomeric spike variant (STFK1628x) that contains key regions and residues across multiple SAR-CoV-2 variants. STFK1628x demonstrated high immunogenicity and mutually complementary antigenicity to its prototypic form (STFK). In hamsters, a bivalent vaccine composed of STFK and STFK1628x elicited high titers of broad-spectrum neutralizing antibodies to 19 circulating SARS-CoV-2 variants, including Omicron sublineages BA.1, BA.1.1, BA.2, BA.2.12.1, BA.2.75, and BA.4/5. Furthermore, this vaccine conferred robust protection against intranasal challenges by either SARS-CoV-2 ancestral strain or immune-evasive Beta and Omicron BA.1. Strikingly, vaccination with the bivalent vaccine in hamsters effectively blocked within-cage virus transmission of ancestral SARS-CoV-2, Beta variant, and Omicron BA.1 to unvaccinated sentinels. Thus, our study provided insight and antigen candidates for the development of next-generation COVID-19 vaccines.

The duration and breadth of antibody responses to 3-dose of inactivated COVID-19 vaccinations in healthy blood donors: An observational study.

Objectives: We aimed to evaluate the duration and breadth of antibodies elicited by inactivated COVID-19 vaccinations in healthy blood donors. Methods: We performed serological tests on 1,417 samples from 658 blood donors who received two (n=357), or three (n=301) doses of COVID-19 inactivated vaccine. We also accessed the change in antibody response before and after booster vaccination in 94 participants and their neutralization breadth to the current variants after the booster. Results: Following vaccination, for either the 2- or 3-dose, the neutralizing antibodies (nAbs) peaked with about 97% seropositivity approximately within one month but subsequently decreased over time. Of plasmas collected 6-8 months after the last immunization, the nAb seropositivities were 37% and 85% in populations with 2-dose and 3-dose vaccinations, respectively. The nAbs of plasma samples (collected between 2-6 weeks after the 3rd dose) from triple-vaccinated donors (n=94) showed a geometric mean titer of 145.3 (95% CI: 117.2 to 180.1) against the ancestral B.1, slightly reduced by 1.7-fold against Delta variant, but markedly decreased by 4-6 fold in neutralizing Omicron variants, including the sub-lineages of BA.1 (5.6-fold), BA.1.1 (6.0-fold), BA.2 (4.2-fold), B.2.12.1 (6.2-fold) and BA.4/5 (6.5-fold). Conclusion: These findings suggested that the 3rd dose of inactivated COVID-19 vaccine prolongs the antibody duration in healthy populations, but the elicited-nAbs are less efficient in neutralizing circulating Omicron variants.

Dual ligand-induced photoelectrochemical sensing by integrating Pt/MoS2 heterostructure and Au polyhedra for sensitive detection of SARS-CoV-2.

The continuous evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with discovery of multiple mutants, has caused widespread panic and concern worldwide. The rapid antigen detection method via a single ligand recognition, although currently implemented in many countries, remains challenging for mutated antigens. Herein, we present a novel strategy using a dual recognition by two types of targeted ligands, based on photoelectrochemical (PEC) sensing for detection of SARS-CoV-2 spike protein. To demonstrate this strategy, the specific antibodies are modified onto the photoactive material with a supported nanostructure, created by loading the Pt nanoparticles onto MoS2 nanosheets (Pt/MoS2) to boost photon-to-electricity conversion efficiency. By subsequent binding of the targeted aptamers to the Au polyhedra, which act as a signal amplifier to suppress PEC photocurrent by competing with the Pt/MoS2 for the absorption of excitation light energy, the dual recognition is successfully achieved. The constructed biosensor not only shows satisfactory stability, high sensitivity, and selectivity, but is effective for test of the pseudovirus of SARS-CoV-2. The work provides useful advance for the development of PEC biosensors for sensitive detection of SARS-CoV-2.

Determinants of Antibody Response to SARS-CoV-2 Vaccines in Liver Transplant Recipients: The Role of Immunosuppression Reduction.

Liver transplant recipients on chronic immunosuppression show an attenuated antibody response after SARS-CoV-2 vaccination. Adjusting immunosuppressants during vaccination remains debated. We enrolled 380 liver transplant recipients receiving 2 doses of a protein subunit, mRNA, or a vector vaccine. The patients were informed to temporarily suspend immunosuppression for 2 weeks for both vaccination doses. We measured anti-live-SARS-CoV-2 spike neutralizing antibody levels at 1-2 months after the second vaccination; 83.9% of patients had humoral responses (SARS-CoV-2 NT50 ≥ 9.62 IU/mL) to 2 doses of vaccines. The mRNA (86.7%) and protein subunit vaccines (85%) yielded higher response rates than the vector vaccines (40.9%). Immunosuppression suspension during the two vaccinations yielded a higher response rate (91.5% vs. 57.7%). Only eight patients (2.1%) experienced transaminase level elevation of thrice the normal value (>110 IU/L) after the second vaccination. Most recovered spontaneously after resuming immunosuppression. Multivariate analysis revealed ABO incompatibility, white blood cell count <4000, lymphocyte count <20%, tacrolimus trough level >6.5 ng/mL, and no immunosuppression adjustment as independent risk factors to nonresponse. The mRNA and protein subunit vaccines yielded a higher response rate. Immunosuppression suspension for 2 weeks enhanced the antibody response. ABO incompatibility, leukopenia, lymphopenia, a high tacrolimus trough level, and no immunosuppression adjustment are associated with nonresponse.

An International Federal Hyperledger Fabric Verification Framework for Digital COVID-19 Vaccine Passport.

The COVID-19 virus has been spreading worldwide on a large scale since 2019, and the most effective way to prevent COVID-19 is to vaccinate. In order to prove that vaccination has been administered to allow access to different areas, paper vaccine passports are produced. However, paper vaccine passport records are vulnerable to counterfeiting or abuse. Previous research has suggested that issuing certificates digitally is an easier way to verify them. This study used the consortium blockchain based on Hyperledger Fabric to upload the digital vaccine passport (DVP) to the blockchain network. In order to enable collaboration across multiple systems, networks, and organizations in different trust realms. Federated Identity Management is considered a promising approach to facilitate secure resource sharing between collaborating partners. Therefore, the international federal identity management architecture proposed in this study enables inspectors in any country to verify the authenticity of the DVP of incoming passengers using the consortium blockchain. Through practical construction, the international federal Hyperledger verification framework for the DVP proposed in this study has shown the feasibility of issuing a global DVP in safety analysis and efficacy testing.

Physicians' attitudes and perceptions of neuromuscular blocker infusions in ARDS.

PURPOSE: The perceptions and practices of ICU physicians regarding initiating neuromuscular blocker infusions (NMBI) in acute respiratory distress syndrome (ARDS) may not be evidence-based amidst the surge of severe ARDS during the SARS-CoV-2 pandemic and new practice guidelines. We identified ICU physicians' perspectives and practices regarding NMBI use in adults with moderate-severe ARDS. MATERIALS AND METHODS: After extensive development and testing, an electronic survey was distributed to 342 ICU physicians from three geographically-diverse U.S. health systems(n = 12 hospitals). RESULTS: The 173/342 (50.5%) respondents (75% medical) somewhat/strongly agreed a NMBI should be reserved until: after a trial of deep sedation (142, 82%) or proning (59, 34%) and be dose-titrated based on train-of-four monitoring (107, 62%). Of 14 potential NMBI risks, 2 were frequently reported to be of high/very high concern: prolonged muscle weakness with steroid use (135, 79%) and paralysis awareness due to inadequate sedation (114, 67%). Absence of dyssychrony (93, 56%) and use ≥48 h (87, 53%) were preferred NMBI stopping criteria. COVID-19 + ARDS patients were twice as likely to receive a NMBI (56 ± 37 vs. 28 ± 19%, p < 0.01). CONCLUSIONS: Most intensivists agreed NMBI in ARDS should be reserved until after a deep sedation trial. Stopping criteria remain poorly defined. Unique considerations exist regarding the role of paralysis in COVID-19+ ARDS.

The Association between Allergic Rhinitis and COVID-19: A Systematic Review and Meta-Analysis.

Objective: Previous studies have yielded conflicting results regarding the association of coronavirus disease 2019 (COVID-19) with allergic rhinitis (AR). Data on AR prevalence in COVID-19 patients are limited. Consequently, whether AR is a harmful or protective factor for COVID-19 patients remains controversial. Therefore, we analyzed the relationship between COVID-19 and AR. Methods: We systematically searched PubMed, Embase, Cochrane, and Web of Science databases for studies published between January 1, 2020 and January 11, 2022. We included studies reporting the epidemiological and clinical characteristics of COVID-19 and its incidence in patients with AR. We excluded letters, case reports, literature review articles, non-English language article, and non-full-text articles. The raw data from these studies were pooled into a meta-analysis. Results: We analyzed the results of nine studies. The prevalence of AR in patients with COVID-19 was 0.13 (95% confidence interval [CI] 0.04-0.25), with an overall I 2 of 99.77%, P=0.24. COVID-19 patients with AR are less prone to severe disease (odds ratio [OR] = 0.79, 95% CI, 0.52-1.18, P=0.25) and hospitalization (OR = 0.23, 95%CI, 0.02-2.67, P ≤ 0.0001) than patients without AR. Conclusion: Our data suggest that allergic rhinitis is a protective factor in patients with COVID-19.

Impact of government interventions on the stock market during COVID-19: a case study in Indonesia

This paper aims to examine the short-term impact of government interventions on 11 industrial sectors in the Indonesian Stock Exchange (IDX) during the COVID-19 pandemic. Whereas earlier studies have widely investigated the impact of government interventions on the financial markets during the pandemic, there is lack of research on analysing the financial impacts of various interventions in different industrial sectors, particularly in Indonesia. In this research, five key types of government interventions are selected amid the pandemic from March 2020 to July 2021, including economic stimulus packages, jobs creation law, Jakarta lockdowns, Ramadan travel restrictions, and free vaccination campaign. Based on an event study methodology, the research reveals that the first economic stimulus package was critical in reviving most sectors following the announcement of the first COVID-19 case in Indonesia. Jakarta lockdowns impacted stock returns negatively in most sectors, but the impacts were relatively insignificant in comparison to other countries in the region. The recurrence of lockdowns in Jakarta had a minor detrimental impact, showing that the market had acclimated to the new normal caused by the COVID-19 pandemic. Additionally, Ramadan travel restrictions caused minor negative impacts on the stock market. Furthermore, the second Ramadan travel restrictions generated a significant reaction from the technology sector. Finally, while free vaccination campaign and job creation law did not significantly boost the stock market, both are believed to result in a positive long-term effect on the country’s economy if appropriately executed. The findings are critical for investors, private companies, and governments to build on recovery action plans for major industrial sectors, allowing the stock market to bounce back quickly and efficiently. As this study limits its analysis to the short-term impact of individual interventions, future studies can examine long-term and combined effects of interventions which could also help policy makers to form effective portfolios of interventions in the event of a pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s43546-022-00312-4.

Polyvinylidene fluoride multi-scale nanofibrous membrane modified using N-halamine with high filtration efficiency and durable antibacterial properties for air filtration.

HYPOTHESIS: Particulate matter (PM) pollution and the coronavirus (COVID-19) pandemic have increased demand for protective masks. However, typical protective masks only intercept particles and produce peculiar odors if worn for extended periods owing to bacterial growth. Therefore, new protective materials with good filtration and antibacterial capabilities are required. EXPERIMENTS: In this study, we prepared multi-scale polyvinylidene fluoride (PVDF) nanofibrous membranes for efficient filtration and durable antibacterial properties via N-halamine modification. FINDINGS: The N-halamine-modified nanofibrous membrane (PVDF-PAA-TMP-Cl) had sufficient active chlorine content (800 ppm), and the tensile stress and strain were improved compared with the original membrane, from 6.282 to 9.435 MPa and from 51.3 % to 56.4 %, respectively. To further improve the interception efficiency, ultrafine nanofibers (20-35 nm) were spun on PVDF-PAA-TMP-Cl nanofibrous membranes, and multi-scale PVDF-PAA-TMP-Cl nanofibrous membranes were prepared. These membranes exhibited good PM0.3 interception (99.93 %), low air resistance (79 Pa), promising long-term PM2.5 purification ability, and high bactericidal efficiency (>98 %). After ten chlorination cycles, the antibacterial efficiency against Escherichia coli and Staphylococcus aureus exceeded 90 %; hence, the material demonstrated highly efficient filtration and repeatable antibacterial properties. The results of this study have implications for the development of air and water filtration systems and multi-functional protective materials.

Changes in interferon-γ release assay readout after COVID-19 vaccination: A prospective cohort study.

OBJECTIVES: Interferon-γ release assays (IGRAs) are widely used in public health practice to diagnose latent tuberculosis. During the COVID-19 pandemic and rollout of COVID-19 vaccination, it has remained unclear whether COVID-19 vaccines interfere with IGRA readouts. METHODS: We prospectively recruited healthcare workers during their annual occupational health examinations in 2021. Baseline IGRA readouts were compared with follow-up data after the participants had received two doses of COVID-19 vaccination. RESULTS: A total of 134 baseline IGRA-negative cases (92 with ChAdOx1 vaccine, 27 with mRNA-1273 vaccine, and 15 with heterologous vaccination) and seven baseline IGRA-positive cases were analyzed. Among the baseline IGRA-negative cases, there were decreased interferon-γ concentrations over the Nil (P = 0.005) and increased Mitogen-Nil (P < 0.001) values after vaccination. For TB2-Nil value, a similar trend (P = 0.057) of increase was observed. Compared with the 0.35 IU/ml threshold, the baseline and follow-up readout differences were less than |± 0.10| IU/ml over the TB1-Nil and TB2-Nil values in >90% baseline IGRA-negative cases. No significant readout difference was observed among baseline IGRA-positive cases. CONCLUSION: COVID-19 vaccination did not change IGRA interpretation in most cases. Cases showing conversion/borderline IGRA readouts should be given special consideration.

Fear of Virus or of Competitors? The Decision Rationales of Financial Managers Under COVID-19.

This paper surveyed 422 financial managers before the number of novel coronavirus (COVID-19) infections in China peaked and used path analysis to study the risk decision-making mechanisms of financial managers. The study found that whether financial managers developed coping strategies depends on their assessment of potential business revenue losses. There are two transmission paths: the direct effect refers to the risk perception directly caused by COVID-19, while the indirect effect refers to managers' fear that they will not make timely adjustments or will make judgment errors, resulting in the loss of competitive advantage. It is worth noting that the indirect effect exceeds the direct effect, which indicates that financial managers are more rational than ordinary people in dealing with COVID-19, that they are relatively more concerned about competitor changes, and that they may even view COVID-19 as an important opportunity to obtain a better competitive position.

Surviving uncertainty: A dual-path model of personal initiative affecting graduate employability.

The increasing uncertainty of our world raises important questions for university students on how they should respond to the employment challenges caused by changing environments. One of the central topics is the development of graduate employability. However, most previous research on graduate employability was undertaken in a stable environment, limiting our understanding of how graduate employability develops in a dynamic context. We have advanced the literature by introducing action theory to investigate the process of personal initiative affecting graduate employability in a period of environmental uncertainty. Using a time-lagged research design, we collected data from a sample of 229 Chinese university students and tested the hypothesized relationships. We find that personal initiative positively affects graduate employability through human and psychological capital. We further show that environmental uncertainty plays a contingent role in the above processes. Specifically, when a high level of environmental uncertainty is perceived, the positive indirect effect of personal initiative on graduate employability through either human capital or psychological capital is more likely to be strengthened. The theoretical and practical implications of these findings are also discussed.