Clustering distribution of COVID-19 in Wenzhou from January to March 2020 based on spatiotemporal analysis. (Special Issue: Spatio-temporal dynamics analysis, risk assessment and emergency management for COVID-19 epidemic.) [Chinese]

Objective: To explore the spatiotemporal distribution of COVID-19 in Wenzhou and to provide theoretical basis for the formulation of preventive and control measures.

A Social Media Infodemic-Based Prediction Model for the Number of Severe and Critical COVID-19 Patients in the Lockdown Area.

Accurately predicting the number of severe and critical COVID-19 patients is critical for the treatment and control of the epidemic. Social media data have gained great popularity and widespread application in various research domains. The viral-related infodemic outbreaks have occurred alongside the COVID-19 outbreak. This paper aims to discover trustworthy sources of social media data to improve the prediction performance of severe and critical COVID-19 patients. The innovation of this paper lies in three aspects. First, it builds an improved prediction model based on machine learning. This model helps predict the number of severe and critical COVID-19 patients on a specific urban or regional scale. The effectiveness of the prediction model, shown as accuracy and satisfactory robustness, is verified by a case study of the lockdown in Hubei Province. Second, it finds the transition path of the impact of social media data for predicting the number of severe and critical COVID-19 patients. Third, this paper provides a promising and powerful model for COVID-19 prevention and control. The prediction model can help medical organizations to realize a prediction of COVID-19 severe and critical patients in multi-stage with lead time in specific areas. This model can guide the Centers for Disease Control and Prevention and other clinic institutions to expand the monitoring channels and research methods concerning COVID-19 by using web-based social media data. The model can also facilitate optimal scheduling of medical resources as well as prevention and control policy formulation.

Combinational benefit of antihistamines and remdesivir for reducing SARS-CoV-2 replication and alleviating inflammation-induced lung injury in mice.

COVID-19 is an immune-mediated inflammatory disease caused by SARS-CoV-2 infection, the combination of anti-inflammatory and antiviral therapy is predicted to provide clinical benefits. We recently demonstrated that mast cells (MCs) are an essential mediator of SARS-CoV-2-initiated hyperinflammation. We also showed that spike protein-induced MC degranulation initiates alveolar epithelial inflammation for barrier disruption and suggested an off-label use of antihistamines as MC stabilizers to block degranulation and consequently suppress inflammation and prevent lung injury. In this study, we emphasized the essential role of MCs in SARS-CoV-2-induced lung lesions in vivo, and demonstrated the benefits of co-administration of antihistamines and antiviral drug remdesivir in SARS-CoV-2-infected mice. Specifically, SARS-CoV-2 spike protein-induced MC degranulation resulted in alveolar-capillary injury, while pretreatment of pulmonary microvascular endothelial cells with antihistamines prevented adhesion junction disruption; predictably, the combination of antiviral drug remdesivir with the antihistamine loratadine, a histamine receptor 1 (HR1) antagonist, dampened viral replication and inflammation, thereby greatly reducing lung injury. Our findings emphasize the crucial role of MCs in SARS-CoV-2-induced inflammation and lung injury and provide a feasible combination antiviral and anti-inflammatory therapy for COVID-19 treatment.

Conceptualizing and Assessing the Competitiveness of Slow Tourism Destinations: Evidence From the First Accredited Cittàslow in China

Characterized with in-depth interactions and self-reflections, slow tourism has been gaining growing popularity in recent years thanks to the importance attached to quality of life and self-actualization of tourists in the post modern era, which has all been necessitated by the challenges wrought by the Covid-19 pandemic. In response to the current research lacuna of competitiveness analyses of specialized small-scale destinations, this study comprehensively proposes and empirically evaluates the competitiveness of slow tourism destinations as indicated by the values perceived by the slow tourists, and explores the mechanism of competitiveness of slow tourism destinations with investigation of the interrelationships between competitiveness and tourist attitude, consumption emotion and behavioral intentions through Structural Equation Modeling (SEM). The Gaochun District, which was the first accredited Cittàslow in China, was selected as the research site. Findings yielded four major competitiveness dimensions of community ambiance and service, tourist, and comprehensive management, cultural resources and values and natural resources and protection, and confirmed that perceived values are positively related to attitude, consumption emotion, and behavioral intentions. In addition to offering a valid scale measuring the competitiveness of slow tourism destinations, this study suggests the integration of cultural components in better planning and management of slow tourism destinations.

Construction of Language Teachers' Professional Competence in Education for Sustainable Development in Higher Education for Post-pandemic Era

Education for sustainable development is essentially a value education. It is an educational process that aims at the value recognition, perception, practice and sustainable value tendency of sustainable development. Language teachers' competences for sustainable development education is a professional ability manifested in sustainable development education activities based on their recognition of relevant concepts and willingness to practice sustainable values in their personal lives and educational activities in higher education. The connotation, pedagogic goals and characteristics of sustainability education constitute the foundation of language teachers' professional competences in education for sustainable development, which fall into three major categories of professional knowledge, professional skills and professional attitude.

Risk factors for severe and critically ill COVID-19 patients: A review.

The pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an unprecedented global social and economic impact, and high numbers of deaths. Many risk factors have been identified in the progression of COVID-19 into a severe and critical stage, including old age, male gender, underlying comorbidities such as hypertension, diabetes, obesity, chronic lung diseases, heart, liver and kidney diseases, tumors, clinically apparent immunodeficiencies, local immunodeficiencies, such as early type I interferon secretion capacity, and pregnancy. Possible complications include acute kidney injury, coagulation disorders, thoromboembolism. The development of lymphopenia and eosinopenia are laboratory indicators of COVID-19. Laboratory parameters to monitor disease progression include lactate dehydrogenase, procalcitonin, high-sensitivity C-reactive protein, proinflammatory cytokines such as interleukin (IL)-6, IL-1ß, Krebs von den Lungen-6 (KL-6), and ferritin. The development of a cytokine storm and extensive chest computed tomography imaging patterns are indicators of a severe disease. In addition, socioeconomic status, diet, lifestyle, geographical differences, ethnicity, exposed viral load, day of initiation of treatment, and quality of health care have been reported to influence individual outcomes. In this review, we highlight the scientific evidence on the risk factors of severity of COVID-19.

Decreased prealbumin level is associated with increased risk for mortality in elderly hospitalized patients with COVID-19.

OBJECTIVES: High-risk patients ≥65 y of age with coronavirus disease 2019 (COVID-19) tended to have lower serum prealbumin concentrations. The aim of this study was to investigate the association of prealbumin at baseline on COVID-19-related mortality in elderly patients (≥65 y of age). METHODS: We non-selectively and consecutively collected participants from Tongji Hospital in Wuhan from January 17 to February 17, 2020. Univariate and multivariate logistic regression models were employed to evaluate the correlation between prealbumin and in-hospital outcomes (in-hospital mortality, admission to the intensive care unit [ICU], and mechanical ventilation) in elderly patients with COVID-19. Linear trend was performed by entering the median value of each category of prealbumin tertile as a continuous variable and was visually confirmed by using generalized additive models. Interaction and stratified analyses were conducted as well. RESULTS: We included 446 elderly patients with COVID-19 in the final analyses. In-hospital mortality was 14.79%. Of the 446 patients, 15.47% were admitted to the ICU and 21.3% required mechanical ventilation. Compared with patients in the highest tertile, the prealbumin of patients in the lowest tertile had a 19.09-fold higher risk for death [odds ratio (OR), 20.09; 95% confidence interval (CI), 3.62-111.64; P = 0.0006], 25.39-fold higher risk for ICU admission (OR, 26.39; 95% CI, 4.04-172.39; P = 0.0006), and 1.8-fold higher risk for mechanical ventilation (OR, 2.8; 95% CI, 1.15-6.78; P = 0.0227) after adjustment for potential confounders. There was a linear trend correlation between serum prealbumin concentration and risk for in-hospital mortality, ICU admission, and mechanical ventilation in elderly patients with COVID-19 infection. CONCLUSION: Prealbumin is an independent risk factor of in-hospital mortality for elderly patients with COVID-19. Assessment of prealbumin may help identify high-risk individuals ≥65 y of age with COVID-19.

Acute Kidney Injury Is Associated With In-hospital Mortality in Older Patients With COVID-19.

BACKGROUND: The epidemic of COVID-19 presents a special threat to older adults. However, information on kidney damage in older patients with COVID-19 is limited. Acute kidney injury (AKI) is common in hospitalized adults and associated with poor prognosis. We sought to explore the association between AKI and mortality in older patients with COVID-19. METHODS: We conducted a retrospective, observational cohort study in a large tertiary care university hospital in Wuhan, China. All consecutive inpatients older than 65 years with COVID-19 were enrolled in this cohort. Demographic data, laboratory values, comorbidities, treatments, and clinical outcomes were all collected. Data were compared between patients with AKI and without AKI. The association between AKI and mortality was analyzed. RESULTS: Of 1764 in-hospital patients, 882 older adult cases were included in this cohort. The median age was 71 years (interquartile range: 68-77), 440 (49.9%) were men. The most presented comorbidity was cardiovascular diseases (58.2%), followed by diabetes (31.4%). Of 882 older patients, 115 (13%) developed AKI and 128 (14.5%) died. Patients with AKI had higher mortality than those without AKI (68 [59.1%] vs 60 [7.8%]; p < .001). Multivariable Cox regression analysis showed that increasing odds of in-hospital mortality are associated with higher interleukin-6 on admission, myocardial injury, and AKI. CONCLUSIONS: Acute kidney injury is not an uncommon complication in older patients with COVID-19 but is associated with a high risk of death. Physicians should be aware of the risk of AKI in older patients with COVID-19.