Study on factors influencing college students' digital academic reading behavior

Background Affected by the COVID-19, many colleges have adopted online teaching. Meanwhile, the digital transformation of academic journals has shifted readers' reading habits from traditional paper media to digital media. Digital academic reading has become the main reading method of college students during the COVID-19 pandemic. Purpose The purpose of this study was to investigate the behavioral characteristics of college students' digital academic reading and explore the internal factors and external environmental factors affecting the Intention and Use behavior of digital academic reading. At the same time this study provide recommendations to address these influencing factors in terms of the individual, the environment and library resources. Methods Based on UTAUT2 model and digital academic reading theories, this paper constructs a digital academic reading information behavior (DARB) model of college students to examine college students' digital academic reading behavior and intention. College students with digital academic reading behavior were recruited as research participants. A multi-stage sampling technique was used to collect representative samples from universities in Nanjing. 239 respondents participated in the questionnaire, with 189 providing valid data. Results: Effort expectancy (EE), social influence (SI), price value (PV), perceived risk (PR) and habit (BH) have a significant impact on behavioral intention (BI), and behavioral intention (BI) and habit (BH) have a significant impact on use behavior (B). However, performance expectancy (PE) and facilitating conditions (FC) have no significant influence on behavioral intention (BI). Originality/value The findings of this study will help fill the gap in previous research on the relationship between the influencing factors of digital academic reading and college students' reading intentions and behaviors, so as to provide a basis for improving the academic reading literacy program in colleges and optimizing the current digital academic reading environment.

Overcome social anxiety disorder and develop visionary leadership in uncertain environments: The important role of psychological resilience

Uncertainty is the main feature of the business environment in the post-coronavirus disease 2019 (COVID-19) era. People taking leadership positions in an uncertain environment constantly encounter unprecedented risks and challenges. Many of them have difficulties adapting to such an environment and thus experience severe anxiety, showing the symptoms of social anxiety disorder (SAD), failing to exert effective leadership in social interaction contexts. How can leaders overcome SAD and effectively motivate their subordinates in an uncertain environment? This study explores the important role of psychological resilience. Using sample data collected from 82 leaders and 363 subordinates of eight enterprises in China from May to June 2020, the current study reveals that a high degree of psychological resilience enables leaders to maintain intrinsic motivated at work in an uncertain environment. Leaders with a high degree of psychological resilience perform better in identifying the organizations' vision and displaying visionary leadership than those with a low degree. The current study enriches the knowledge of leaders' psychological well-being and effective leadership in the post-COVID-19 era.

Impacts of Lockdown Policy on Air Quality in Chinese Cities on Different Economic Levels during the COVID-19 Pandemic (preprint)

The sudden outbreak of the Corona Virus Disease 2019 (COVID-19) broke the stable trend of air quality improvement in Chinese cities due to the emergency response measures, such as the lockdown policy. In this study, 333 Chinese cities are divided into six levels by economic factors, such as first-tier, new first-tier, second-tier, third-tier, fourth-tier, and fifth-tier, and the time of each year was defined as pre-lockdown, lockdown and reopen periods. The results show that, during the pre-lockdown period, the concentrations of NO2 and PM2.5 decreased by 10.13% and 6.15%, respectively, compared with the same period averages in 2017–2019. The fifth-tier cities have the minimum reductions of NO2 and PM2.5. The lockdown policy has significantly improved the air quality in Chinese cities during the COVID-19 pandemic. The concentrations of NO2 and PM2.5 decreased by 42.38% and 29.34%, respectively, but the air quality of first-tier cities was least affected by lockdown. During the reopen period, the concentrations of NO2 and PM2.5 decreased by 14.28% and 25.71%, respectively, and the NO2 concentrations in each city are similar for the season. The NO2 and PM2.5 concentrations in 2020 without lockdown were estimated through a multivariate linear regression model. The actual values of both NO2 and PM2.5 concentrations during the lockdown period are lower than the projected values based on the 2017–2019 trend, again indicating that the lockdown policy influences their concentrations.

Clinical characteristics and outcomes in COVID-19 patients with chronic kidney disease in the SARS-CoV-2 Omicron wave: a case-control study (preprint)

Background Since March 2022, the SARS-CoV-2 Omicron variant, mainly the BA.2 sub-lineage, has swept throughout Shanghai, China and caused a wide range of infections. Patients with chronic kidney disease (CKD) are particularly vulnerable to the subvariant and have unique clinical manifestations and outcomes, which have not been studied yet.Methods We retrospective collected data from 2140 hospitalized patients with SARS-CoV-2 Omicron infection from March 29, 2022, to May 17, 2022. Demographic characteristics, clinical symptoms, ancillary examination results, and treatments were described respectively. Presence of COVID-19 pneumonia, disease severity (according to WHO), composite outcome (critical COVID-19 and death), and negative conversion time were defined as primary outcomes. Multivariate analyses were used to evaluate risk factors affecting the primary outcomes.Results The main clinical types of CKD group were severe and critical. Negative conversion time varies according to the stage of CKD patients. The CKD group was more likely to have pneumonia, respiratory and circulatory support, severe disease and death, as compared to the non-CKD group. CKD and the number of comorbidities were found to be risk factors for pneumonia, critical COVID-19and composite outcome among Omicron patients.Conclusion We provided the first snapshot of clinical characteristics and outcomes of CKD patients in the Omicron wave, highlighting the vulnerability of CKD population and providing clues for future studies in special or immunocompromised populations.

Randomized, placebo-controlled, single-blind phase 1 studies of the safety, tolerability, and pharmacokinetics of BRII-196 and BRII-198, SARS-CoV-2 spike-targeting monoclonal antibodies with an extended half-life in healthy adults

Background: BRII-196 and BRII-198 are two anti-SARS-CoV-2 monoclonal neutralizing antibodies as a cocktail therapy for treating COVID-19 with a modified Fc region that extends half-life. Methods: Safety, tolerability, pharmacokinetics, and immunogenicity of BRII-196 and BRII-198 were investigated in first-in-human, placebo-controlled, single ascending dose phase 1 studies in healthy adults. 44 participants received a single intravenous infusion of single BRII-196 or BRII-198 up to 3,000 mg, or BRII-196 and BRII-198 combination up to 1500/1500 mg, or placebo and were followed up for 180 days. Primary endpoints were incidence of adverse events (AEs) and changes from pre-dose baseline in clinical assessments. Secondary endpoints included pharmacokinetics profiles of BRII-196/BRII-198 and detection of anti-drug antibodies (ADAs). Plasma neutralization activities against SARS-CoV-2 Delta live virus in comparison to post-vaccination plasma were evaluated as exploratory endpoints. Results: All infusions were well-tolerated without systemic or local infusion reactions, dose-limiting AEs, serious AEs, or deaths. Most treatment-emergent AEs were isolated asymptomatic laboratory abnormalities of grade 1-2 in severity. BRII-196 and BRII-198 displayed pharmacokinetics characteristic of Fc-engineered human IgG1 with mean terminal half-lives of 44.6–48.6 days and 72.2–83.0 days, respectively, with no evidence of interaction or significant anti-drug antibody development. Neutralizing activities against the live virus of the SARS-CoV-2 Delta variant were maintained in plasma samples taken on day 180 post-infusion. Conclusion: BRII-196 and BRII-198 are safe, well-tolerated, and suitable therapeutic or prophylactic options for SARS-CoV-2 infection. Clinical Trial Registration:ClinicalTrials.gov under identifiers NCT04479631, NCT04479644, and NCT04691180.

A survey on mental health of medical staff fighting COVID-19 in Wuhan

Objectives: To assess the mental health status of medical staff that fight against the maim irus diseases 2019 (COV1D- 19) in Wuhan. and provide data support for medical staff psychological intervention and protection. Methods The meritul health status of 224 medical staff in the prevention and control of GOVID-19 and 127 controls was investigated by combining scale filling and online survey methods. Results The anxiety store of medical shill in Wuhan survey group 18.6 t 5.9 / was significantly higher than that of ordinary medical staff in Xi' an f 16.0 +or-4.6 . and the difference was statistically significant (P< 0.01). 29.991 of the medical staff that fight against COVID -19 in Wuhan had a high score of anxiety. The degree of anxiety of military medical staff was significantly lower than that of non-military medical staff t 11/4 0.001. Those who had participated in the fight against SARS. disaster rescue or exercises had significantly loner anxiety than those without any experience (P<0.001). However, there was no significant difference in anxiety between medical staff who participated in the exercise and those who participated in the fight against SARS and disaster rescue (P=036). Conclusions The front-line medical staff who fight against COV1D- 19 show a high level of anxiety. Participation in the exercise can significantly reduce the anxiety of medical staff fighting against the epidemic.

Development and characterization of neutralizing antibodies against SRAS-CoV-2 (preprint)

Background The novel coronavirus disease 2019(COVID-19) caused by SARS-CoV-2 that belongs to betacoronaviruseis, and is an enveloped, single and positive-stranded RNA virus. In this study, we describe the production and characterization of four monoclonal antibodies (mAb) with neutralization activities.Methods Thirteen mAbs that identified positive were characterized by neutralization assays, binding affinities identification, and ELISA to evaluate the immunocompetence. The genes of neutralizing antibodies were sequenced and analyzed.Results All mAbs recognized two different epitopes respectively, including RBD and hFc, and the binding affinities are also different. Four of nine mAbs that can recognize the epitopes of RBD are conformation neutralizing antibodies that have high binding affinity and neutralization ability. Based on the sequencing, the mAbs are unique antibodies with specificity.Conclusions We characterized thirteen monoclonal antibodies, four of which are neutralizing antibodies and identified unique antibodies with specificity. The results highlight the promise of antibody-based therapeutics and provide the structural basis of rational vaccine design.

Comprehensive genomic, immunological and clinical analysis of COVID-19 vaccine breakthrough infections: a prospective, comparative cohort study (preprint)

Objectives: As the COVID-19 pandemic is still ongoing and SARS-CoV-2 variants are circulating worldwide, an increasing number of breakthrough infections have been detected despite the good efficacy of COVID-19 vaccines. Methods: A prospective, comparative cohort study was conducted in Beijing Ditan Hospital to evaluate the clinical, immunological and genomic characteristics of COVID-19 breakthrough infections. Data on 88 COVID-19 breakthrough cases (vaccinated group) and 41 unvaccinated cases (unvaccinated group) from June 1 to August 20, 2021 were extracted from a cloud database. Among these 129 COVID-19 cases, we successfully sequenced 33 whole genomes, including 16 from the vaccinated group and 17 from the unvaccinated group. Results: Asymptomatic and mild cases predominated in both groups, but 2 patients developed severe disease in the unvaccinated group. Between the two groups, the median time of viral shedding in the vaccinated group were significantly lower than those in the unvaccinated group (p = 0.003). A comparison of dynamic IgG titres of cases in the two groups indicated that IgG titres in the vaccinated group showed a significantly increasing trend (P =0.028). The CD4+T lymphocyte count was lower in the unvaccinated group, and there was a significant difference between the two groups (p=0.018). In the vaccinated group, the number of moderate cases who received Sinopharm BBIBP (42 cases) was significantly higher than those who received Sinovac Coronavac (p=0.020). Whole-genome sequencing revealed 23 cases of delta variants, including 15 patients from the vaccinated group. However, no significant difference was observed in either the RT-qPCR results or viral shedding time. Conclusions: COVID-19 vaccine breakthrough infections were mainly asymptomatic and mild, the IgG titres were significantly higher and increased rapidly, and the viral shedding was short. Delta variants may be more likely to cause breakthrough infections, and vaccination may not reduce the viral loads and shedding time.

Viral E Protein Neutralizes BET Protein-Mediated Post-Entry Antagonism of SARS-CoV-2 (preprint)

Inhibitors of Bromodomain and Extra-terminal domain (BET) proteins are possible anti-SARS-CoV-2 prophylactics as they downregulate angiotensin-converting enzyme 2 (ACE2). Here, we show that BET proteins should not be inactivated therapeutically as they are critical antiviral factors at the post-entry level. Knockouts of BRD3 or BRD4 in cells overexpressing ACE2 exacerbate SARS-CoV-2 infection; the same is observed when cells with endogenous ACE2 expression are treated with BET inhibitors during infection, and not before. Viral replication and mortality are also enhanced in BET inhibitor-treated mice overexpressing ACE2. BET inactivation suppresses interferon production induced by SARS-CoV-2, a process phenocopied by the envelope (E) protein previously identified as a possible "histone mimetic." E protein, in an acetylated form, directly binds the second bromodomain of BRD4. Our data support a model where SARS-CoV-2 E protein evolved to antagonize interferon responses via BET protein inhibition; this neutralization should not be further enhanced with BET inhibitor treatment.

A semi-automatic ultrasound image analysis system for the grading diagnosis of COVID-19 pneumonia (preprint)

This paper proposes a semi-automatic system based on quantitative characterization of the specific image patterns in lung ultrasound (LUS) images, in order to assess the lung conditions of patients with COVID-19 pneumonia, as well as to differentiate between the severe / and no-severe cases. Specifically, four parameters are extracted from each LUS image, namely the thickness (TPL) and roughness (RPL) of the pleural line, and the accumulated with (AWBL) and acoustic coefficient (ACBL) of B lines. 27 patients are enrolled in this study, which are grouped into 13 moderate patients, 7 severe patients and 7 critical patients. Furthermore, the severe and critical patients are regarded as the severe cases, and the moderate patients are regarded as the non-severe cases. Biomarkers among different groups are compared. Each single biomarker and a classifier with all the biomarkers as input are utilized for the binary diagnosis of severe case and non-severe case, respectively. The classifier achieves the best classification performance among all the compared methods (area under the receiver operating characteristics curve = 0.93, sensitivity = 0.93, specificity = 0.85). The proposed image analysis system could be potentially applied to the grading and prognosis evaluation of patients with COVID-19 pneumonia.

Usage of Compromised Lung Volume in Monitoring Steroid Therapy on Severe COVID-19 (preprint)

Background: Quantitative computed tomography (QCT) analysis may serve as a tool for assessing the severity of coronavirus disease 2019 (COVID-19)and for monitoringits progress. The present study aimed to assess the association between steroid therapy and quantitative CT parameters in a longitudinal cohort with COVID-19. Methods: Between February 7 and February 17, 2020, 300 chest CT scans from 72 patients with severe COVID-19 were retrospectively collected and classified into five stages according to the interval between hospital admission and follow-up CT scans: Stage 1 (at admission); Stage 2 (3–7 days); Stage 3 (8–14 days); Stage 4 (15–21 days); and Stage 5 (22–31 days). QCT was performed using a threshold-based quantitative analysis to segment the lungaccording to different Hounsfield unit (HU) intervals. The primary outcomeswerechanges in percentage of compromised lung volume (%CL, –500 to 100 HU) at different stages. Multivariate Generalized Estimating Equations were performed after adjusting for potential confounders. Results: Of 72 patients, 31 patients (43.1%) received steroid therapy. Steroid therapy was associated with a decrease in %CL (-3.27% [95%CI, -5.86 to -0.68, P = 0.01]) after adjusting for duration and baseline %CL. Associations between steroid therapy and changes in %CL varied between different stages or baseline %CL (all interactions, P <0.01). Steroid therapy was associated with decrease in %CL after stage 3 (all P <0.05), but not at stage 2. Similarly, steroid therapy was associated with a more significant decrease in %CL in the high CL group ( P <0.05), but not inthe low CL group. Conclusions: Steroid administration was independently associated with a decrease in %CL, with interaction by duration or disease severity in a longitudinal cohort. The quantitative CT parameters, particularly compromised lung volume, may provide a useful tool to monitor COVID-19 progression during the treatment process. Trial registration Clinicaltrials.gov, NCT04953247. Registered July 7, 2021, https://clinicaltrials.gov/ct2/show/NCT04953247

Co-benefits of reducing PM2.5 and improving visibility by COVID-19 lockdown in Wuhan

The less improvement of ambient visibility suspects the government’s efforts on alleviating PM2.5 pollution. The COVID-19 lockdown reduced PM2.5 and increased visibility in Wuhan. Compared to pre-lockdown period, the PM2.5 concentration decreased by 39.0 μg m−3, dominated by NH4NO3 mass reduction (24.8 μg m−3) during lockdown period. The PM2.5 threshold corresponding to visibility of 10 km (PTV10) varied in 54–175 μg m−3 and an hourly PM2.5 of 54 μg m−3 was recommended to prevent haze occurrence. The lockdown measures elevated PTV10 by 9–58 μg m−3 as the decreases in PM2.5 mass scattering efficiency and optical hygroscopicity. The visibility increased by 107%, resulted from NH4NO3 extinction reduction. The NH4NO3 mass reduction weakened its mutual promotion with aerosol water and increased PM2.5 deliquescence humidity. Controlling TNO3 (HNO3 + NO3−) was more effective to reduce PM2.5 and improve visibility than NHx (NH3 + NH4+) unless the NHx reduction exceeded 11.7–17.5 μg m−3.

Phase 1 safety and pharmacokinetics studies of BRII-196 and BRII-198, SARS-CoV-2 spike-targeting monoclonal antibodies (preprint)

Background. BRII-196 and BRII-198 are two anti-SARS-CoV-2 monoclonal neutralizing antibodies with modified Fc region that extends half-life and are being developed as cocktail therapy for the treatment of COVID-19. Safety, tolerability, pharmacokinetics, and immunogenicity of BRII-196 and BRII-198 were investigated in healthy adults. Methods. Single ascending doses of BRII-196 and BRII-198 were evaluated in parallel in the first-in-human, placebo-controlled phase 1 studies. A total of 32 healthy adults were randomized and received a single intravenous infusion of 750, 1500, and 3000 mg of BRII-196 (n=12), BRII-198 (n=12), or placebo (n=8) and were followed for 180 days. Results. All infusions were well tolerated at infusion rates between 0.5 mL/min to 4 mL/min with no dose-limiting adverse events, deaths, serious adverse events, or any systemic or local infusion reactions. Most treatment-emergent adverse events were isolated asymptomatic laboratory abnormalities of Grade 1-2 in severity. Each mAb displayed pharmacokinetics expected of Fc-engineered human IgG1 with mean terminal half-lives of approximately 46 days and 76 days, respectively, with no evidence of significant anti-drug antibody development. Conclusions. BRII-196 and BRII-198 were well-tolerated. Clinical results support further development as therapeutic or prophylactic options for SARS-CoV-2 infection.

Preliminary study on environmental and climatic characteristics of historical infectious diseases and some thoughts of COVID-19

The outbreak and pandemic of COVID-19 pose a serious threat to the safety of human society and examine the ability of public health care resources around the world to deal with the large sudden infectious diseases. A review on the environmental and climatic characteristics related to historical infectious diseases will shed immediate light on the scientific research and control of COVID-19. Our results show that:(1) Historically, outbreaks of human-to-human coronavirus and orthomyxoviridae infectious diseases mainly occurred in the subtropical monsoon climate of the northern hemisphere in the winter and spring, while the outbreaks of flaviridae infectious diseases mostly occurred in tropical regions in hot and rainy summer and autumn.(2) Global warming and extreme weather may exacerbate the outbreak and spread of infectious diseases.(3) The impact of human activities on the ecosystem balance forces the habitat migration of virus hosts and the aggregation of different virus hosts, increasing the probability of virus mutation and the risk of infectious disease outbreaks. The lessons from historical outbreak of infectious diseases suggest that suitable climate factors might be conducive to the outbreak and epidemics, while the outbreaks in tropical countries also indicate that it is necessary to scrutinize the roles of climate, environmental conditions and ecological factors in the global wave of COVID-19. Our study provides some useful insights for the prevention and control of COVID-19 plague and other potential pandemics in the future.

SARS-CoV-2 infection causes transient olfactory dysfunction in mice (preprint)

Olfactory dysfunction caused by SARS-CoV-2 infection represents as one of the most predictive and common symptoms in COVID-19 patients. However, the causal link between SARS-CoV-2 infection and olfactory disorders remains lacking. Herein we demonstrate intranasal inoculation of SARS-CoV-2 induces robust viral replication in the olfactory epithelium (OE), resulting in transient olfactory dysfunction in humanized ACE2 mice. The sustentacular cells and Bowman's gland cells in OE were identified as the major targets of SARS-CoV-2 before the invasion into olfactory sensory neurons. Remarkably, SARS-CoV-2 infection triggers cell death and immune cell infiltration, and impairs the uniformity of OE structure. Combined transcriptomic and proteomic analyses reveal the induction of antiviral and inflammatory responses, as well as the downregulation of olfactory receptors in OE from the infected animals. Overall, our mouse model recapitulates the olfactory dysfunction in COVID-19 patients, and provides critical clues to understand the physiological basis for extrapulmonary manifestations of COVID-19.

Does Non-COVID19 Lung Lesion Help? Investigating Transferability in COVID-19 CT Image Segmentation (preprint)

Coronavirus disease 2019 (COVID-19) is a highly contagious virus spreading all around the world. Deep learning has been adopted as an effective technique to aid COVID-19 detection and segmentation from computed tomography (CT) images. The major challenge lies in the inadequate public COVID-19 datasets. Recently, transfer learning has become a widely used technique that leverages the knowledge gained while solving one problem and applying it to a different but related problem. However, it remains unclear whether various non-COVID19 lung lesions could contribute to segmenting COVID-19 infection areas and how to better conduct this transfer procedure. This paper provides a way to understand the transferability of non-COVID19 lung lesions. Based on a publicly available COVID-19 CT dataset and three public non-COVID19 datasets, we evaluate four transfer learning methods using 3D U-Net as a standard encoder-decoder method. The results reveal the benefits of transferring knowledge from non-COVID19 lung lesions, and learning from multiple lung lesion datasets can extract more general features, leading to accurate and robust pre-trained models. We further show the capability of the encoder to learn feature representations of lung lesions, which improves segmentation accuracy and facilitates training convergence. In addition, our proposed Hybrid-encoder learning method incorporates transferred lung lesion features from non-COVID19 datasets effectively and achieves significant improvement. These findings promote new insights into transfer learning for COVID-19 CT image segmentation, which can also be further generalized to other medical tasks.

A Survey of Characteristics and Potential Contribution of Registered Studies for 2019 novel coronavirus disease (COVID-19) (preprint)

Background The World Health Organization characterized the 2019 novel coronavirus disease (COVID-19) as a pandemic on March 11. Many clinical trials on COVID-19 have been registered, and we aim to review the characteristics of the trials and provide guidance for future trials to avoid duplicated effort.Methods All the studies on COVID-19 registered before Mar 3, 2020 on eight registry platforms worldwide were searched and the data of design, participants, interventions, and outcomes were extracted and analyzed. The most promising trials were screened based on study design, rationale, and resource availability.Results 393 studies registered were identified until Mar 3 2020 and 380 (96.7%) studies were from mainland China, while 3 in Japan, 3 in France, 2 in the US, and 3 were international collaborative studies. 363 studies (92.4%) recruited participants from hospitals and 266 studies (67.7%) aimed at therapeutic effect, others were for prevention, diagnosis, prognosis, etc. 202 studies (51.4%) were randomized controlled trials (RCTs). The average sample size was 1061 and ranged from 8 to 150,000 per study. 177 out of 266 therapeutic studies (66.5% ) tested Western medicines including antiviral drugs (17.7%), stem cell and cord blood therapy (10.2%), chloroquine and derivatives (8.3%), 16 (6.0%) on Chinese medicines, and 73 (27.4%) on integrated therapy of Western and Chinese medicines. 14 Chinese medicines had its clear rationale for evaluation of therapeutic effects. 31 studies among 266 therapeutic studies (11.7%) used mortality as primary outcome, while the most designed secondary outcomes were symptoms and signs (47.0%). 106 studies (27.0%) were funded by the government, and 268 (68.2%) demonstrated ethical approval. 45.5% studies (179 out of 266) had not started recruiting till Mar 3. Eight RCTs were evaluated as the most promising trials.Conclusions Majority of the studies focused on assessing therapeutics for COVID-19 but inappropriate outcome setting, delayed recruitment and insufficient numbers of new cases in China implied many studies may fail to complete. Strategies and protocols of the studies with robust and rapid data sharing from international collaboration are warranted for emergency public health events, helping to accelerate priority setting for timely evidence-based decision-making.