CBPH assay for the highest sensitive detection of SARS-COV-2 in the semen.

BACKGROUND: Great concerns have been raised on SARS-CoV-2 impact on men's andrological well-being, and many studies have attempted to determine whether SARS-CoV-2 is present in the semen and till now the data are unclear and somehow ambiguous. However, these studies used quantitative real-time (qRT) PCR, which is not sufficiently sensitive to detect nucleic acids in clinical samples with a low viral load. METHODS: The clinical performance of various nucleic acid detection methods (qRT-PCR, OSN-qRT-PCR, cd-PCR, and CBPH) was assessed for SARS-CoV-2 using 236 clinical samples from laboratory-confirmed COVID-19 cases. Then, the presence of SARS-CoV-2 in the semen of 12 recovering patients was investigated using qRT-PCR, OSN-qRT-PCR, cd-PCR, and CBPH in parallel using 24 paired semen, blood, throat swab, and urine samples. RESULTS: The sensitivity and specificity along with AUC of CBPH was markedly higher than the other 3methods. Although qRT-PCR, OSN-qRT-PCR and cdPCR detected no SARS-CoV-2 RNA in throat swab, blood, urine, and semen samples of the 12 patients, CBPH detected the presence of SARS-CoV-2 genome fragments in semen samples, but not in paired urine samples, of 3 of 12 patients. The existing SARS-CoV-2 genome fragments were metabolized over time. CONCLUSIONS: Both OSN-qRT-PCR and cdPCR had better performance than qRT-PCR, and CBPH had the highest diagnostic performance in detecting SARS-CoV-2, which contributed the most improvement to the determination of the critical value in gray area samples with low vrial load, which then provides a rational screening strategy for studying the clearance of coronavirus in the semen over time in patients recovering from COVID-19. Although the presence of SARS-CoV-2 fragments in the semen was demonstrated by CBPH, COVID-19 is unlikely to be sexually transmitted from male partners for at least 3 months after hospital discharge.

Healthy Aging at Family Mealtimes: Associations of Clean Cooking, Protein Intake, and Dining Together with Mental Health of Chinese Older Adults amid COVID-19 Pandemic.

The present study aims to examine whether multiple dietary factors affect the mental health of older adults amid the COVID-19 pandemic. It proposes an integrative dietary framework that highlights environmental, nutritional, and social aspects of diet for healthy aging. Based on a sample of 7858 Chinese older adults, the associations between diet and depressive symptoms, along with the rural-urban divide, were examined using zero-inflated negative binomial regression. Overall, protein intake (incidence-rate ratio [IRR] = 0.89, p < 0.001), frequency of family dining together (IRR = 0.98, p < 0.001), and using tap water for cooking (IRR = 0.92, p < 0.01) were associated with lower incidence rates of depressive symptoms among older adults. Among rural older adults, frequency of family dining together (IRR = 0.97, p < 0.001) and tap water use (IRR = 0.89, p < 0.001) were associated with fewer depressive symptoms. However, urban residents who had a higher frequency of family dining together (IRR = 0.98, p < 0.05) and protein intake (IRR = 0.81, p < 0.001) exhibited fewer depressive symptoms. The findings revealed multifaceted dietary pathways towards healthy aging, which call for policies and interventions that improve diet quality for community-dwelling older adults.

The effect of COVID-19 risk perception on pro-environmental behavior of Chinese consumers: Perspectives from affective event theory.

Introduction: COVID-19 has altered human cognition and changed the cultural values of society. However, there has not been much debate among scholars about whether these above changes have led to an increase in pro-environmental behavior (PEB) of Chinese consumers. Methods: A comprehensive model was developed based on affective event theory. An online questionnaire was distributed, and 501 usable questionnaires were collected. In addition, two complementary approaches were employed: partial least squares structural equation modeling (PLS-SEM) and necessary condition analysis (NCA). Results: The PLS-SEM results showed that COVID-19 risk perception, nostalgia, the awe of nature, and attitude were found to have a positive effect on PEB; and the moderating effect of power distance belief (PD) between nostalgia (NO), attitude (AT) and PEB was confirmed. According to the NCA results, AT and NO are necessary conditions for the PEB of consumers. Discussion: This study provides deeper insight into the understanding of consumers' pro-environmental behavior in the context of COVID-19 through the combined use of PLS-SEM and NCA.

How negative anthropomorphic message framing and nostalgia enhance pro-environmental behaviors during the COVID-19 pandemic in China: An SEM-NCA approach.

Although extensive research has been conducted on promoting pro-environmental behaviors among consumers, little is known about whether and how negative anthropomorphic message framing (NAMF) and nostalgia affect pro-environmental behavior. To provide a framework for explaining pro-environmental behavior, this study integrates protection motivation theory, the stimulus-organism-response model, and message framing. To create the model of the influences on pro-environmental behavior, NAMF was employed as the external stimulus; the sense of environmental responsibility, environmental empathy, perceived threat, and perceived vulnerability as the psychological and cognitive response factors; pro-environmental behavior as the final decision of consumers; and nostalgia as the moderating variable. An online questionnaire was distributed and 380 usable questionnaires were collected using convenience sampling and analyzed using two complementary approaches: partial least squares structural equation modeling (PLS-SEM) and necessary condition analysis (NCA). PLS-SEM results showed that pro-environmental behavior was significantly affected by NAMF (ß = 0.313, t-value = 5.583), environmental responsibility (ß = 0.207, t-value = 3.994), and perceived threats (ß = 0.252, t-value = 4.889). Meanwhile, an increase in nostalgia increased the effect of NAMF and environmental responsibility on pro-environmental behavior. The NCA results revealed that NAMF (d = 0.108, p < 0.001) and perceived threat (d = 0.209, p < 0.001) were key factors of pro-environmental behavior. In addition, for high level of pro-environmental behavior (>80%), NAMF (12.1%) and perceived threat (39.6%) are required. Finally, we offer several suggestions based on the results of our empirical research. For example, marketing and service offerings should be tailored to the needs of masses with different nostalgic tendencies to enhance their pro-environmental behaviors.

Emergency department treatment process planning: a field research, case analysis, and simulation approach.

Background: The coronavirus disease 2019 (COVID-19) has forced accelerated optimization of Emergency Department (ED) process, and simulation tools offer an alternative approach to strategic assessment and selection. Methods: Field research and case analysis methods were used to obtain the treatment process and medical records information from the ED of a general hospital. Minitab was used for analysis of the measurement system, and Arena was applied for simulation modelling. We established a framework for the triage protocol of ordinary and quarantined patients, analysed bottlenecks in the treatment time of the hospital's ED, and proposed an optimised management strategy. Results: The computed tomography (CT) pre-scheduling strategy simulation results demonstrated that longer CT room preparation times for quarantined people before their arrival (Tp) resulted in reduced CT scan and waiting times for quarantined patients, but these times were longer for ordinary patients. The nucleic acid priority strategy simulation results demonstrated that when the average daily number of ordinary patients (λc) was relatively stable, the hospital could guide ordinary patients to perform nucleic acid testing first followed by CT testing. However, when λc fluctuated greatly, the hospital could appropriately reduce the proportion of preferential nucleic acid testing. Furthermore, when λc was overloaded, the nucleic acid priority strategy showed no advantages. The joint analysis results demonstrated that the optimal strategy selection was significantly affected by the severity of the epidemic. The nucleic acid detection sample size optimisation strategy demonstrated that optimizing the sample size of each batch according to the number of patients could effectively reduce the waiting times for nucleic acid testing (Tn). Conclusions: Simulation tools are an alternative method for strategic evaluation and selection that do not require external factors.

Cross-Sectional Associations between Living and Built Environments and Depression Symptoms among Chinese Older Adults

In this study, we explored the cross-sectional associations between living and built environments and depression among older Chinese adults. Data from 5822 participants were obtained. Depression symptoms were evaluated through the use of the Patient Health Questionnaire (PHQ-9), with a score higher than 4 categorized as having depression symptoms. The living environment was assessed by asking about dust in the environment and barrier-free facilities. We considered the presence of amenities within a 10 min walking distance and the proportion of green space within an 800 m distance from participants’ dwellings to reflect the built environment. Data were analyzed by multilevel logistic regression. Participants living in a non-dusty environment with proximity to green space had a lower risk of depression (non-dusty environment: OR = 0.784, 95% CI = 0.642, 0.956;green space: OR = 0.834, 95% CI = 0.697, 0.998). However, having no access to barrier-free facilities and hospital proximity increased the depression risk (barrier-free facilities: OR = 1.253, 95% CI = 1.078, 1.457;hospital: OR = 1.318, 95% CI = 1.104, 1.574). Dusty environments, access to barrier-free facilities and proximity to hospitals and green spaces were associated with depression symptoms among older Chinese adults.

Risks associated with cryopreserved semen in a human sperm bank during and after the COVID-19 pandemic.

RESEARCH QUESTION: What are the risks associated with cryopreserved semen collected during and after the coronavirus disease 2019 (COVID-19) pandemic wave in Wuhan, China? DESIGN: Retrospective cohort study involving young adult men who were qualified sperm donors at the Hunan Province Human Sperm Bank (China) during the pandemic wave (1 January 2020 to 30 January 2020) and after the wave and return to work (7 April 2020 to 30 May 30 2020). One hundred paired semen and blood specimens from 100 donors were included. One-step single-tube nested quantitative real-time polymerase chain reaction (OSN-qRT-PCR) was used to detect SARS-CoV-2. Moreover, to control the unacceptable risk of false-negative results, a second round of screening was performed with pooled RNA from negative semen samples using crystal digital PCR (cd-PCR). RESULTS: For individual blood and semen samples, the target genes, namely the nucleocapsid protein (N) and open reading frame (ORF-1ab) genes, tested negative in all of the 100 paired samples. Further, as per cd-PCR results, there were >20,000 droplets per well in the RNA for each combined sample and no positive droplets were present for either of the aforementioned target genes. A total of 100 paired semen and blood samples from these two groups tested negative for SARS-CoV-2. CONCLUSIONS: Cryopreserved semen at the Hunan Province Human Sperm Bank during and after the COVID-19 pandemic wave was free of SARS-CoV-2 and was judged safe for external use in the future.

Establishing a standardized FUO emergency department: design and practice in dealing with COVID-19.

BACKGROUND: Since the outbreak of COVID-19 in January, 2020, the fever of unknown origin (FUO) emergency department has become the first station for disease prevention and identification in hospitals. Establishing a standardized FUO emergency department within a short period of time has become the key to preventing and controlling COVID-19 in densely populated Chinese cities. METHODS: Based on the lean management model, the research group established a process of less-link visits, which sees reduced contact between patients and physicians during diagnosis and treatment, and zero-contact consultation through lean workflow and value stream analysis. Three steps were implemented to improve the operations of the FUO emergency department: the rapid establishment of an isolation zone, the refinement of duty and protection configuration, and the use of Internet and technology to establish a full-process follow-up consultation system. RESULTS: (I) Tests related to COVID-19 screening are all completed in the FUO emergency department; (II) 12 new isolated observation rooms have been built; (III) hospital visiting time, waiting time for consultation, and the time from pre-examination to virus screening has been shortened from 18 to 8 hours, from 2 hours to 10 minutes, and from 34 to 3 hours, respectively; (IV) the transfer distance has been shortened from 450 to 20 m, and the observation time has been shortened from 72 to 26 hours. The median waiting time for image examination has been reduced from 40 to 3 minutes, and the moving distance has been shortened from 800 to 10 m; (V) the diagnosis and treatment process is facilitated by 5G, achieving zero contact between doctors and patients. CONCLUSIONS: Through the implantation of information technology, the local transformation of the site, the rational allocation of medical teams and the planned distribution of protective equipment, in a short period of time, individual medical institutions can set up a safe FUO emergency department to provide 24-hour screening and detention services. Establishing an FUO emergency department with lean management and realizing the management approach of combining daily operation with prevention and control could help China and other countries to handle the outbreak of fulminant infectious diseases.