Uneven domestic tourism demand in times of pandemic

This study investigates the short-run impact of the COVID-19 pandemic on the number of domestic overnight stays at the regional level in the summer season 2020. Official data for 65 regions in four countries are used for the analysis (Austria, the Czech Republic, Germany and Switzerland). Dynamic panel data models are employed to estimate a tourism demand equation (real GDP and price fluctuations) augmented by average temperatures. Estimation results reveal that domestic overnight stays evolve unevenly in the first summer after the outbreak of the COVID-19 pandemic. The short-run effects show that the number of domestic overnight stays in densely populated regions decreases by 27% in July as well as in August 2020, in comparison with the same months in previous years, ceteris paribus. To the contrary, there is a surge of 27 and 10%, respectively, for sparsely populated areas in the same months.JEL: Z3, R11 and R12.

Stock Market Performance of the US Hospitality And Tourism During the Covid-19 Pandemic

In this study, the stock market performance of the travel and leisure industry during the COVID-19 pandemic is investigated by use of the three-regime Markov switching model. The analysis employs daily data for six subsectors (airlines, gambling, hotels, leisure services, restaurants and bars, as well as travel and tourism) for the US from January 2018 to November 2021. Estimation results provide strong evidence of regime switching behavior with wide differences across subsectors during the course of the COVID-19 pandemic. A longer duration of high volatility characterizes the airline and leisure services indices. These sectors exhibit the most pronounced downturn that was not fully recovered in November 2021. In contrast, the period of high volatility in the restaurant, gaming, and hotel industries is relatively short, and stock market performance recovers almost to the general trend. Of all subsectors, restaurants and bars experience the shortest duration of high volatility, limited to the second quarter of 2020. The stock market indices for the travel and tourism industry (mainly car rentals) are also highly volatile, but this pattern was observed already before the pandemic.

Importance of land characteristics for resilience of domestic tourism demand

This study investigates empirically if land characteristics (especially forests and mountains) are of importance for the local ability to withstand the shock of the Covid-19 on domestic tourism demand during the summer of 2020. A second step of the analysis focuses on the recovery stage in the subsequent summer. Three tourism indicators are considered: arrivals, overnight stays and length of stay. Official data on land use characteristics of 2029 villages in the Federal state of Bavaria (South Germany) are employed for the analysis. Estimations using the Spatial Durbin model combined with the Heckman selection model reveal that there is a significant relationship between the proportion of forest within as well as surrounding the village and the demand for domestic tourism compared with the 2019 baseline. There is also a significant relationship with the altitude of the surrounding areas. The importance of mountains and forests is present in both the initial year of the pandemic and in the recovery year of 2021, although the magnitude is lower in the summer of 2021. Direct and spatial effects can also be found for lakes and rivers on overnight stays and length of stay.

Mitochondrial regulation of acute extrafollicular B-cell responses to COVID-19 severity.

BACKGROUND: Patients with COVID-19 display a broad spectrum of manifestations from asymptomatic to life-threatening disease with dysregulated immune responses. Mechanisms underlying the detrimental immune responses and disease severity remain elusive. METHODS: We investigated a total of 137 APs infected with SARS-CoV-2. Patients were divided into mild and severe patient groups based on their requirement of oxygen supplementation. All blood samples from APs were collected within three weeks after symptom onset. Freshly isolated PBMCs were investigated for B cell subsets, their homing potential, activation state, mitochondrial functionality and proliferative response. Plasma samples were tested for cytokine concentration, and titer of Nabs, RBD-, S1-, SSA/Ro- and dsDNA-specific IgG. RESULTS: While critically ill patients displayed predominantly extrafollicular B cell activation with elevated inflammation, mild patients counteracted the disease through the timely induction of mitochondrial dysfunction in B cells within the first week post symptom onset. Rapidly increased mitochondrial dysfunction, which was caused by infection-induced excessive intracellular calcium accumulation, suppressed excessive extrafollicular responses, leading to increased neutralizing potency index and decreased inflammatory cytokine production. Patients who received prior COVID-19 vaccines before infection displayed significantly decreased extrafollicular B cell responses and mild disease. CONCLUSION: Our results reveal an immune mechanism that controls SARS-CoV-2-induced detrimental B cell responses and COVID-19 severity, which may have implications for viral pathogenesis, therapeutic interventions and vaccine development.

Domestic tourism demand in the North and the South of Europe in the Covid-19 summer of 2020.

This study investigates empirically changes in domestic summer tourism demand following the Covid-19 pandemic in 305 regions across six European countries (Denmark, Finland, France, Italy, Spain and Sweden) based on official data. Five different groups of NUTS 3 regions are identified in accordance with a typology suggested by the OECD where density and connectivity are aspects of importance. Dynamic panel data estimations show that large metropolitan regions experience strong decreases in demand (approximately 30 per cent) both in July and August 2020. There are, however, clear differences between the Northern and Southern European countries. In the North, the remote regions encounter an increased demand that is partially offsetting losses in the large metropolitan regions. This pattern cannot be found in the South. The decline in domestic tourism flows to the major metropolitan areas is also more pronounced in the South of Europe, approximately 50 per cent per summer month compared with 20 per cent (July 2020) and stagnation (August 2020) in the North regions.

Examination of the Impact of CYP3A4/5 on Drug–Drug Interaction between Schizandrol A/Schizandrol B and Tacrolimus (FK-506): A Physiologically Based Pharmacokinetic Modeling Approach

Schizandrol A (SZA) and schizandrol B (SZB) are two active ingredients of Wuzhi capsule (WZC), a Chinese proprietary medicine commonly prescribed to alleviate tacrolimus (FK-506)-induced hepatoxicity in China. Due to their inhibitory effects on cytochrome P450 (CYP) 3A enzymes, SZA/SZB may display drug–drug interaction (DDI) with tacrolimus. To identify the extent of this DDI, the enzymes’ inhibitory profiles, including a 50% inhibitory concentration (IC50) shift, reversible inhibition (RI) and time-dependent inhibition (TDI) were examined with pooled human-liver microsomes (HLMs) and CYP3A5-genotyped HLMs. Subsequently, the acquired parameters were integrated into a physiologically based pharmacokinetic (PBPK) model to quantify the interactions between the SZA/SZB and the tacrolimus. The metabolic studies indicated that the SZB displayed both RI and TDI on CYP3A4 and CYP3A5, while the SZA only exhibited TDI on CYP3A4 to a limited extent. Moreover, our PBPK model predicted that multiple doses of SZB would increase tacrolimus exposure by 26% and 57% in CYP3A5 expressers and non-expressers, respectively. Clearly, PBPK modeling has emerged as a powerful approach to examine herb-involved DDI, and special attention should be paid to the combined use of WZC and tacrolimus in clinical practice.

Uneven domestic tourism demand in times of pandemic

This study investigates the short-run impact of the COVID-19 pandemic on the number of domestic overnight stays at the regional level in the summer season 2020. Official data for 65 regions in four countries are used for the analysis (Austria, the Czech Republic, Germany and Switzerland). Dynamic panel data models are employed to estimate a tourism demand equation (real GDP and price fluctuations) augmented by average temperatures. Estimation results reveal that domestic overnight stays evolve unevenly in the first summer after the outbreak of the COVID-19 pandemic. The short-run effects show that the number of domestic overnight stays in densely populated regions decreases by 27% in July as well as in August 2020, in comparison with the same months in previous years, ceteris paribus. To the contrary, there is a surge of 27 and 10%, respectively, for sparsely populated areas in the same months.JEL: Z3, R11 and R12.

The short version of students' perceptions of interprofessional clinical education-revised (SPICE-R3): a confirmatory factor analysis.

The Students' Perceptions of Physician-Pharmacist Interprofessional Clinical Education and its revision (SPICE, SPICE-R) were designed to understand medicine and pharmacy students' perceptions of interprofessional education and collaborative practice in managing complex health problems. The SPICE-R authors, however, suggested for additional items for subscales "roles and responsibilities for collaborative care" and "patient outcomes from collaborative practice". We added two items and introduced SPICE-R3 to differentiate it from the 10-item SPICE-R2 and to adapt the scale to a wider range of healthcare members. We administered the SPICE-R3 to healthcare students at the height of the COVID-19 outbreak in Hong Kong in February 2020. Using data from 225 students from Chinese medicine, medicine, nursing, and pharmacy, confirmatory factor analysis indicated nine items having acceptable item coefficients. Our data obtained a good fit to the three-factor, nine-item model suggesting construct validity. Results of the between-network analysis suggest that the three subscales of SPICE-R3 correlated systematically with other theoretically relevant variables in the nomological network suggesting convergent validity. The SPICE-R3 is a valid measure to examine Hong Kong healthcare students' interprofessional attitudes in online interprofessional education even during the pandemic. Implications and directions for future research are provided.

Detection of Microbial Agents in Oropharyngeal and Nasopharyngeal Samples of SARS-CoV-2 Patients.

The novel coronavirus outbreak started in December 2019 and rapidly spread around the globe, leading to a global pandemic. Here we reported the association of microbial agents identified in oropharyngeal and nasopharyngeal samples from patients with SARS-CoV-2 infection, using a Pan-microarray based technology referred to as PathoChIP. To validate the efficiency of PathoChIP, reference viral genomes obtained from BEI resource and 25 SARS-CoV-2 positive clinical samples were tested. This technology successfully detected femtogram levels of SARS-CoV-2 viral RNA, which demonstrated greater sensitivity and specificity than conventional diagnostic techniques. Simultaneously, a broad range of other microorganisms, including other viruses, bacteria, fungi and parasites can be detected in those samples. We identified 7 viral, 12 bacterial and 6 fungal agents common across all clinical samples suggesting an associated microbial signature in individuals who are infected with SARS-CoV-2. This technology is robust and has a flexible detection methodology that can be employed to detect the presence of all human respiratory pathogens in different sample preparations with precision. It will be important for differentiating the causative agents of respiratory illnesses, including SARS-CoV-2.

Nordic stock market performance of the travel and leisure industry during the first wave of Covid-19 pandemic

This article investigates the performance of the stock market and its volatility in the travel and leisure industry for three Nordic countries using daily data from June 2018 to June 2020, a period that includes the first wave of Covid-19 pandemic. The methodology is based on the Markov regime switching model that allows unobservable regime shifts in the stock return relationship between the travel and leisure industry and the overall market in the period before the outbreak of Covid-19 crisis and during the recovery period at the end of the first wave. The results provide strong evidence of regime switching behaviour in the form of idiosyncratic risk as measured by volatility. The period before Covid-19 corresponds to a low/medium idiosyncratic risk, while the period of the pandemic is characterized by a regime with high idiosyncratic risk. Overall, the timing, likelihood and duration of this crisis regime depend on the composition of the travel and leisure firms. Those with a large proportion of online gambling firms perform better, while those consisting of international transportation firms, hotels and restaurants perform negatively. This study shows that the high-frequency data and the model chosen here can provide timely information on the impact of the pandemic on various tourism and leisure businesses that could be useful for policymaking.

Worries, strategies, and confidence of older Chinese adults during the 2019 novel coronavirus outbreak.

OBJECTIVES: Since the novel coronavirus disease (COVID-19) outbreak started in late 2019, the older population has accounted for a large proportion of severe and fatal cases. This study investigated the mental state and attitudes of older Chinese adults during this epidemic. DESIGN: Cross-sectional online surveys on a convenience sample of China's general population at two different time points. Online surveys were disseminated through popular Chinese social media applications. Adults 18 or older living in China during the initial (N = 1148) and second stages (N = 470) were included in the survey. The Worries, Strategies, and Confidence Questionnaire was created to assess worries and awareness of the disease. RESULTS: Combined responses (N = 1618), 76.1% were female and about 7.0% were 60 years or above. In the first wave, older adults were found less likely to worry about being infected by COVID-19 (p < 0.05) and reported less attention paid to protective measures (p = 0.004) than young adults. However, as the disease evolved, older participants in the second wave were more worried than young adults (p = 0.027) and older adults in the first wave (p = 0.001). CONCLUSIONS: During the epidemic of COVID-19, watchfulness of the epidemic among older Chinese adults fluctuated over time. Initially, they were slow to respond proactively, but their worries gradually increased. Health care and social service professionals need to address the vulnerabilities of older adults to this public health crisis.

Beliefs towards the COVID-19 pandemic among patients with emotional disorders in China.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic has given rise to fear and panic in the public. Although hospitals in China reduced outpatient visits and restricted inpatient admission to lower the risk of transmission of COVID-19, this has significantly affected patients in need of medical attention, for example, patients with emotional disorders. AIMS: This study aimed to compare the beliefs towards COVID-19 among outpatients with emotional disorders (ie, anxiety or depression) with those of family caregivers and the general public and examine factors that shape the beliefs towards COVID-19 among outpatients with emotional disorders. METHODS: Survey data from 570 outpatients with anxiety or depression disorders, 449 family caregivers and 470 general public subjects were collected. Multiple stepwise regression analyses were used to describe participants' level of concern, prevention attitude and positive expectations towards the COVID-19 outbreak. RESULTS: About 70.9% of outpatients had to postpone their mental health treatment; 43.2% of patients admitted that their mental health was adversely affected by the COVID-19 outbreak-these patients tended to be older, male and less educated. After controlling for age and education level, outpatients with emotional disorders had significantly lower levels of concerns but more negative expectations towards COVID-19, compared with family caregivers and the public. Multivariate linear stepwise regression analysis showed that age, education and the perception of the impact of COVID-19 on one's existing mental illness were significantly associated with outpatients' beliefs about the epidemic. CONCLUSION: Outpatients with anxiety or depression disorders were relatively less focused on the COVID-19 outbreak, but the impact of the infection was found to be independently associated with their beliefs towards COVID-19. In addition, outpatients who were older and of low educational levels particularly held more negative beliefs about the epidemic, which may place them at a higher risk for poor mental health.

Antibody responses to SARS-CoV-2 in COVID-19 patients: the perspective application of serological tests in clinical practice (preprint)

Background We aim to investigate the profile of acute antibody response in COVID-19 patients, and provide proposals for the usage of antibody test in clinical practice. Methods A multi-center cross-section study (285 patients) and a single-center follow-up study (63 patients) were performed to investigate the feature of acute antibody response to SARS-CoV-2. A cohort of 52 COVID-19 suspects and 64 close contacts were enrolled to evaluate the potentiality of the antibody test. Results The positive rate for IgG reached 100% around 20 days after symptoms onset. The median day of serocon-version for both lgG and IgM was 13 days after symptoms onset. Seroconversion of IgM occurred at the same time, or earlier, or later than that of IgG. IgG levels in 100% patients (19/19) entered a platform within 6 days after seroconversion. The criteria of IgG seroconversion and [≥] 4-fold increase in the IgG titers in sequential samples together diagnosed 82.9% (34/41) of the patients. Antibody test aided to confirm 4 patients with COVID-19 from 52 suspects who failed to be confirmed by RT-PCR and 7 patients from 148 close contacts with negative RT-PCR. Conclusion IgM and IgG should be detected simultaneously at the early phase of infection. The serological diagnosis criterion of seroconversion or [≥] 4-fold increase in the IgG titer is suitable for a majority of COVID-19 patients. Serologic test is helpful for the diagnosis of SARS-CoV-2 infection in suspects and close contacts.