Prevalence and factors influencing long COVID among primary healthcare workers after epidemic control policy adjustment in Jiangsu, China (preprint)

Objective: This study aims to evaluate the prevalence of long COVID infections and their influencing factors among primary HCWs after epidemic control policy adjustment in Jiangsu. Methods: : A self-designed questionnaire was administered through on-site surveys among primary HCWs in five counties and districts within Jiangsu Province from July 4 to July 20, 2023. Results: : The prevalence of long COVID among primary HCWs stood at 12.61% (95% confidence interval (CI) of 11.67%-13.55%). The most common long COVID symptoms were hypomnesia (4.90%), sleep difficulties (2.73%), fatigue (2.35%), disturbances in the reproductive system (1.93%), hair loss (1.85%), and myalgia/arthralgia (1.51%). Multivariate logistic regression revealed that older age groups (30-45 years (adjusted odds ratios (aOR) =1.93, 95%CI: 1.44-2.58), 45-60 years (aOR=2.82, 95%CI: 2.07-3.84)), females (aOR=1.26, 95%CI: 1.03-1.55), and higher work stress (high stress (aOR=1.52, 95%CI: 1.24-1.86), extremely high stress (aOR=1.37, 95%CI: 1.03-1.82)) were more prone to long COVID. Conversely, individuals with educational attainment below the bachelor’s degree (aOR=0.67, 95%CI: 0.55-0.82) and those who received four or more doses of the COVID-19 vaccine (aOR=0.55, 95%CI: 0.33-0.92) were at a reduced risk. Conclusion: To mitigate the incidence of long COVID, healthcare providers and authorities should implement effective measures, including optimizing work-rest schedules and actively advocating for vaccination.

Analysis of the Integrated Role of the Yangtze River Delta based on the Industrial Resilience of Cities during COVID-19 (preprint)

The enhancement of regional comprehensive development ability is significantly impacted by the study on the implementation effect of regional integration strategies. The integration strategy's impact on urban development during COVID-19 in the Yangtze River Delta(YRD) is unclear. According to prior industrial transfer theory, Hefei, Anhui's capital, is difficult to transfer industries, and other YRD cities push industry integration in Anhui. This study employs the theory of economic and land resource use to examine the resilience of the industrial economy during an epidemic by using industrial land as a representation of industrial economic development. The three cities in Anhui—Wuhu, Maanshan, and Chuzhou (Wu-ma-Chu) were selected as the research area. The study employed the UNet deep learning method to detect the land use types in Wu-ma-Chu. The land transfer matrix and the standard deviation ellipse were utilised to research the alterations in industrial land use and the spatial distribution of industrial output value, respectively. The results showed that the industrial land in Machu continued to grow during the outbreak, highlighting the resilience of the region's industrial economy. During 2019–2022, the elliptical ring of industrial output value is distributed in Nanjing, revealing the radiating role of Nanjing in integrating into the integration of the YRD. This confirms China's YRD integration strategy, strengthens regional economic resilience, and encourages coordinated regional economic development.

Dynamics of SARS-CoV-2 Seroprevalence in a Large US population Over a Period of 12 Months (preprint)

Due to a combination of asymptomatic or undiagnosed infections, the proportion of the United States population infected with SARS-CoV-2 was unclear from the beginning of the pandemic. We previously established a platform to screen for SARS-CoV-2 positivity across a representative proportion of the US population, from which we reported that almost 17 million Americans were estimated to have had undocumented infections in the Spring of 2020. Since then, vaccine rollout and prevalence of different SARS-CoV-2 variants have further altered seropositivity trends within the United States population. To explore the longitudinal impacts of the pandemic and vaccine responses on seropositivity, we re-enrolled participants from our baseline study in a 6- and 12- month follow-up study to develop a longitudinal antibody profile capable of representing seropositivity within the United States during a critical period just prior to and during the initiation of vaccine rollout. Initial measurements showed that, since July 2020, seropositivity elevated within this population from 4.8% at baseline to 36.2% and 89.3% at 6 and 12 months, respectively. We also evaluated nucleocapsid seropositivity and compared to spike seropositivity to identify trends in infection versus vaccination relative to baseline. These data serve as a window into a critical timeframe within the COVID-19 pandemic response and serve as a resource that could be used in subsequent respiratory illness outbreaks.

COVID-19 Distress, Parenting Stress, Maladaptive Parenting and Children’s Problematic Media Use in China: Evidence from 2022 Spring in Shanghai (preprint)

The COVID-19 lockdowns have forced young children to spend more time in front of the media and significantly impacted their mothers' mental health. This study explored how mothers' individual distress influences children's problematic media use during the Shanghai citywide lockdown caused by COVID-19. Data were collected from 1889 Chinese mothers (Mage = 34.69 years, SD = 3.94 years) with preschoolers aged 3–6 years (Mage = 4.38 years, SD = 1.06 years; 49.0% boys) via an online survey. The statistical analyses relied on SPSS Statistics version 26.0 and macro-program PROCESS 3.3. to investigate the associations and mediation analysis among all the study variables. The results indicated that: (1) significant associations between individual maternal distress with children's problematic media use; (2) maternal parenting stress and maladaptive parenting serial mediated the relationship between mothers' individual distress and children's problematic media use. The findings imply that parents need to enhance their ability to manage risk and promote mental health during periods of significant stress and routine disruption to reduce children's problematic media use.

Safety and Efficacy of Combination SARS-CoV-2 Neutralizing Monoclonal Antibodies Amubarvimab Plus Romlusevimab in Nonhospitalized Patients With COVID-19.

BACKGROUND: Development of safe and effective SARS-CoV-2 therapeutics is a high priority. Amubarvimab and romlusevimab are noncompeting anti-SARS-CoV-2 monoclonal antibodies with an extended half-life. OBJECTIVE: To assess the safety and efficacy of amubarvimab plus romlusevimab. DESIGN: Randomized, placebo-controlled, phase 2 and 3 platform trial. (ClinicalTrials.gov: NCT04518410). SETTING: Nonhospitalized patients with COVID-19 in the United States, Brazil, South Africa, Mexico, Argentina, and the Philippines. PATIENTS: Adults within 10 days onset of symptomatic SARS-CoV-2 infection who are at high risk for clinical progression. INTERVENTION: Combination of monoclonal antibodies amubarvimab plus romlusevimab or placebo. MEASUREMENTS: Nasopharyngeal and anterior nasal swabs for SARS-CoV-2, COVID-19 symptoms, safety, and progression to hospitalization or death. RESULTS: Eight-hundred and seven participants who initiated the study intervention were included in the phase 3 analysis. Median age was 49 years (quartiles, 39 to 58); 51% were female, 18% were Black, and 50% were Hispanic or Latino. Median time from symptom onset at study entry was 6 days (quartiles, 4 to 7). Hospitalizations and/or death occurred in 9 (2.3%) participants in the amubarvimab plus romlusevimab group compared with 44 (10.7%) in the placebo group, with an estimated 79% reduction in events (P < 0.001). This reduction was similar between participants with 5 or less and more than 5 days of symptoms at study entry. Grade 3 or higher treatment-emergent adverse events through day 28 were seen less frequently among participants randomly assigned to amubarvimab plus romlusevimab (7.3%) than placebo (16.1%) (P < 0.001), with no severe infusion reactions or drug-related serious adverse events. LIMITATION: The study population was mostly unvaccinated against COVID-19 and enrolled before the spread of Omicron variants and subvariants. CONCLUSION: Amubarvimab plus romlusevimab was safe and significantly reduced the risk for hospitalization and/or death among nonhospitalized adults with mild to moderate SARS-CoV-2 infection at high risk for progression to severe disease. PRIMARY FUNDING SOURCE: National Institute of Allergy and Infectious Diseases of the National Institutes of Health.

East Asian Population.

This article explores the ways East Asian American (EAA) children and adolescents have experienced disparities in the United States throughout the COVID-19 pandemic. The history of racism toward Asian American and Pacific Islanders (AAPI) and the complexities of acculturation are reflected through this contemporary lens. Traditional East Asian (EA) values were disrupted during this period. Implications for children and families are discussed. Persistent underlying xenophobia and racism, such as the model minority myth or perpetual foreigner stereotype, rose to new prominence, furthering emotional distress in EA and EAA youths beyond those already experienced universally by AAPI families during the pandemic.

Neutralizing antibodies and T-cell responses to inactivated SARS-CoV-2 vaccine in COVID-19 convalescents one and a half years after infection.

Vaccines have been considered the most promising solution for ending the coronavirus disease 2019 (COVID-19) pandemic. Information regarding neutralizing antibodies (NAbs) and T-cell immune response in inactivated SARS-CoV-2 vaccine-immunized COVID-19 convalescent patients were either only available for a short time after illness recovered or not available at all (T-cell immunity). We evaluated SARS-CoV-2 NAbs and cellular immune responses to the SARS-CoV-2 inactivated vaccine in convalescent patients who recovered from infection for about one and a half years. We found that compared to before vaccination, SARS-CoV-2 NAbs and specific T-cell responses were significantly boosted by the inactivated vaccine in convalescent patients, which confirmed the pre-existing adaptive immunity in SARS-CoV-2 infected people. We observed that NAbs and IFN-γ-secreting T-cell response elicited by a single vaccine dose in subjects with prior COVID-19 infection were higher than after two doses of vaccine in SARS-CoV-2 naïve subjects. Both humoral and cellular immune responses elicited by one and two doses of inactivated vaccine were comparable in COVID-19-recovered persons. In conclusion, inactivated COVID-19 vaccine induced robust NAbs and T-cell responses to SARS-CoV-2 in COVID-19 convalescent patients and immune responses after one dose were equal to that after receiving two doses, which highlighted that robust humoral and cellular immune response can be reactivated by the inactivated vaccine in SARS-CoV-2 convalescent patients.

Long-Term Follow-Up Study of COVID-19: Evaluation on Thin-Slice CT.

Purpose: To retrospectively analyse the CT imaging during the long-term follow-up of COVID-19 patients after discharge. Patients and Methods: A total of 122 patients entered the study group. All patients underwent CT examinations. The CT images, which included distribution and imaging signs, were evaluated by two chest radiologists. Laboratory examinations included routine blood work, biochemical testing, and SARS-CoV-2 antibody screening. Statistical methods include chi-square, Fisher's exact test, one-way analysis of variance, rank sum test and logistic regression by SPSS 17.0. Results: There were 22 (18.0%) patients in the mild group, 74 (60.7%) patients in the moderate group, and 26 (21.3%) patients in the severe-critical group. The median follow-up interval was 405 days (378.0 days, 462.8 days). Only monocytes, prothrombin activity, and γ-glutamyltransferase showed significant differences among the three groups. We found that the more severe the patient's condition, the more SARS-CoV-2 IgG antibodies existed. Only 11 patients (11.0%) showed residual lesions on CT. The CT manifestations included irregular linear opacities in nine cases (9.0%), reticular patterns in six cases (6.0%), and GGOs in five cases (5.0%). Conclusion: The proportion of residual lesions on CT in COVID-19 patients was significantly reduced after long-term follow-up. The patients' age and disease conditions were positively correlated with residual lesions.

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 bibliometric analysis of telerehabilitation services for patients with stroke

Background Routine rehabilitation services were disrupted by the COVID-19 pandemic outbreak. Telehealth was identified as an alternative means to provide access to these services. This bibliometric study aimed to analyze the scientific literature to discover trends and topics in the potential applications of telerehabilitation for patients with stroke. Methods The Web of Science electronic database was searched to retrieve relevant publications on telerehabilitation. Bibliometric data, including visual knowledge maps of authors, countries, institutions, and references, were analyzed in CiteSpace. Visualization maps were generated in VOSviewer to illustrate recurrent keywords and countries actively involved in this research area. Results The analysis was performed based on 6,787 publications. The number of publications peaked between 2019 and 2021, coinciding with the years of the COVID-19 outbreak. A total of 113 countries in Europe, North America, Asia, and Oceania had at least one publication in this research field, implying global attention in this research area. Nine of the top 10 most productive countries are developed countries, indicating a potentially higher capability to implement a telerehabilitation program. Conclusion The potential benefits and diversity of telerehabilitation are already highly visible from clinical studies, and further improvements in these technologies are expected to enhance functionality and accessibility for patients. More relevant research is encouraged to understand the barriers to increased adaptation of telerehabilitation services, which will finally translate into a significant therapeutic or preventive impact.

Consumer perception of clean food labels

Purpose>This study puts forth a consumer-oriented concept of clean labels and attempts to empirically investigate consumer perceptions of these labels.Design/methodology/approach>A self-administered survey (n = 346) was used as the research instrument for data collection in the current study.Findings>Results from an online survey indicate that consumers perceived less processed, elimination of undesired ingredients and ethical concerns as salient attributes associated with clean labels. Consumer-perceived benefits of these attributes include healthiness, social responsibility, sensory appeal, reliable product and low calorie. Additionally, canonical correlation analysis yields two significant associations between clean label attributes and the corresponding benefits. Attributes of elimination of undesired ingredients and utilization of familiar elements drive the benefits of healthiness, low calorie and social responsibility. Attributes of being less processed and with simple ingredients are associated with the benefit of sensory appeal.Originality/value>This study systematically investigates the discrete clean halo effect by empirically examining the associations between the clean label attributes and the dimensionalities of benefits as perceived by consumers.

Rapid development and mass production of SARS-CoV-2 neutralizing Chicken egg yolk antibodies with protective efficacy in hamsters (preprint)

Despite the record speed of developing vaccines and therapeutics against the SARS-CoV-2 virus, it is not a given that such success can be secured in future pandemics. In addition, COVID-19 vaccination and application of therapeutics remain low in developing countries. Rapid and low cost mass production of antiviral IgY antibodies could be an attractive alternative or complementary option for vaccine and therapeutic development. In this article, we rapidly produced SARS-CoV-2 antigens, immunized hens and purified IgY antibodies in 2 months after the SARS-CoV-2 gene sequence became public. We further demonstrated that the IgY antibodies competitively block RBD binding to ACE2, neutralize authentic SARS-CoV-2 virus and effectively protect hamsters from SARS-CoV-2 challenge by preventing weight loss and lung pathology, representing the first comprehensive study with IgY antibodies. The process of mass production can be easily implemented in most developing countries and hence could become a new vital option in our toolbox for combating viral pandemics. This study could stimulate further studies, optimization and potential applications of IgY antibodies as therapeutics and prophylactics for human and animals.

Cost-effectiveness of the second COVID-19 booster vaccination in the United States (preprint)

ABSTRACT Background: On March 29, 2022, the United States (US) authorized the second booster dose of COVID-19 vaccine for individuals aged 50 years and older. To date, the cost-effectiveness of the second booster strategy remains unassessed. Methods: We developed a decision-analytic SEIR-Markov model by five age groups (0-4yrs with 18,827,338 individuals, 5-11yrs with 28,584,443 individuals, 12-17yrs with 26,154,652 individuals, 18-49yrs with 138,769,369 individuals, and 50+yrs with 119,557,943 individuals) to evaluate the cost-effectiveness of the second COVID-19 booster vaccination (administered 4 months after the first booster dose) over an evaluation period of 180 days in the US, from a healthcare system perspective. Results: Implementing the second booster strategy among individuals aged 50+ years would cost US$807 million but reduce direct medical care costs by $1,128 million, corresponding to a benefit-cost ratio of 1.40. This strategy would also result in a gain of 1,048 QALYs during the 180 days, indicating it was cost-saving. Probabilistic sensitivity analysis demonstrated that the probability of being cost-effective with the strategy was 68%. Further, vaccinating individuals aged 18-49 years with the second booster would result in an additional gain of $1,566 million and 2,276 QALYs. Expanding vaccination to individuals aged 12-17 years would result in an additional gain of $15 million and 89 QALYs. Coverage of the first booster vaccination in age groups under 12 was too low to consider the administration of the second booster. If the social interaction between all age groups was severed, vaccination expansion to 18-49yrs and 12-17yrs would no longer be cost-effective. Conclusion: The second booster strategy was likely to be effective and cost-effective in reducing the disease burden of the COVID-19 pandemic. Expanding the second booster strategy to 18-49yrs and 12-17yrs remains cost-effective due to their social contacts with the older age group. Keywords: COVID-19; Second booster; Cost-effective analysis; SEIR-Markov model; Age groups

Comparative analysis of epidemic characteristics and prevention and control measures of corona virus disease 2019 in Russian Federation

Objective: This article analyzes the epidemic situation and characteristics of Corona virus disease 2019 (COVID-19) in Russian Federation (referred to as Russia). summarizes the effective measures and problems exposed by Russia to deal with COVID-19, so as to provide reference for our country's epidemic prevention and control, and seek the direction of cooperation under the background of Sino Russia scientific and technological innovation in view of public health emergency.

Semiparametric estimation of expected shortfall and its application in finance

Measuring risk effectively is crucial for managing risk in financial markets. The expected shortfall has become an increasingly popular metric for risk in recent years. How to estimate it is important in statistics and financial econometrics. Based on the single index quantile regression, we introduce a new semiparametric approach, namely, weighted single index quantile regression. We assess the performance of the proposed expected shortfall estimator with backtesting. Our simulation results indicate that the estimator has a good finite sample performance and often outperforms existing methods. By applying the new method to both a market index and individual stocks, we show that it not only exhibits the best performance but also reveals an insight about the effect of the COVID pandemic, that is, the pandemic increases the market risk.