A randomised controlled trial to improve the resilience of oesophageal cancer survivors in rural China: A study protocol.

AIM: To design a protocol based on the experiences of long-term survivors to facilitate resilience for oesophageal cancer patients in rural China. BACKGROUND: According to the latest Global Cancer Statistics Report, 604,000 new cases of oesophageal cancer were reported, of which over 60% of the disease burden is distributed in China. The incidence of oesophageal cancer in rural China (15.95/100,000) is twice as high as those in urban areas (7.59/100,000). To be sure, resilience can help patients better adapt to post-cancer life. But universal interventions involving improving the resilience of oesophageal cancer patients have much less been explored, especially for rural patients. METHODS: The two-arm, parallel design, non-blinded, randomised controlled trial will be implemented in 86 adults diagnosed with oesophageal cancer and will be randomly assigned to the control group or the intervention group via the blocked randomisation. The intervention group will undergo an intervention with one-on-one guidance from a nurse while viewing a CD of the experiences of long-term survivors with oesophageal cancer in rural areas. Every 2 weeks, a theme session will be introduced, and the entire intervention will continue for 12 weeks. Psychosocial variables (resilience, self-efficacy, coping mode and family support) will be surveyed at baseline, post-intervention and 3 months after the intervention. The paper complies with the Standard Protocol Items: Recommendations for Intervention Trials 2013 and Consolidated Standards of Reporting Trials guidelines for study protocols adapted for designing and reporting parallel group randomised trials. CONCLUSION: The intervention programme transitions from hospitalisation to discharge, which includes one-on-one interventions by medical personnel and a portable CD describing the experiences of long-term survivors with rural oesophageal cancer. Once the intervention's effectiveness is proven, this protocol will provide psychological support for massive oesophageal cancer patients. RELEVANCE TO CLINICAL PRACTICE: The intervention programme may be used as an auxiliary therapy to promote patients' postoperative psychological rehabilitation. This programme has the advantages of being cost-effective, flexible, accessible, and convenient and can be implemented without the limitation of time, place and clinical medical staff. TRIAL REGISTRATION: The Chinese Clinical Trial Registration number is ChiCTR2100050047. Registered on 16 August 2021.

A kinetic model considering the decline of antibody level and simulation about vaccination effect of COVID-19.

We build a model that consider the falling antibody levels and vaccination to assess the impact of falling antibody levels and vaccination on the spread of the COVID-19 outbreak, and simulate the influence of vaccination rates and failure rates on the number of daily new cases in England. We get that the lower the vaccine failure rate, the fewer new cases. Over time, vaccines with low failure rates are more effective in reducing the number of cases than vaccines with high failure rates and the higher the vaccine efficiency and vaccination rate, the lower the epidemic peak. The peak arrival time is related to a boundary value. When the failure rate is less than this boundary value, the peak time will advance with the decrease of failure rate; when the failure rate is greater than this boundary value, the peak time is delayed with the decrease of failure rate. On the basis of improving the effectiveness of vaccines, increasing the vaccination rate has practical significance for controlling the spread of the epidemic.

Estimating New Cases Among Athletes During the Winter Olympics Based on a Dynamic Model - Beijing, China, February 2022.

Introduction: Since first appearing in late 2021, the Omicron variant has spread rapidly around the world. Nevertheless, the XXIV Winter Olympic Games (WOG) were held in Beijing in February 2022, which undoubtedly posed a huge challenge to domestic epidemic prevention and control. Methods: To analyze and evaluate the spread of the epidemic within the closed-loop management of the Beijing 2022 WOG, an improved dynamics model was established. Using the known dynamics parameters, the new daily cases and final members of quarantined people were predicted, and the influence of different factors on the change of the number of quarantined people was analyzed. Results: When the proportion of exposed persons being detected and the degree of admixture between the two populations varied between 0.5 and 0.9, there was little change in the daily predicted number of new cases and the final number of quarantined patients. As the initial value of the exposed among inbound personnel increased, the final size of quarantined patients increased proportionally. Discussion: From the analysis results, detecting potential virus carriers at the entry stage is the most effective way to control the spread of the epidemic within the closed-loop management of the Beijing 2022 WOG.

Autocrine vitamin D signaling switches off pro-inflammatory programs of TH1 cells.

The molecular mechanisms governing orderly shutdown and retraction of CD4+ type 1 helper T (TH1) cell responses remain poorly understood. Here we show that complement triggers contraction of TH1 responses by inducing intrinsic expression of the vitamin D (VitD) receptor and the VitD-activating enzyme CYP27B1, permitting T cells to both activate and respond to VitD. VitD then initiated the transition from pro-inflammatory interferon-γ+ TH1 cells to suppressive interleukin-10+ cells. This process was primed by dynamic changes in the epigenetic landscape of CD4+ T cells, generating super-enhancers and recruiting several transcription factors, notably c-JUN, STAT3 and BACH2, which together with VitD receptor shaped the transcriptional response to VitD. Accordingly, VitD did not induce interleukin-10 expression in cells with dysfunctional BACH2 or STAT3. Bronchoalveolar lavage fluid CD4+ T cells of patients with COVID-19 were TH1-skewed and showed de-repression of genes downregulated by VitD, from either lack of substrate (VitD deficiency) and/or abnormal regulation of this system.