An effectiveness study of vaccination and quarantine combination strategies for containing mpox transmission on simulated college campuses.

The ongoing transmission of mpox in specific countries and regions necessitates urgent action. It is essential to implement targeted containment strategies that concentrate on high-risk populations and critical locations, such as college campuses, to effectively curb the spread of mpox. This study is dedicated to evaluating the performance of various vaccination and quarantine strategies in curbing the spread of mpox and estimating the outbreak risk. To accomplish this, we constructed a stochastic, agent-based, discrete-time susceptible-latent-infectious-recovered (SLIR) model, to examine mpox transmission on a simulated college campus. Our findings reveal that relying solely on PEP is insufficient in containing mpox effectively. To bolster the population immunity and protect the vulnerable, pre-exposure vaccination among high-risk populations prior to an outbreak is imperative. Our study demonstrates that a pre-exposure vaccination rate of 50% in high-risk populations can led to a remarkable 74.2% reduction of infections. This translated to a mere 1.0% cumulative infection incidence in the overall population. In cases where the desired vaccination coverage is not attainable, enhancing case detection and isolation measures can serve as an effective emergency response to contain mpox outbreaks. For pre-exposure vaccination coverage of 20% or lower, a 40% isolation ratio is necessary to keep the cumulative number of infections in check. However, when the coverage exceeds 30%, a reduced isolation ratio of 20% becomes sufficient to manage the outbreak effectively. These insights underscore the importance of strategic pre-exposure vaccination in conjunction with robust surveillance and isolation protocols to safeguard public health and prevent the escalation of mpox outbreaks.

Increased population susceptibility to seasonal influenza during the COVID-19 pandemic in China and the United States.

To the best of our knowledge, no previous study has quantitatively estimated the dynamics and cumulative susceptibility to influenza infections after the widespread lifting of COVID-19 public health measures. We constructed an imitated stochastic susceptible-infected-removed model using particle-filtered Markov Chain Monte Carlo sampling to estimate the time-dependent reproduction number of influenza based on influenza surveillance data in southern China, northern China, and the United States during the 2022-2023 season. We compared these estimates to those from 2011 to 2019 seasons without strong social distancing interventions to determine cumulative susceptibility during COVID-19 restrictions. Compared to the 2011-2019 seasons without a strong intervention with social measures, the 2022-2023 influenza season length was 45.0%, 47.1%, and 57.1% shorter in southern China, northern China, and the United States, respectively, corresponding to an 140.1%, 74.8%, and 50.9% increase in scale of influenza infections, and a 60.3%, 72.9%, and 45.1% increase in population susceptibility to influenza. Large and high-intensity influenza epidemics occurred in China and the United States in 2022-2023. Population susceptibility increased in 2019-2022, especially in China. We recommend promoting influenza vaccination, taking personal prevention actions on at-risk populations, and monitoring changes in the dynamic levels of influenza and other respiratory infections to prevent potential outbreaks in the coming influenza season.

The association between ambient pollutants and influenza transmissibility: A nationwide study involving 30 provinces in China.

Background: The impact of exposure to ambient pollutants on influenza transmissibility is poorly understood. We aim to examine the associations of six ambient pollutants with influenza transmissibility in China and assess the effect of the depletion of susceptibles. Methods: Provincial-level surveillance data on weekly influenza-like illness (ILI) incidence and viral activity were utilized to estimate the instantaneous reproduction number (Rt) using spline functions. Log-linear regression and the distributed lag non-linear model (DLNM) were employed to investigate the effects of ambient pollutants-ozone (O3), particulate matter ≤2.5 µm (PM2.5), particulate matter ≤10 µm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO)-on influenza transmissibility across 30 Chinese provinces from 2014 to 2019. Additionally, the potential effects of the depletion of susceptibles and regional characteristics were explored. Results: There is a significantly positive correlation between influenza transmissibility and five distinct ambient pollutants: PM2.5, PM10, SO2, CO, and NO2. On average, these ambient pollutants explained percentages of the variance in Rt: 0.8%, 0.8%, 1.9%, 1.3%, and 1.4%, respectively. Conversely, O3 was found to be negatively associated with Rt, explaining 1.5% of the variance in Rt. When controlling for the effect of susceptibles depletion, the effects of all pollutants were more pronounced. The effects of PM2.5, PM10, CO, and SO2 were higher in the eastern and southern regions. Conclusions: Most ambient pollutants may potentially contribute to the facilitation of human-to-human influenza virus transmission in China. This observed association was maintained even after adjusting for variation in the susceptible population.

High activity levels of avian influenza upwards 2018-2022: A global epidemiological overview of fowl and human infections.

Due to growing activities of avian influenza, more attention should be paid to avian influenza virus infections. Global summaries or national reports lack data on epidemiological patterns of avian influenza. A descriptive epidemiological analysis of avian influenza outbreaks from 2018 to 2022 was conducted, particularly fowl infections, human infections, and sequence alterations. The number of fowl infection outbreaks in the first half of 2022 was the highest level in the five-year period. Countries or regions could reliably be classified into three clusters according to fowl infection activity scores, with 60.0% of countries or regions in C1 in Europe. Additionally, two host infection patterns of countries were noted, led by the Taiwan (China) region and Germany. Human infections also increased, with 88.1% of cases being in China with an increasing risk of cases in northern China. Sequences that were furin cleavage motif present spread from Asia to Europe and North America over the five-year period. Continuous changes in the global activities of avian influenza highlight the need for sustained global surveillance, including strengthening monitoring capacity for vulnerable population and dynamically detecting new cases or genetic variations of the avian influenza virus under the One Health framework.

Risk assessment for cross-border transmission of multi-country Mpox outbreaks in 2022.

OBJECTIVES: Global trade and travel have facilitated infectious disease transmission. In 2022, over a short time, cross-border Mpox (monkeypox) outbreaks were reported. Since, most countries are at risk of cross-border Mpox transmissions, in this study, we developed a real-time risk assessment model for the cross-border transmission of Mpox. METHODS: This model includes priori indicators related to the source area before the Mpox outbreak and posterior indicators derived from the quantitative data evaluation afterward. Based on transportation, this model can also be used to assess the global import risk of Mpox for specific countries and cities. RESULTS: European risk values displayed high levels between May and July 2022 and gradually decreased after July. After September 2022, risk values elevated in most countries and regions in the Americas. As for China, high importation risk cities were highly exposed to the United States and moderately exposed to Australia and Germany. Some cities were exposed to the potential risks from only one source country. CONCLUSIONS: Dynamic surveillance of the cross-border spread of infectious diseases is essential. Importation risks vary widely across cities and regions, and developing risk prevention and control strategies specific to the traffic flow, medical care capabilities, and risk levels in the main source countries are essential.

Self-reported vaccination-related behavior patterns among healthcare workers and the association with self-directed learning frequency: A nationwide cross-sectional survey.

Background: Healthcare workers play an essential role in improving the public's vaccination uptake, but the full picture of such workers' engagement in vaccination-related behaviors has not been appropriately identified. According to the Integrated Theory of Health Behavior Change, self-directed learning may be a promising intervention for fostering engagement in vaccination-related behaviors, but the association between self-directed learning and such behaviors remains unclear. This study aimed to determine Chinese healthcare workers' level of engagement in behaviors for combatting vaccine-preventable diseases and assess the association between frequency of performing vaccine-focused SDL and engagement in vaccination-related behaviors. Materials and methods: An online cross-sectional survey was conducted from January 27 to February 21, 2022, using the survey platform "wjx." Respondents were restricted to healthcare workers aged 18-65 years. A Sankey diagram and bar plots were constructed to determine patterns of engagement in a vaccination-related-behavior chain. Unconditional binary logistic regression models were fitted to determine the association between frequency of performing vaccine-focused self-directed learning and engagement in vaccination-related behaviors. Results: Of the 2,248 survey respondents, data for 2,065 were analyzed. Participants who had received influenza or pneumococcal vaccination, routinely recommended vaccination to patients, tracked patients' vaccination status, and recommended efficiently accounted for 43.2%, 50.8%, 40.3%, and 36.4% of the total participants, respectively. When only considering those who routinely made such recommendations, the proportion of those who performed tracking and efficient recommendation was 28.8% and 26.2%, respectively. When compared to performing self-directed learning "never to less than once/six months," performing self-directed learning "more than once/week" was positively associated with being vaccinated (OR, 95% CI: 2.30, 1.74-3.03), routinely recommending vaccination (OR, 95% CI: 4.46, 3.30-6.04), and tracking the status of patients so recommended (OR, 95% CI: 6.18, 4.35-8.76). Conclusions: Chinese healthcare workers' pattern of engagement in vaccination-related behaviors must be improved. Higher frequencies of engagement in self-directed learning are associated with more active engagement in vaccination-related behaviors, meaning raising such frequencies could be a promising intervention for fostering behavior changes in this regard and ultimately increasing vaccination coverage.

Willingness to accept herpes zoster vaccines and the influencing factors in China.

BACKGROUND: Herpes zoster increases the burden on the elderly in an aging society. Although an effective vaccine licensed by China Food and Drug Administration in 2019 was introduced into the market in June 2020, the willingness and influencing factors of herpes zoster vaccines in Chinese adults ≥ 50-years-old during coronavirus disease-2019 pandemic are yet to be elucidated. METHODS: An online questionnaire survey was conducted using a simple random sampling method in October 2021 for viewers of the broadcast program. A binary logistic regression and multiple response analysis were conducted for herpes zoster vaccine and vaccination willingness. Pareto's graphs were plotted to present the multiple-choice questions of influencing factors. RESULTS: A total of 3838 eligible participants were included in this study. Among them, 43.02% intended to be vaccinated, including 10.34% self-reported about receiving at least one shot of shingles vaccine, 30.22% declined, and 26.76% were hesitant. This population comprised a large proportion of middle-aged and older people (≥ 50-years-old) who have not experienced an episode of herpes zoster (54.98%) or are unaware of the virus (33.22%). The strongest determinants of vaccine hesitancy among older people were education background of Master's degree or above compared to senior high or equivalent and below, personal monthly income < 3000 RMB compared to 3000-5999 RMB, and living in a rural area. CONCLUSIONS: The willingness to get shingles vaccines can be improved further. Professional education and credible recommendation might prompt the elderly to improve their willingness and reassure them of the safety and efficacy of the vaccine. Also, accessibility and affordability should also be improved in the future.

Decreased influenza vaccination coverage among Chinese healthcare workers during the COVID-19 pandemic.

BACKGROUND: Healthcare workers (HCWs) were the priority group for influenza vaccination, in China during the 2020/2021 and 2021/2022 influenza seasons. However, vaccination rates in HCWs have always been low. This study investigated influenza vaccination status among Chinese HCWs and analyzed the factors driving vaccination. METHODS: We provided electronic questionnaires to HCWs from January 27, 2022 to February 21, 2022, using the WeChat platform "Breath Circles". HCWs who received the link could also forward it to their colleagues. Binary logistic regression models were used to analyze vaccination-associated factors among HCWs. RESULTS: Among the 1697 HCWs surveyed, vaccination coverage was 43.7% (741/1697) during the 2020/2021 influenza season, and 35.4% (600/1697) during the 2021/2022 influenza season, as of February 21, 2022. Additionally, 22.7% (385/1697) and 22.1% (358/1697) of HCWs reported that their workplaces implemented a free vaccination policy for all employees during the 2020/2021 and 2021/2022 influenza seasons. HCWs who were required to be vaccinated according to hospital regulations, and whose hospitals implemented the free influenza vaccine policy were more likely to be vaccinated (2020/2021 and 2021/2022; P < 0.05). In addition, the economic level of the HCWs' province (2021/2022, P < 0.05) and the HCWs' knowledge about vaccination and willingness to get vaccinated, such as active learning about vaccines (2020/2021, P < 0.05), supportive attitude toward vaccination for all HCWs (2020/2021 and 2021/2022; P < 0.05), also had an impact on vaccine coverage. CONCLUSIONS: A free influenza vaccination policy and workplace required vaccination are effective in improving influenza vaccination coverage among HCWs. Influenza vaccination coverage of Chinese HCWs remained low and showed a downward trend after the COVID-19 outbreak. Further effective measures, such as advocacy campaigns, free vaccine policies, and on-site vaccination could be implemented to improve influenza vaccination coverage.

Canthin-6-one (CO) from Picrasma quassioides (D.Don) Benn. ameliorates lipopolysaccharide (LPS)-induced astrocyte activation and associated brain endothelial disruption.

BACKGROUND: Canthin-6-one (CO) is an active ingredient found in Picrasma quassioides (D.Don) Benn. (PQ) that displays various biological activities including anti-inflammatory properties. Several studies reported PQ displayed neuroprotective activities, but its effects on astrocytes have not yet been investigated. Astrocytes are crucial regulators of neuroinflammatory responses under pathological conditions in the central nervous system (CNS). Proinflammatory astrocytes can induce the blood-brain barrier (BBB) breakdown, which plays a key role in the progression of neurodegenerative disorder (ND). PURPOSE: This study aims to investigate the anti-neuroinflammatory effects of CO in LPS-induced astrocyte activation and its underlying mechanisms in protecting the blood-brain barrier (BBB) in vitro. METHODS: Mouse astrocytes (C8-D1A) were activated with lipopolysaccharide (LPS) with or without CO pretreatment. Effects of CO on astrocyte cell viability, secretions of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1ß (IL-1ß) and nitric oxide (NO) were determined. Intracellular transcriptions and translations of proinflammatory mediators, molecular signaling, [Ca2+] and the levels of reactive oxygen species (ROS) were evaluated by RT-PCR, western blotting, and flow cytometry, respectively. Astrocyte-conditioned medium (ACM) was further prepared for incubating endothelial monolayer (bEnd.3) grown on transwell. Endothelial disruptions were evaluated by transendothelial electrical resistance (TEER), FITC-dextran permeability and monocyte adhesion assays. Endothelial tight junctions (TJs) and molecular signaling pathways were evaluated by immunofluorescence staining and western blotting. RESULTS: CO attenuated LPS-induced expression of astrocytic proinflammatory mediators (TNF-α, IL-1ß, IL-6, NO) and inhibited deleterious molecular activities including inducible nitric oxide synthase (iNOS), p-NFκB and p-STAT3 in astrocytes. Incubation of ACM collected from CO-treated astrocytes significantly ameliorated endothelial disruptions, reduced expressions of endothelial cytokine receptors (IL-6R, gp130 (IL-6RB), TNFR and IL-1R), suppressed proinflammatory pathways, MAPKs (p-AKT, p-MEK, p-ERK, p-p38, p-JNK) and p-STAT3, restored endothelial stabilizing pathways (p-Rac 1) and upregulated beneficial endothelial nitric oxide synthase (eNOS). CONCLUSION: Our study demonstrates for the first time CO exhibited potent protective effects against astrocyte-mediated proinflammatory responses and associated endothelial barrier disruptions.

Anti-proliferative cassane-type diterpenoids from the seeds of Caesalpinia minax.

The seeds of Caesalpinia minax Hance have shown anti-tumor potential, while the chemical principle is still unknown. In a search for anti-tumor compounds, six new cassane-type diterpenoids, 12-demethylcaesalpin G (1), caesalpinolide H (2), 12-demethylcaesalpin H (3), caesalpinolide J (4), 12-O-ethyl neocaesalpin B (5), and 3-deacetyldecapetpene B (6), were isolated from the seeds of C. minax Hance, along with fifteen known analogues. The structures of the new compounds were established by means of spectroscopic techniques (NMR, HRESIMS and IR). The absolute configurations of the new compounds were determined by their ECD spectra. All of the new compounds were tested for their anti-proliferative activity against human lung cancer A549 cells, breast cancer MCF-7 cells, and ovarian cancer HEY cells. The results indicated that only compound 6 displayed moderate cytotoxicity against three cancer cell lines. Thus, the opening of furan ring in cassane-type diterpenoids might enhance the cytotoxic activity.

Caesalpinaxin, a cassane-type diterpenoid with a 21-carbon core skeleton from the seeds of Caesalpinia minax possessing pro-angiogenetic property.

A novel cassane-type diterpenoid, caesalpinaxin (1), was isolated from the seeds of Caesalpinia minax Hance. The structure of caesalpinaxin was established by means of spectroscopic techniques (NMR, HR-ESIMS, UV and IR). The absolute configuration of caesalpinaxin was determined by quantum chemical calculations of its theoretical electronic circular dichroism (ECD) spectrum. Caesalpinaxin is the first cassane-type diterpenoid with 21 carbons core skeleton, containing an unusual δ-lactone ring. A plausible biosynthetic pathway was proposed for compound 1. Furthermore, caesalpinaxin was tested for the pro-angiogenetic activity on human umbilical vein endothelial cells(HUVECs). The results indicated that this compound significantly stimulated migration and tuber formation through enhancing the level of vascular endothelial growth factor (VEGF). Thus, caesalpinaxin might be applied in accelerating wound healing.

Cassane-Type Diterpenoids from the Seeds of Caesalpinia bonduc†(L.) Roxb.

Ten new cassane-type diterpenoids were isolated from the seeds of Caesalpinia bonduc (L.) Roxb., including 6α-hydroxycaesalpinin P (1), 14-epi-caesalpinin E1 (2), 6-deacetylcaesalmin Z (3), 14-epi-caesalmin Z (4), caesalpinolides I (5), K (6), L (7), M (9) and N (10), and 14-epi-neocaesalpin L (8). Their planar structures and absolute configurations were fully determined by comprehensive spectroscopic methods, including 2D NMR and electronic circular dichroism spectra. Compounds 1-4 are tetracyclic cassane diterpenoids possessing a furan ring, and compounds 5-10 are tetracyclic cassane diterpenoids possessing a fused butenolide moiety. The anti-inflammatory and cytotoxic activities of the isolates were evaluated, while none of them showed obvious effects. The current study identified ten new cassane-type diterpenoids from the seeds of C. bonduc (L.) Roxb., which enriched the chemical diversity of the titled herbal medicine.

A Scenario-Based Evaluation of COVID-19-Related Essential Clinical Resource Demands in China.

The coronavirus disease 2019 (COVID-19) pandemic is a global crisis, and medical systems in many countries are overwhelmed with supply shortages and increasing demands to treat patients due to the surge in cases and severe illnesses. This study aimed to assess COVID-19-related essential clinical resource demands in China, based on different scenarios involving COVID-19 spreads and interventions. We used a susceptible-exposed-infectious-hospitalized/isolated-removed (SEIHR) transmission dynamics model to estimate the number of COVID-19 infections and hospitalizations with corresponding essential healthcare resources needed. We found that, under strict non-pharmaceutical interventions (NPIs) or mass vaccination of the population, China would be able to contain community transmission and local outbreaks rapidly. However, under scenarios involving a low intensity of implemented NPIs and a small proportion of the population vaccinated, the use of a peacetime-wartime transition model would be needed for medical source stockpiles and preparations to ensure a normal functioning healthcare system. The implementation of COVID-19 vaccines and NPIs in different periods can influence the transmission of COVID-19 and subsequently affect the demand for clinical diagnosis and treatment. An increased proportion of asymptomatic infections in simulations will not reduce the demand for medical resources; however, attention must be paid to the increasing difficulty in containing COVID-19 transmission due to asymptomatic cases. This study provides evidence for emergency preparations and the adjustment of prevention and control strategies during the COVID-19 pandemic. It also provides guidance for essential healthcare investment and resource allocation.

Pimarane Diterpenoids from the Seeds of Caesalpinia minax as PTP1B Inhibitors and Insulin Sensitizers.

Protein-tyrosine phosphatase 1B (PTP1B) has been considered as a promising target for treating insulin resistance. In searching for naturally occurring PTB1B antagonists, two new pimarane diterpenoids, named 2α-hydroxy-7-oxo-pimara-8(9),15-diene (1) and 19-hydroxy-2α-acetoxy-7-oxo-pimara-8(9),15-diene (2), were isolated from the seeds of Caesalpinia minax. Their structures were determined by extensive analysis of NMR and HR-ESIMS data, and their absolute configurations were determined by electronic circular dichroism (ECD) spectra. Compound 1 was disclosed as a competitive inhibitor of PTP1B with an IC50 (the half-maximal inhibitory concentration) value of 19.44 ± 2.39 µM and a Ki (inhibition constant) value of 13.69 ± 2.72 µM. Moreover, compound 1 dose-dependently promoted insulin-stimulated glucose uptake in C2C12 myotubes through activating insulin signaling pathway. Compound 1 might be further developed as an insulin sensitizer.

Biscembranoids and Cembranoids from the Soft Coral Sarcophyton elegans.

Two novel biscembranoids, sarelengans A and B (1 and 2), five new cembranoids, sarelengans C-G (3-7), along with two known cembranoids (8 and 9) were isolated from the South China Sea soft coral Sarcophyton elegans. Their structures were determined by spectroscopic and chemical methods, and those of 1, 4, 5, and 6 were confirmed by single crystal X-ray diffraction. Compounds 1 and 2 represent the first example of biscembranoids featuring a trans-fused A/B-ring conjunction between the two cembranoid units. Their unique structures may shed light on an unusual biosynthetic pathway involving a cembranoid-∆8 rather than the normal cembranoid-∆¹ unit in the endo-Diels-Alder cycloaddition. Compounds 2 and 3 exhibited potential inhibitory effects on nitric oxide production in RAW 264.7 macrophages, with IC50 values being at 18.2 and 32.5 µM, respectively.