Impact of early in-hospital nutritional status on clinical outcomes in Coronavirus disease 2019 patients: A single-center retrospective analysis (preprint)

Background: ： This study investigated the effects of nutritional status at the time of admission on clinical outcomes in patients with Coronavirus disease 2019 (COVID-19). Methods：A retrospective analysis was performed on 54 patients diagnosed with COVID-19. Clinical data of admitted patients, albumin and pre-serum albumin levels, gastrointestinal intolerance, and general information were collected and analyzed. The primary clinical outcomes were length of hospital stay and hospitalization costs. Results：The results showed that albumin and pre-serum albumin levels of patients at admission were negatively associated with the length of hospital stay and hospitalization costs (P < 0.001). Patients with poor appetite had longer hospital stays (P < 0.001) and higher hospital costs (P = 0.022). Conclusion：These results indicated that the nutritional status at admission can directly influence the clinical outcomes of COVID-19.

Interaction between travel restriction policies and the spread of COVID-19.

To investigate the interaction between travel restriction policies and the spread of COVID-19, we collected data on human mobility trends, population density, Gross Domestic Product (GDP) per capita, daily new confirmed cases (or deaths), and the total confirmed cases (or deaths), as well as governmental travel restriction policies from 33 countries. The data collection period was from April 2020 to February 2022, resulting in 24,090 data points. We then developed a structural causal model to describe the causal relationship between these variables. Using the Dowhy method to solve the developed model, we found several significant results that passed the refutation test. Specifically, travel restriction policies played an important role in slowing the spread of COVID-19 until May 2021. International travel controls and school closures had an impact on reducing the spread of the pandemic beyond the impact of travel restrictions. Additionally, May 2021 marked a turning point in the spread of COVID-19 as it became more infectious, but the mortality rate gradually decreased. The impact of travel restriction policies on human mobility and the pandemic diminished over time. Overall, the cancellation of public events and restrictions on public gatherings were more effective than other travel restriction policies. Our findings provide insights into the effects of travel restriction policies and travel behavioral changes on the spread of COVID-19, while controlling for informational and other confounding variables. This experience can be applied in the future to respond to emergent infectious diseases.

Deep learning models for hepatitis E incidence prediction leveraging meteorological factors.

BACKGROUND: Infectious diseases are a major threat to public health, causing serious medical consumption and casualties. Accurate prediction of infectious diseases incidence is of great significance for public health organizations to prevent the spread of diseases. However, only using historical incidence data for prediction can not get good results. This study analyzes the influence of meteorological factors on the incidence of hepatitis E, which are used to improve the accuracy of incidence prediction. METHODS: We extracted the monthly meteorological data, incidence and cases number of hepatitis E from January 2005 to December 2017 in Shandong province, China. We employ GRA method to analyze the correlation between the incidence and meteorological factors. With these meteorological factors, we achieve a variety of methods for incidence of hepatitis E by LSTM and attention-based LSTM. We selected data from July 2015 to December 2017 to validate the models, and the rest was taken as training set. Three metrics were applied to compare the performance of models, including root mean square error(RMSE), mean absolute percentage error(MAPE) and mean absolute error(MAE). RESULTS: Duration of sunshine and rainfall-related factors(total rainfall, maximum daily rainfall) are more relevant to the incidence of hepatitis E than other factors. Without meteorological factors, we obtained 20.74%, 19.50% for incidence in term of MAPE, by LSTM and A-LSTM, respectively. With meteorological factors, we obtained 14.74%, 12.91%, 13.21%, 16.83% for incidence, in term of MAPE, by LSTM-All, MA-LSTM-All, TA-LSTM-All, BiA-LSTM-All, respectively. The prediction accuracy increased by 7.83%. Without meteorological factors, we achieved 20.41%, 19.39% for cases in term of MAPE, by LSTM and A-LSTM, respectively. With meteorological factors, we achieved 14.20%, 12.49%, 12.72%, 15.73% for cases, in term of MAPE, by LSTM-All, MA-LSTM-All, TA-LSTM-All, BiA-LSTM-All, respectively. The prediction accuracy increased by 7.92%. More detailed results are shown in results section of this paper. CONCLUSIONS: The experiments show that attention-based LSTM is superior to other comparative models. Multivariate attention and temporal attention can greatly improve the prediction performance of the models. Among them, when all meteorological factors are used, multivariate attention performance is better. This study can provide reference for the prediction of other infectious diseases.

Thermophysiological and Perceptual Responses of Amateur Healthcare Workers: Impacts of Ambient Condition, Inner-Garment Insulation and Personal Cooling Strategy.

While personal protective equipment (PPE) protects healthcare workers from viruses, it also increases the risk of heat stress. In this study, the effects of environmental heat stress, the insulation of the PPE inner-garment layer, and the personal cooling strategy on the physiological and perceptual responses of PPE-clad young college students were evaluated. Three levels of wet bulb globe temperatures (WBGT = 15 °C, 28 °C, and 32 °C) and two types of inner garments (0.37 clo and 0.75 clo) were chosen for this study. In an uncompensable heat stress environment (WBGT = 32 °C), the effects of two commercially available personal cooling systems, including a ventilation cooling system (VCS) and an ice pack cooling system (ICS) on the heat strain mitigation of PPE-clad participants were also assessed. At WBGT = 15 °C with 0.75 clo inner garments, mean skin temperatures were stabilized at 31.2 °C, Hskin was 60-65%, and HR was about 75.5 bpm, indicating that the working scenario was on the cooler side. At WBGT = 28 °C, Tskin plateaued at approximately 34.7 °C, and the participants reported "hot" thermal sensations. The insulation reduction in inner garments from 0.75 clo to 0.37 clo did not significantly improve the physiological thermal comfort of the participants. At WBGT = 32 °C, Tskin was maintained at 35.2-35.7 °C, Hskin was nearly 90% RH, Tcore exceeded 37.1 °C, and the mean HR was 91.9 bpm. These conditions indicated that such a working scenario was uncompensable, and personal cooling to mitigate heat stress was required. Relative to that in NCS (no cooling), the mean skin temperatures in ICS and VCS were reduced by 0.61 °C and 0.22 °C, respectively, and the heart rates were decreased by 10.7 and 8.5 bpm, respectively. Perceptual responses in ICS and VCS improved significantly throughout the entire field trials, with VCS outperforming ICS in the individual cooling effect.

SMRI: A New Method for siRNA Design for COVID-19 Therapy.

First discovered in Wuhan, China, SARS-CoV-2 is a highly pathogenic novel coronavirus, which rapidly spread globally and became a pandemic with no vaccine and limited distinctive clinical drugs available till March 13th, 2020. Ribonucleic Acid interference (RNAi) technology, a gene-silencing technology that targets mRNA, can cause damage to RNA viruses effectively. Here, we report a new efficient small interfering RNA (siRNA) design method named Simple Multiple Rules Intelligent Method (SMRI) to propose a new solution of the treatment of COVID-19. To be specific, this study proposes a new model named Base Preference and Thermodynamic Characteristic model (BPTC model) indicating the siRNA silencing efficiency and a new index named siRNA Extended Rules index (SER index) based on the BPTC model to screen high-efficiency siRNAs and filter out the siRNAs that are difficult to take effect or synthesize as a part of the SMRI method, which is more robust and efficient than the traditional statistical indicators under the same circumstances. Besides, to silence the spike protein of SARS-CoV-2 to invade cells, this study further puts forward the SMRI method to search candidate high-efficiency siRNAs on SARS-CoV-2's S gene. This study is one of the early studies applying RNAi therapy to the COVID-19 treatment. According to the analysis, the average value of predicted interference efficiency of the candidate siRNAs designed by the SMRI method is comparable to that of the mainstream siRNA design algorithms. Moreover, the SMRI method ensures that the designed siRNAs have more than three base mismatches with human genes, thus avoiding silencing normal human genes. This is not considered by other mainstream methods, thereby the five candidate high-efficiency siRNAs which are easy to take effect or synthesize and much safer for human body are obtained by our SMRI method, which provide a new safer, small dosage and long efficacy solution for the treatment of COVID-19. Supplementary Information: The online version contains supplementary material available at 10.1007/s11390-021-0826-x.

Impact of early in-hospital nutritional status on clinical outcomes in Coronavirus disease 2019 patients: A single-center retrospective analysis (preprint)

Background This study investigated the effects of nutritional status at the time of admission on clinical outcomes in patients with Coronavirus disease 2019 (COVID-19).Methods A retrospective analysis was performed on 54 patients diagnosed with COVID-19. Clinical data of admitted patients, albumin and pre-serum albumin levels, gastrointestinal intolerance, and general information were collected and analyzed. The primary clinical outcomes were length of hospital stay and hospitalization costs.Results The results showed that albumin and pre-serum albumin levels of patients at admission were negatively associated with the length of hospital stay and hospitalization costs (P < 0.001). Patients with poor appetite had longer hospital stays (P < 0.001) and higher hospital costs (P = 0.022).Conclusion These results indicated that the nutritional status at admission can directly influence the clinical outcomes of COVID-19.

The effects of Wuhan highway lockdown measures on the spread of COVID-19 in China.

To verify the effects of Wuhan highway lockdown measures on the spread of COVID-19 across China cities, we extracted the vehicle outflow from Wuhan to 245 cities from the Chinese highway toll system. A dynamic exponential risk model that considered the vehicle outflow, city gross domestic product, city population, and distance between two cities was established to characterize the spread of pandemics and quantify the blocking effects. Results showed that an early highway lockdown measure could indeed reduce the confirmed cases and vehicles with 1-9 seats played a leading role. The confirmed cases in Guangxi, Henan, and Shanxi could be reduced by more than 50%, as well as Hubei by 20% if the highway was closed 3 days in advance. The blocking effects on Fujian, Jiangxi, Guangdong, Hunan, and Shandong were not obvious, where the number of confirmed cases only decreased by a small proportion (below 10%). The findings could be used to help each provincial government to adjust policies properly and improve the effectiveness of epidemic control and prevention. Moreover, the proposed method could also be applied to various countries or regions affected by COVID-19, as well as other similar pandemics.

Genomic epidemiology of SARS-CoV-2 in the UAE reveals novel virus mutation, patterns of co-infection and tissue specific host immune response.

To unravel the source of SARS-CoV-2 introduction and the pattern of its spreading and evolution in the United Arab Emirates, we conducted meta-transcriptome sequencing of 1067 nasopharyngeal swab samples collected between May 9th and Jun 29th, 2020 during the first peak of the local COVID-19 epidemic. We identified global clade distribution and eleven novel genetic variants that were almost absent in the rest of the world and that defined five subclades specific to the UAE viral population. Cross-settlement human-to-human transmission was related to the local business activity. Perhaps surprisingly, at least 5% of the population were co-infected by SARS-CoV-2 of multiple clades within the same host. We also discovered an enrichment of cytosine-to-uracil mutation among the viral population collected from the nasopharynx, that is different from the adenosine-to-inosine change previously reported in the bronchoalveolar lavage fluid samples and a previously unidentified upregulation of APOBEC4 expression in nasopharynx among infected patients, indicating the innate immune host response mediated by ADAR and APOBEC gene families could be tissue-specific. The genomic epidemiological and molecular biological knowledge reported here provides new insights for the SARS-CoV-2 evolution and transmission and points out future direction on host-pathogen interaction investigation.

Electrospun polyvinyl butyral/ berberine membranes for antibacterial air filtration

At the beginning of 2020, the whole world suffered from the new coronavirus (COVID-19). Wearing a mask was believed to reduce the spread of the virus. The core material of a mask required good air permeability and efficient filtration. Electrospun materials may match these requirments. By electrospinning, we prepared polyvinyl butyral (PVB)/berberine hydrochloride (BH) membranes onto the spunbonded nonwovens. The composite meshes showed a porous structures, good air permeability (164±16 mm/s) and air filtration efficiency 96.4% for PM 0.3, 100% for PM 2.5, with pressure drop (108 Pa). Moreover, with the addition of BH, the as-spun membranes showed good antibacterial property for staphylococcus aureus. Furthermore, the prepared PVB/berberine membranes had good hydrophobicity with water contact angle higher than 140°. These results indicated that the fabricated PVB/berberine membranes have potential applications in mask and air filtration.

[Rationality of Asari Radix et Rhizoma in Qingfei Paidu Decoction based on literature analysis].

Qingfei Paidu Decoction is a traditional Chinese medicine compound recommended by National Health Commission of the People's Republic of China and National Administration of Traditional Chinese Medicine for clinical therapies of coronavirus disease 2019(COVID-19). Qingfei Paidu Decoction consists of 21 traditional Chinese medicines, such as Asari Radix et Rhizoma. However, the dosage of Asari Radix et Rhizoma has been questioned by some people, because of one ancient proverb. To explore the rationality of the dosage of Asari Radix et Rhizoma in Qingfei Paidu Decoction, this study systematically examined the ancient and modern physicians' understanding of the toxicity of Asari Radix et Rhizoma, and collated the application and dosage of Asari Radix et Rhizoma in ancient prescriptions and modern clinics based on literature analysis. As a result, we found that ancient and modern physicians have different understanding on the toxicity of Asari Radix et Rhizoma and that the theory about the dosage of Asari Radix et Rhizoma is flawed. We also found that the dose of Asari Radix et Rhizoma in ancient and modern clinical applications was not constrained by ancient experience. Physicians usually increase the dosage of Asari Radix et Rhizoma in clinical therapy according to the actual conditions, and there were no adverse reactions. Additionally, according to laws and regulations concerning medical affairs, physician could increase or decrease the dosage of the drug under special circumstances. Based on the analysis of safety and effectiveness of Asari Radix et Rhizoma in Qingfei Paidu Decoction, we conclude that the dose of Asari Radix et Rhizoma in Qingfei Paidu Decoction is safe, effective and reasonable.