Civil Aviation Customer Satisfaction Automatic Evaluation System

In 2021, the airline industry was affected by COVID-19, and many airlines suffered losses. The main reason for the loss were the decline in revenue and the surge in costs. Therefore, in terms of creating the competitive advantage of airlines, "price war" is no longer applicable, and improving service quality has become an effective means. Customer satisfaction is the most effective indicator to measure service quality. In this study, a satisfaction evaluation system is established based on structural equation model and customer satisfaction importance matrix. Then, a questionnaire is designed to analyze the influence of different factors on customer satisfaction. The research finds that brand image and perceived quality have a great impact on customer satisfaction. In addition, some suggestions for airlines to improve customer satisfaction are given. © 2023 SPIE.

Potential of Antibody-Dependent Cellular Cytotoxicity in Acute and Recovery Phases of SARS-CoV-2 Infection

Background:Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused a global pandemic that has resulted in millions of casualties. Although researchers have reported the existence of neutralizing antibodies and viral T cell immunity against SARS-CoV-2, little is known about the presence of antibody-dependent cellular cytotoxicity (ADCC) and its role in combating SARS-CoV-2 infection.Methods:Nineteen acute COVID-19 patients at the First Affiliated Hospital of Guangzhou Medical University from January to February, 2020 and 55 recovery COVID-19 patients at the Second Peoples Hospital of Changde City from February, 2020 to February, 2021 were recruited in this study. Longitudinal plasma samples were collected. A virus-specific ADCC assay was performed to study the COVID-19 plasma samples. The correlations between ADCC and total IgG titer, including anti-RBD, anti-N, and neutralizing antibody titer were analyzed.Results:A high level of ADCC with 0.86% of IFN-γ+CD107a+NK cells induced by anti RBD antibodies and with 0.54% of IFN-γ+CD107a+NK cells induced by anti N antibodies was observed. This activity peaked at 3 weeks after disease onset with 1.16% and 0.63% of IFN-γ+CD107a+NK cells induced by anti RBD and anti N antibodies respectively, declined to 0.32% and 0.32% of IFN-γ+CD107a+NK cells respectively after more than 2 months, and persisted for 12 months after disease onset. The ADCC did not aggravate the severity of COVID-19 in terms of sequential organ failure assessment, although ADCC decreased with the age of COVID-19 patients. Interestingly, ADCC response is not correlated with neutralizing antibody titer or total IgG titers against S protein RBD and N protein in acute patients. ADCC in recovered patients showed a significant correlation with anti RBD IgG titer (R2 = 0.33, P < 0.001).Conclusion:Antibodies from COVID-19 patients against the N protein and S protein RBD domains could stimulate high levels of ADCC response. Our results provide evidence that vaccination should not only focus on neutralizing antibodies but also binding antibodies that may facilitate the antiviral function of ADCC, especially in the elderly. © 2022 Journal of Bone and Joint Surgery Inc.. All rights reserved.

Risk assessment and prevention and control effective assessment for COVID-19 in Hainan based on population migration

Objective To assess imported risk of COVID-19 in Hainan province from January 10 to March 7 in 2020, and to assess the effect of "The Normalization Prevention and Control" (measures during the Spring Festival Travel Rush (SFTR) in Hainan in 2021. Methods The daily reported imported cases in Hainan province, the daily reported cases in other 30 province of China, and the Baidu Migration Index were collected to calculated into the Imported Risk Index (IRI) to quantitatively assess the imported risk of Hainan province. Based on the analysis of the relationship between the imported risk index and imported cases, an imported case prediction model was constructed to fit the number of imported cases in "emergency containment" stage in Hainan. And number of imported cases during the Spring Festival Travel rush in 2021 was predicted by this model to compared with the actual number, which was to evaluate the "Normalization Prevention and Control" measures in this model was also used to assess the effect of "Normalization Prevention and Control" measures during the SFTR in 2021. Results Totally 112 imported cases were reported in Hainan. The average IRI was 0.98. Haikou, Sanya and Danzhou have the highest imported risk. Except Haikou, the imported risk index of all cities and counties reached the maximum value around January 24th. The generalized additive model based on the lag 4 days and lag 5 days was best fitted with the actual imported cases number (R2adjust1=83.50%, R2adjust2=82.00%, MRE=17.61%). If "Emergency Containment" strategy was still adopted, there were 10 COVID-19 cases imported into Hainan during the SFTR in 2021. Under the "Normalization Prevention and Control" strategy, virtually no imported cases were found in Hainan. Conclusions Tourism cities such as Haikou and Sanya have high imported risks. Hubei and Guangdong provinces are the main imported provinces. The Generalized Additive Model based on the Imported Risk Index can better fit with the imported cases number of COVID-19 in Hainan Province in "emergency containment". Compared with the "Emergency Containment" strategy, the "Normalization Prevention and Control" strategy adopted during the SFTR in 2021 reduced imported cases in Hainan by about 10. © 2022. China Tropical Medicine. All rights reserved.

How does nature heal tourists in the context of COVID-19? The perspective of the emotional mechanism

Nature has healing powers that provide physical and mental benefits to tourists and reduce their anxiety related to COVID-19. However, few empirical studies have examined the emotional mechanism that induces tourists to feel satisfied with, rather than anxious about, their lives. We explain the underlying impact mechanism that connects nature and subjective well-being in a natural heritage context by analyzing data collected from a sample of 534 tourists in Wulingyuan (south-central China). Our study revealed interesting and meaningful findings: (a) nature has healing powers that directly and indirectly (via awe and place attachment) influence tourists' sub-jective well-being;(b) tourists with a relatively low level of positive emotions who become attached to a destination, subsequently experience a greater degree of healing;and (c) there are significant gender differences concerning the healing powers of nature among tourists. These findings contribute to well-being research by highlighting the underlying emotional mechanism whereby nature influences tourists' subjective well-being. The paper also demonstrates the moderating effects of positive emotions and gender in the proposed model, which offers valuable practical insights for governments in tourist destinations.

The existence of flight-to-quality under extreme conditions: Evidence from a nonlinear perspective in Chinese stocks and bonds' sectors

The COVID-19 pandemic has showed that distress to the financial system is always accompanied with the interconnection between the stock and bond markets. However, limited studies have identified the flight-toquality effect between these two markets from a nonlinear extreme perspective. Thus, using the multi-quantile VaR Granger causality test that measures the non-linearity of extreme risk, we investigated this effect in Chinese sectors via extreme risk spillover networks. Based on the findings, defensive (offensive) sectors are dominant in the stock market when facing upside (downside) risk to avoid potential investment losses. The results also confirm the robustness of the conclusion that the investment function of the financial markets weakened during the financial crisis. Moreover, compared to the Financial Bond and Enterprise Bond, the Government Bond is likely to show better risk hedging effect in cross-market risk spillover networks due to its high information transparency.

Safety and immunogenicity of Nanocovax, a SARS-CoV-2 recombinant spike protein vaccine: Interim results of a double-blind, randomised controlled phase 1 and 2 trial.

Background: Nanocovax is a recombinant severe acute respiratory syndrome coronavirus 2 subunit vaccine composed of full-length prefusion stabilized recombinant SARS-CoV-2 spike glycoproteins (S-2P) and aluminium hydroxide adjuvant. Methods: We conducted a dose-escalation, open label trial (phase 1) and a randomized, double-blind, placebo-controlled trial (phase 2) to evaluate the safety and immunogenicity of the Nanocovax vaccine (in 25 mcg, 50 mcg, and 75 mcg doses, aluminium hydroxide adjuvanted (0·5 mg/dose) in 2-dose regime, 28 days apart (ClinicalTrials.gov number, NCT04683484). In phase 1, 60 participants received two intramuscular injection of the vaccine following dose-escalation procedure. The primary outcomes were reactogenicity and laboratory tests to evaluate the vaccine safety. In phase 2, 560 healthy adults received either vaccine doses similar in phase 1 (25 or 50 or 75 mcg S antigen in 0·5 mg aluminium per dose) or adjuvant (0·5 mg aluminium) in a ratio of 2:2:2:1. One primary outcome was the vaccine safety, including solicited adverse events for 7 day and unsolicited adverse events for 28 days after each injection as well as serious adverse event or adverse events of special interest throughout the study period. Another primary outcome was anti-S IgG antibody response (Index unit/ml). Secondary outcomes were surrogate virus neutralisation (inhibition percentage), wild-type SARS-CoV-2 neutralisation (dilution fold), and T-cell responses by intracellular staining for interferon gamma (IFNg). Anti-S IgG and neutralising antibody levels were compared with convalescent serum samples from symptomatic Covid-19 patients. Findings: For phase 1 study, no serious adverse events were observed for all 60 participants. Most adverse events were grade 1 and disappeared shortly after injection. For phase 2 study, after randomisation, 480 participants were assigned to receive the vaccine with adjuvant, and 80 participants were assigned to receive the placebo (adjuvant only). Reactogenicity was absent or mild in the majority of participants and of short duration (mean ≤3 days). Unsolicited adverse events were mild in most participants. There were no serious adverse events related to Nanocovax. Regarding the immunogenicity, Nanocovax induced robust anti-S antibody responses. In general, there humoral responses were similar among vaccine groups which reached their peaks at day 42 and declined afterward. At day 42, IgG levels of vaccine groups were 60·48 [CI95%: 51·12-71·55], 49·11 [41·26-58·46], 57·18 [48·4-67·5] compared to 7·10 [6·32-13·92] of convalescent samples. IgG levels reported here can be converted to WHO international standard binding antibody unit (BAU/ml) by multiplying them to a conversion factor of 21·8. Neutralising antibody titre of vaccine groups at day 42 were 89·2 [52·2-152·3], 80·0 [50·8-125.9] and 95·1 [63·1-143·6], compared to 55·1 [33·4-91·0] of the convalescent group. Interpretation: Up to day 90, Nanocovax was found to be safe, well tolerated, and induced robust immune responses. Funding: This work was funded by the Coalition for Epidemic Preparedness Innovations (CEPI), the Ministry of Science and Technology of Vietnam, and Nanogen Pharmaceutical Biotechnology JSC.

Environmental Adaptive Privacy Preserving Contact Tracing System: A Construction from Public Key Rerandomizable BLS Signatures

The COVID-19 pandemic has made the scientific community devise means to implement “contact tracing" mechanisms to mitigate the spread of the infection. The crucial idea is to scan and record close contacts between users using mobile device, in order to notify persons when their close contact(s) is diagnosed positive. First, the ability granted to service providers of the contact tracing systems to access user data violates user privacy, and attackers can fabricate identities and contact records in their devices, which harms the integrity of the system. Moreover, current contact tracing systems’false-positive rate is too high to be practical as they do not filter scan results outside the range of infections, since the range of transmission for droplets is far less than the scanning range for Bluetooth Low Energy used by these systems. Furthermore, current systems neglect airborne transmission, a far cry from a tool against viruses suspended in the air. In this paper, we propose a cryptographic framework for contact tracing and provide a construction based on public key rerandomizable BLS signature, being capable of providing users of contact tracing with comprehensive privacy protection. Besides, we also implement a commitment scheme to prevent fabrication of identities and contact records. To prove the concept of our framework and to solve other problems mentioned above, we proposed a new contact tracing system, using environmental factors (temperature, humidity and airflow) to filter out results outside estimated effective transmission distance, and also take airborne transmission into consideration. Finally, we evaluate the performance of our design by implementing our algorithm on mobile devices with satisfactory results. Author

Mass Spectrometry Analysis of SARS-CoV-2 Nucleocapsid Protein Reveals Camouflaging Glycans and Unique Post-Translational Modifications

The devastating coronavirus disease 2019 (COVID-19) pandemic has prompted worldwide efforts to study structural biological traits of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its viral components. Compared to the Spike protein, which is the primary target for currently available vaccines or antibodies, knowledge about other virion structural components is incomplete. Using high-resolution mass spectrometry, we report a comprehensive post-translational modification (PTM) analysis of nucleocapsid phosphoprotein (NCP), the most abundant structural component of the SARS-CoV-2 virion. In addition to phosphoryl groups, we show that the SARS-CoV-2 NCP is decorated with a variety of PTMs, including N-glycans and ubiquitin. Based on newly identified PTMs, refined protein structural models of SARS-CoV-2 NCP were proposed and potential immune recognition epitopes of NCP were aligned with PTMs. These data can facilitate the design of novel vaccines or therapeutics targeting NCP, as valuable alternatives to the current vaccination and treatment paradigm that is under threat of the ever-mutating SARS-CoV-2 Spike protein.

Complementary Blockchain-Based Privacy Protection for Covid-19 Contact Tracing

Fighting any pandemic outbreak begins with health authorities already behind time. They are required to locate, isolate and treat infected individuals while tracking possibly infected ones. In the case of Covid-19, the high reproductive number of the virus necessitates that all contacts of an infected individual be found within the shortest possible time to slow the rate of spreading. This presents multiple challenges because of the highly invasive nature of tracing activities which demand the mobility history of patients. Patients may be unwilling to cooperate or may be unable to communicate if the infection has advanced to the point where critical care is necessary. To speedily locate contacts of an infected individual, we propose using communications data logs from telecommunications operators. We employ a modified directed graph to determine which other individuals have been in close proximity to an infected individual in a specific frame of time. We then generate a contact graph and place it in a secure offline storage platform. We employ Smart Contracts to control access to the data while the blockchain keeps records of the provenance of all data and transactions. We find this method of conducting the contact tracing and protecting the resulting data more secure and pliant to the privacy laws that regulate the handling of sensitive personal data. © 2021 IEEE.

Environmental Adaptive Privacy Preserving Contact Tracing System for Respiratory Infectious Diseases

The COVID-19 pandemic has made the scientific community devise means to implement “contact tracing” mechanisms to mitigate the spread of the infection. The crucial idea is to scan and record close contacts between users using mobile devices, in order to notify persons when their close contact(s) is diagnosed positive. Current contact tracing systems’ false-positive rate is too high to be practical as they do not filter Bluetooth scan results outside range of infection. Furthermore current systems neglect airborne transmission other than droplet transmission. Moreover, the ability granted to service providers of the contact tracing systems to access user data violates user privacy. Finally, attackers can modify, remove or fabricate contact records in their devices, which harms the integrity of the system. In this paper, we propose and develop a new contact tracing system which uses environmental factors to filter out results outside estimated effective transmission distance, and also take airborne transmission into consideration. In addition, we implement a rerandomizable signature scheme with blockchain bulletin board to provide confidentiality and integrity. We also evaluate the performance of our theory by implementing our algorithm on mobile devices. © 2022, Springer Nature Switzerland AG.

Venetoclax, Obinutuzumab and Atezolizumab (PD-L1 Checkpoint Inhibitor) for First-Line Treatment for Patients with Chronic Lymphocytic Leukemia (CLL)

Background: Dysfunction of T cells, NK cells and other immune subsets is common in patients (pts) with CLL. Venetoclax (VEN), a BCL-2 inhibitor and obinutuzumab (OBIN), a CD20 monoclonal antibody (mAb) are approved for pts with CLL (Fischer, NEJM 2019). Atezolizumab, a PD-L1 checkpoint inhibitor (CPI), is approved for melanoma, lung cancer and other solid tumors. Preclinical studies showed synergy of VEN and CD20 mAb with CPI (Kohlhapp, Cancer Discovery 2021;Westin, Lancet Oncology 2014). Clinical studies showed activity of PD1 inhibition in pts with Richter's transformation, but not CLL (Ding, Blood 2017;Jain, ASH 2018). To our knowledge, no prior study has evaluated PD-L1 inhibition in pts with CLL, nor combined CPI, VEN and OBIN. We hypothesized that combined VEN, OBIN and atezolizumab will be synergistic. Methods: This is an investigator-initiated Phase II trial of combined VEN, OBIN and atezolizumab in pts with previously untreated CLL meeting 2008 IWCLL treatment criteria (NCT02846623). Eligibility criteria included age ≥18 years, adequate organ function (total bilirubin ≤1.5 x ULN, ALT and AST ≤2.5 x ULN, creatinine ≤1.5 x ULN). OBIN was given at a flat dose of 100mg IV Cycle (C)1 Day (D)1, 900 mg C1D2, 1000mg on C1D8, 1000mg on C1D15 and then 1000mg on C2-9 D1. Atezolizumab was given at a flat dose of 1680 mg IV (split over 2 days) on C1D3-4 and then C2-9D1-2. VEN was initiated at the start of C3 with the weekly dose-escalation (20mg daily to a target dose of 400mg daily) and continued daily until end of C14 (total 12 cycles of VEN). All pts stopped therapy at the end of C14. Response assessments were done with CT imaging and bone marrow aspirate/biopsy with MRD assessment (multi-color flow cytometry;sensitivity 10 -4) at the end of C2 (prior to VEN initiation), end of C6, end of C9, and end of C14. Results: From July 2019 to December 2020, a total of 26 pts were enrolled. The median age was 60 years (range, 21-74). The baseline characteristics are shown in Table 1. A total of 19/26 (73%) had unmutated IGHV gene. Though the study did not restrict pts with del(17p) or mutated TP53, no pt in the current cohort had del(17p)/ mutated TP53. A total of 14 (54%) pts had a baseline lymph node >5cm. The median follow-up is 13.3 months. One pt came off study in C1 (details below). A total of 25 pts initiated VEN. The TLS risk categories at the start of C1 were high (n=9, 36%), medium (n=12, 48%), and low (n=4, 16%). After 2 cycles of OBIN and atezolizumab (prior to VEN initiation), the majority of pts had downgrading of TLS risk category [high (n=2, 8%), medium (n=3, 12%), and low (n=20, 80%)]. After C6 (about 3 cycles of VEN 400mg daily), bone marrow undetectable (U)-MRD rate was 19/25 (76%);4/25 (16%) had low+ MRD and 2/25 (8%) had high+ MRD. After C9 (about 6 cycles of VEN 400mg daily), among the 21 pts (4 pts have not reached this time-point), the bone marrow U-MRD rate was 18/21 (86%);2/21 (10%) had low+ MRD and 1/21 (5%) had high+ MRD. A total of 14 pts completed C14 (9 pts have not reached this time-point;2 pts came off study prior to completing C14, details below);13/14 (93%) achieved bone marrow U-MRD and 1/14 (7%) has low+ MRD. No patient had disease progression or MRD relapse so far. One pt died (details below). Three pts came off study (one developed retroperitoneal hematoma after receiving enoxaparin for DVT in C1;one developed CPI-induced colitis and removed from the study in C10;one died from COVID-19 pneumonia in C14 while in bone marrow U-MRD remission). Grade 3-4 neutropenia occurred in 14/26 (54%) pts. Grade 3 thrombocytopenia occurred in 5/26 (19%) pts;no pt had G4 thrombocytopenia. A total of 4 pts developed CPI-induced toxicities (colitis, G3, n=1;mucositis, G3, n=1;nephritis, G2, n=1;myositis, G2, n=1). A total of 10/25 (40%) pts had dose reduction of VEN, the majority due to neutropenia. Atezolizumab was discontinued early in 3 pts due to CPI-induced toxicities. Laboratory correlative studies including scRNAseq and CyTOF are ongoing. Conclusions: Treatment with combined VE , OBIN and atezolizumab leads to high rate of early U-MRD remission with 76% bone marrow U-MRD remission at the end of C6 (about 3 cycles of VEN 400mg daily). Four pts had CPI-induced toxicities. The enrollment in this trial continues and updated data and correlative studies will be presented at the ASH meeting. [Formula presented] Disclosures: Jain: Pfizer: Research Funding;Bristol Myers Squibb: Honoraria, Research Funding;Precision Biosciences: Honoraria, Research Funding;Aprea Therapeutics: Research Funding;AstraZeneca: Honoraria, Research Funding;Servier: Honoraria, Research Funding;Incyte: Research Funding;Pharmacyclics: Research Funding;Genentech: Honoraria, Research Funding;AbbVie: Honoraria, Research Funding;TG Therapeutics: Honoraria;Janssen: Honoraria;Beigene: Honoraria;Fate Therapeutics: Research Funding;Adaptive Biotechnologies: Honoraria, Research Funding;Cellectis: Honoraria, Research Funding;ADC Therapeutics: Honoraria, Research Funding. Ferrajoli: Janssen: Other: Advisory Board;AstraZeneca: Other: Advisory Board, Research Funding;BeiGene: Other: Advisory Board, Research Funding. Yilmaz: Daiichi-Sankyo: Research Funding;Pfizer: Research Funding. Thompson: AbbVie: Other: Institution: Advisory/Consultancy, Honoraria, Research Grant/Funding;Gilead: Other: Institution: Advisory/Consultancy, Honoraria;Janssen: Consultancy, Honoraria;Pharmacyclics: Other: Institution: Advisory/Consultancy, Honoraria, Research Grant/Funding;Adaptive Biotechnologies: Other: Institution: Advisory/Consultancy, Honoraria, Research Grant/Funding, Expert Testimony;Genentech: Other: Institution: Advisory/Consultancy, Honoraria, Research Grant/Funding;Amgen: Other: Institution: Honoraria, Research Grant/Funding. Konopleva: Novartis: Other: research funding pending, Patents & Royalties: intellectual property rights;Reata Pharmaceuticals: Current holder of stock options in a privately-held company, Patents & Royalties: intellectual property rights;Eli Lilly: Patents & Royalties: intellectual property rights, Research Funding;KisoJi: Research Funding;Stemline Therapeutics: Research Funding;Sanofi: Other: grant support, Research Funding;Rafael Pharmaceuticals: Other: grant support, Research Funding;AstraZeneca: Other: grant support, Research Funding;Cellectis: Other: grant support;F. Hoffmann-La Roche: Consultancy, Honoraria, Other: grant support;Calithera: Other: grant support, Research Funding;Ascentage: Other: grant support, Research Funding;Ablynx: Other: grant support, Research Funding;Genentech: Consultancy, Honoraria, Other: grant support, Research Funding;Forty Seven: Other: grant support, Research Funding;AbbVie: Consultancy, Honoraria, Other: Grant Support, Research Funding;Agios: Other: grant support, Research Funding. Neelapu: Takeda Pharmaceuticals and related to cell therapy: Patents & Royalties;Kite, a Gilead Company, Bristol Myers Squibb, Merck, Poseida, Cellectis, Celgene, Karus Therapeutics, Unum Therapeutics (Cogent Biosciences), Allogene, Precision BioSciences, Acerta and Adicet Bio: Research Funding;Kite, a Gilead Company, Merck, Bristol Myers Squibb, Novartis, Celgene, Pfizer, Allogene, Kuur, Incyte, Precision BioSciences, Legend, Adicet Bio, Calibr, and Unum Therapeutics: Other: personal fees;Kite, a Gilead Company, Merck, Bristol Myers Squibb, Novartis, Celgene, Pfizer, Allogene Therapeutics, Cell Medica/Kuur, Incyte, Precision Biosciences, Legend Biotech, Adicet Bio, Calibr, Unum Therapeutics and Bluebird Bio: Honoraria. Takahashi: Symbio Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees;Celgene/BMS: Consultancy;Novartis: Consultancy;GSK: Consultancy. Burger: TG Therapeutics: Other: Travel/Accommodations/Expenses, Research Funding, Speakers Bureau;Beigene: Research Funding, Speakers Bureau;Novartis: Other: Travel/Accommodations/Expenses, Speakers Bureau;Pharmacyclics LLC: Consultancy, Other: Travel/Accommodations/Expenses, Research Funding, Speakers Bureau;Gilead: Consultancy, Other: Travel/Accommodations/Expenses, Rese rch Funding, Speakers Bureau;AstraZeneca: Consultancy;Janssen: Consultancy, Other: Travel/Accommodations/Expenses, Speakers Bureau. Khoury: Stemline Therapeutics: Research Funding;Kiromic: Research Funding;Angle: Research Funding. Kantarjian: Jazz: Research Funding;NOVA Research: Honoraria;Novartis: Honoraria, Research Funding;KAHR Medical Ltd: Honoraria;Precision Biosciences: Honoraria;Amgen: Honoraria, Research Funding;Astra Zeneca: Honoraria;AbbVie: Honoraria, Research Funding;Ipsen Pharmaceuticals: Honoraria;Pfizer: Honoraria, Research Funding;Astellas Health: Honoraria;Aptitude Health: Honoraria;Taiho Pharmaceutical Canada: Honoraria;Immunogen: Research Funding;Daiichi-Sankyo: Research Funding;BMS: Research Funding;Ascentage: Research Funding. Wierda: Karyopharm: Research Funding;Miragen: Research Funding;Acerta Pharma Inc.: Research Funding;Cyclacel: Research Funding;Oncternal Therapeutics, Inc.: Research Funding;Pharmacyclics LLC, an AbbVie Company: Research Funding;Sunesis: Research Funding;Juno Therapeutics: Research Funding;Gilead Sciences: Research Funding;AstraZeneca: Research Funding;Genentech: Research Funding;Loxo Oncology, Inc.: Research Funding;Janssen: Research Funding;Xencor: Research Funding;GSK/Novartis: Research Funding;KITE Pharma: Research Funding;Genzyme Corporation: Consultancy;AbbVie: Research Funding. OffLabel Disclosure: Atezolizumab is not approved for CLL

The impact of COVID-19 on the cascade of care of HCV in the u.s. and china

Introduction: The COVID-19 pandemic has dramatically imperiled the health system worldwide. It may also negatively impact the cascade of care of hepatitis C virus (HCV) infection and the progress on WHO 2030 goal of HCV elimination. In this study, we used a multinational, multicenter cohort to estimate the change in the completion of DAA therapy, HCV RNA testing, and clinical encounter during pandemic. Methods: We collected data patients who underwent DAA therapy at three tertiary medical centers in Los Angeles (US), Xi'an (China), and Nanjing (China) between January 1, 2019 to June 30, 2020 and followed until November 30, 2020. We compared the proportions of HCV patients who completed DAA therapy as well as had HCV RNA testing and follow-up visits during and after the end of the HCV therapy between COVID-19 pandemic and the periods before pandemic. Additionally, we determined the frequency and predictive factors of utilization of telemedicine. Results: A total of 256 patients with HCV infection were included. Despite no significant reduction in the completion of DAA before and during the pandemic, the proportion of patients undergoing HCV RNA testing during DAA treatment decreased from about 80% before pandemic to 67% during the pandemic, with a more prominent decrease in the US. There were less than 10% of patients who had HCV RNA testing 12 weeks post-treatment during COVID-19 era. Compared to pre-pandemic period, post-treatment clinic encounter decreased significant in China but elevated in the US. Further analysis showed that the increase was due to the surge in utilization of telemedicine. However, the increased number of follow-up visits during COVID-19 pandemic period did not result in an increase in HCV RNA testing. Conclusion: COVID-19 pandemic carried profound impact on the cascade of care for HCV patients in both the US and China. Despite the increased use of telemedicine in the US, the adherence to recommendations for HCV RNA testing was still disappointingly low. Stakeholders should identify the modifiable barriers and reinforce the care while withstanding the pandemic.

From Norms to Expectations: Balancing Trade and Security Interests in the Post-COVID-19 World

Often depicted as a ‘nuclear button', the significance of the security exceptions to the world trade legal regime goes well beyond an exception that exempts states from legal commitments to trade liberalisation. As a general exception enshrined into the GATT/WTO regime, the national security exceptions are a reflection of historical negotiations which eventually led to a compromise and consensual expectation among WTO members. This consensus entails a two-pronged attribute of this provision. On the one hand, the possibility and the scope of review of the security exceptions was intentionally made ambiguous. On the other hand, there lies an implied expectation among the state actors as to its applicability. The existing literature in the field of international trade law focuses predominantly on the former attribute of the issue. This paper turns to the latter. Our analysis explores three imperative questions. First, this paper attempts to understand the ‘circumstances' in which the national security exceptions are likely to be invoked. Second, this paper looks into whether the aforementioned expectations have changed over time. Lastly, the paper analyses how the rules of the international trade regime should interact with the common expectations. In view of the above questions, this paper argues that the security exceptions rule was invoked in the most severe cases of interstate confrontation, closely related to wars, armed conflicts and similar situations endangering the territory, population and political system of a state. This reflects a common expectation among states that the national security exceptions rule is to be employed for the protection of essential security interests. After an examination of recent trade disputes between China and the United States and between Russia and the United States/European Union over Ukraine, we conclude that so far this common expectation persists. On this ground, we argue that the WTO panels should be mindful of any arbitrary extension of the use of the national security exception and the delimitation between security and other national interests. © 2021. All Rights Reserved.

Changes in Source-Specific Black Carbon Aerosol and the Induced Radiative Effects Due to the COVID-19 Lockdown

The impacts of anthropogenic emissions on the reduction of source-specific equivalent black carbon (eBC) aerosols and their direct radiative effects (DREs) were investigated during the lockdown of the coronavirus outbreak in a megacity of China in 2020. Five eBC sources were identified using a hybrid environmental receptor model. Results showed that biomass burning, traffic-related emissions, and coal combustion were the dominant contributors to eBC. The generalized additive model indicated that the reduction of traffic-related eBC during the lockdown was entirely attributed to the decrease of emissions. Decreased biomass-burning activities and favorable meteorological factors are both important drivers for the biomass-burning eBC reduction during the lockdown. A radiative transfer model showed that the DRE efficiency of eBC from biomass burning was the strongest, followed by coal combustion and traffic-related emissions. This study highlights that aggressive reduction in the consumption of residential solid fuels would be effective in achieving climate change mitigation.

SARS-CoV-2 associated guillain-barré syndrome with dysautonomia

Background: SARS-CoV-2 emerged in Wuhan in late 2019 and has become a major healthcare challenge around the globe. Neurological complications of this disease are increasingly common. We present one of the first published cases of Guillan-Barré Syndrome (GBS) associated with SARS-CoV-2 infection in the United States. Design/Methods: Data regarding this case was recorded and reviewed through use of the Computerized Patient Record System from the Veteran's Affairs Hospital in Pittsburgh, Pennsylvania. SARS-CoV-2 polymerase chain reaction assays met federal guidelines for clinical use. Results: A 72 year-old male presented after a fall with one day of progressive distal limb weakness and numbness in the setting of a recent diarrheal illness. Exam demonstrated tetraparesis, distal sensation loss, and areflexia. Admission nasopharyngeal SARS-CoV-2 PCR swab was positive. Cerebrospinal fluid studies revealed albuminocytological dissociation and SARS-CoV-2 PCR testing of fluid was negative. Neurophysiologic studies performed supported a diagnosis of acute inflammatory demyelinating polyradiculoneuropathy subtype of GBS. His course was complicated by respiratory failure, requiring intubation and eventual tracheostomy, dysautonomia, and syndrome of inappropriate antidiuretic hormone secretion. Patient received a course of intravenous immunoglobulin and with near complete resolution 90 days after symptom onset. Conclusions: As a threat to global health, SARS-CoV-2 needs to be recognized as a possible trigger for GBS and patients should be screened and tested, as deemed appropriate by their care team. Ultimately, more epidemiological studies are needed to understand SARS-CoV-2 associated GBS and whether or not it varies from GBS caused by other infections.

Study on pathological mechanism of pneumonia infected by coronavirus based on time-series gene co-expression network analysis

Recently, the epidemic of COVID-19 infection broke out in Wuhan, China. To explore the pathological mechanism of pneumonia infected by coronavirus, we built a bioinformatics pipeline based on time-series gene co-expression network analysis to analyze the gene expression profile of lung cells in mice infected by SARS-Cov (GSE19137). In this study, Pearson correlation analysis was performed to construct a gene co-expression network. Time-ordered gene network modules were digged out by BFS algorithm. PageRank algorithm was used to explore HUB genes related to pneumonia infected by coronavirus. Based on the information we got, we think that cell lines infected by coronavirus might go through 5 stages, and 10 HUB genes(AKT1, CD68, CTSS, FCGR3A, HSPA8, PTPRC, UBC, VCP, PRPF31, ITPKB) might play a key role in coronavirus infection. This might provide some hints for coronavirus related research. © 2021 IEEE.

High-Flow Nasal Cannula for COVID-19 Patients: A Multicenter Retrospective Study in China

Background: High-flow nasal cannula (HFNC) may help avoid intubation of hypoxemic patients suffering from COVID-19;however, it may also contribute to delaying intubation, which may increase mortality. Here, we aimed to identify the predictors of HFNC failure among patients with COVID-19.