COVID-19 ACE2 related to hepatocellular carcinoma in single cell analyses and immuno-cancer microenvironment infiltrated with macrophage

Background: Hepatocellular carcinoma (HCC) is the second leading cause of malignancy-related mortality and the fifth most common worldwide. Immuno-cancer microenvironment (ICME) was highlighted recently because scientists want to unlock the detailed mechanism in carcinogenesis pathway and find the novel interactions in ICME. Besides, single cell analysis could mitigate the interrupted signals between cells and tissues. On the other hand, COVID-19 angiotensin I converting enzyme (ACE) previously was reported associated with cancer. However, the robust association between COVID-19 and HCC ICME is still unaddressed. Aim(s): We plan to investigate the COVID-19 ACE relevant genes to HCC ICME regarding survival. Method(s): We used Reactome for COVID-19 ACE gene pathway mapping and explored the positive relevant gene expression. DISCO website was applied for single cell analyses using the above-collected genes from Reactome. Finally, we implanted the biomedical informatics into TIMER 2.0 for ICME survival analyses. Result(s): In Fig. 1, the gene-gene interaction mapping was shown. We collected 13 genes (CPB2, ACE2, AGT, MME, ANPEP, CPA3, ENPEP, GZMH, CTSZ, CTSD, CES1, ATP6AP2, and AOPEP) for further single cell relevant analyses, in Table 1, with detailed expression level (TPM). Among the above 13 genes, AGT, GZMH, CTSZ, CTSD, CES1, and ATP6AP2 were strongly expressed in liver tissue. We then applied the initial 13 genes to TIMER 2.0 for HCC ICME 2-year survival analyses. CPA3 and GZMH low expressions with high macrophage infiltration in HCC ICME showed significantly worse 2-year cumulative survival [hazard ratio (HR):CPA3 2.21, p-value 0.018;GZMH 2.07, p-value 0.0341]. ACE2, CPB2, AGT, MME, ANPEP, ENPEP, CTSZ, CTSD, CES1, and ATP6AP2 high expressions with high macrophage infiltration in HCC ICME revealed significantly worse 2-year cumulative survival. Conclusion(s): We demonstrate that ACE2 was strongly associated with HCC clinical survival with macrophage infiltration. However, the bidirectional translational roles about ACE2 relevant genes in HCC should be documented.

Week 48 results of a phase 3 randomized controlled trial of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) vs dolutegravir 1 emtricitabine/tenofovir disoproxil fumarate (DTG 1 F/TDF) as initial treatment in HIV-1/HBV-coinfected adults (ALLIANCE)

Background/Aims: The clinical course of hepatitis B virus (HBV) infection in individuals with HIV-1 coinfection is marked by accelerated disease progression. A tenofovir-containing antiretroviral regimen is recommended in most people with HIV-1/HBV-coinfection, but there have not been randomized studies of tenofovir disoproxil fumarate (TDF) vs tenofovir alafenamide (TAF) in treatment- naive HIV-1/HBV-coinfected individuals. We report primary endpoint results from a Phase 3 study comparing bictegravir/emtricitabine/ TAF (B/F/TAF) vs dolutegravir + emtricitabine/TDF (DTG + F/TDF) at Week (W)48 in participants initiating treatment for both viruses. Method(s): Adults with HIV-1/HBV coinfection were randomized 1:1 to initiate blinded treatment with B/F/TAF or DTG + F/TDF (with placebo). Primary endpoints were the proportion of participants with HIV-1 RNA<50 copies/mL (FDA Snapshot) and plasma HBV DNA<29 IU/mL (missing = failure) at W48. Noninferiority was assessed with 95% CI (12% margin). Secondary and other endpoints included change from baseline cluster of differentiation 4 (CD4) count, proportion with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) loss/seroconversion, and alanine transaminase (ALT) normalization (AASLD criteria). Result(s): Participants (N = 243) were randomized and treated (B/F/ TAF [n = 121], DTG + F/TDF [n = 122]) from 11 countries in Asia, Europe, North, and Latin America. Baseline characteristics were median age of 32 years, 4.5% female, 88% Asian, 30% HIV-1 RNA>100,000 c/mL, 40% CD4<200 cells/lL, median HBV DNA 8.1 log10 IU/mL, 78% HBeAg+. At W48, B/F/TAF was noninferior to DTG + F/TDF at achieving HIV-1 RNA<50 copies/mL (95% vs 91%, difference 4.1%;95% CI -2.5%-10.8%;P = 0.21), with mean CD4 gains of + 200 and + 175 cells/lL, respectively. B/F/TAF was superior to DTG + F/TDF at achieving HBV DNA<29 IU/mL (63% vs 43%, difference 16.6%;95% CI 5.9%-27.3%;P = 0.0023). Participants treated with B/F/TAF vs DTG + F/TDF had numerically higher HBsAg loss (13% vs 6%;P = 0.059), HBeAg loss (26% vs 14%;P = 0.055), HBeAg seroconversion (23% vs 11%;P = 0.031), and ALT normalization (73% vs 55%;P = 0.066). The most frequent adverse events among participants treated with B/F/TAF vs DTG + F/TDF were upper respiratory tract infection (17% vs 11%), COVID- 19 (13% vs 11%), pyrexia (9% vs 12%), ALT increase (7% vs 11%), and nasopharyngitis (11% vs 4%). ALT flares (elevations at >= 2 consecutive postbaseline visits) occurred in 11 participants (7 B/F/ TAF, 4 DTG + F/TDF), and all resolved. Conclusion(s): Among adults with HIV-1/HBV-coinfection starting antiviral therapy, both B/F/TAF and DTG + F/TDF had high HIV-1 suppression at year 1, with B/F/TAF resulting in superior HBV DNA suppression and significantly more HBeAg seroconversion. Safety findings were similar between groups.

Comparison of the Effectiveness of Different Covid-19 Vaccines among Plwh

Background: Previous studies have demonstrated promising serologic responses in PLWH receiving a third dose of vaccine against SARS-CoV-2. However, real-world clinical effectiveness, especially during the pandemic caused by B.1.1.529 variant, remains less investigated. Method(s): PLWH seeking HIV care at our hospital from 2021/6 to 2022/6 were included and advised to receive the third dose of COVID-19 vaccine. Individuals were excluded from this study if they had been previously diagnosed with COVID-19. Different types of COVID-19 vaccines were available in the vaccination program, including BNT162b2, mRNA-1273 (either 50 or 100 mug), MVC-COV1901 and NVX-CoV2373 vaccines. PLWH were screening for the occurrence of COVID-19 through the reporting system of notifiable diseases of Taiwan CDC, and were tested for anti-nucleocapsid (anti-N) IgG every 1 to 3 months. Participants were followed for 180 days until the fourth dose of COVID-19 vaccination, occurrence of SARS-CoV-2 infection, seroconversion of anti-N IgG, death, or loss to follow-up, whichever occurred first. Result(s): 1,496 PLWH were included: 631 (42.2%) receiving 100 mug mRNA-1273 vaccine, 468 (31.3%) 50 mug mRNA-1273 vaccine, and 328 (21.9%) BNT162b2 vaccine, 65 (4.3%) MVC-COV1901 vaccine, and 4 (0.3%) NVX-CoV2373 vaccine for the third dose of SARS-CoV-2 vaccination. 297 (19.9%) PLWH were diagnosed with COVID-19 during the follow-up period, including 92 (14.6%) who received 100 mug mRNA-1273, 111 (23.7%) 50 mug mRNA-1273, 79 (24.1%) BNT162b2 and 15 (21.7%) either MVC-COV1901 or NVX-CoV2373;in addition, 98 PLWH had seroconversion of anti-N IgG during follow-up, including 23, 50, 19 and 6 PLWH who received 100 mug mRNA-1273, 50 mug mRNA-1273, BNT162b2, and either MVC-COV1901 or NVX-CoV2373, respectively. Similar rates of new infection with SARS-CoV-2 or seroconversion of anti-N IgG were demonstrated regardless the vaccine type of the third dose (log-rank test, p=0.46). Factors associated with a diagnosis of SARS-CoV-2 infection and seroconversion of anti-N IgG included an age >50 years (aOR, 0.67;95% CI, 0.49-0.91) and newly infected with hepatitis C virus (HCV) (aOR, 1.41;95% CI, 1.09-1.83). Conclusion(s): Our study demonstrated that clinical effectiveness of the third dose of different vaccines available to PLWH was similar in preventing SARSCoV- 2 infection or seroconversion of anti-N IgG Taiwan. PLWH aged less than 50 years and those with newly diagnosed HCV infection were at higher risk of acquiring COVID-19. Kaplan-Meier survival curve for acquiring COVID-19 or seroconversion of anti-N IgG in PLWH receiving different COVID-19 vaccination of the third dose (log-rank test, 4 groups, p = 0.46).

Restoration of Humoral Response to Covid-19 Vaccination in Rituximab-Treated Patients

Background: Previous studies had demonstrated that patients with hematologic malignancies had suboptimal antibody response after receiving COVID-19 vaccines, especially among those having previously treated with anti- CD20 monoclonal antibodies. Method(s): Adult patients with non-Hodgkin's lymphoma or chronic lymphocytic leukemia (CLL) were enrolled before receiving the second dose of SARS-CoV-2 vaccine. Determinations of anti-SARS-CoV-2 spike and nucleocapsid IgG titers were performed every 1-3 months, after they received the second and the third dose of SARS-CoV-2 vaccine, respectively. Patients were excluded from analysis if they were diagnosed with COVID-19. All serum samples were tested for anti-nucleocapsid antibody and those tested positive were excluded from subsequent analyses. Result(s): A total of 85 participants were enrolled, including 42 (49.4%) with diffused large B-cell lymphoma, and 13 (15.3) with follicular lymphoma and 9 with CLL. 72 (84.7%) participants had received anti-CD20 monoclonal antibodies, with a median interval of 24 months between last anti-CD20 treatment and the second dose of vaccine, and 21 (24.7%) had HIV infection. Factors associated with failure to achieve an anti-spike IgG titer >141 BAU/ mL within 12 weeks after the second dose of vaccine included HIV infection (adjusted odds ratio [aOR], 0.14;95% CI, 0.04-0.51), active hematologic disease (aOR, 5.50;95% CI 1.42-21.32), receipt of anti-CD20 monoclonal antibodies (aOR, 6.65;95% CI 1.52-29.07), and receipt of two doses of homologous mRNA vaccination (aOR, 0.17;95% CI 0.05-0.56). In the participants having previously treated with anti-CD20 regimen, only 8.6% achieved an antibody response ( >141 BAU/mL) in the first year, while 78.3% achieved anti-spike IgG titer > 141 BAU/mL after two years post B-cell depleting treatment. After the third dose of SARS-CoV-2 vaccine, 53.6% achieved an antispike IgG titer > 141 BAU/mL in the first year post anti-CD20 treatment. Conclusion(s): Our study demonstrated that previous treatment with anti-CD20 monoclonal antibodies was associated a lower antibody response among patients with lymphoproliferative disorders receiving two doses of SARS-CoV-2 vaccine. While two doses of SARS-CoV-2 vaccines might not be sufficient even one year apart from the last dose of rituximab, a third dose of vaccine may boost anti-spike IgG particularly in the subset of recent exposure to rituximab. Anti-spike IgG determined 1-3 months after the second (A) / third (B) dose of COVID-19 vaccine, stratified by the interval between last anti-CD20 regimen and the second / third dose of COVID-19 vaccine. (Figure Presented).

Impact of coronavirus disease 2019 on the HIV testing and health care delivery at a university hospital in Taiwan, 2020-2021

Background: To contain the coronavirus disease 2019 (Covid-19) pandemic, non-pharmacologic interventions, including lockdown and social distancing, may have adverse impact on access to HIV testing and care. This study investigated the impact of Covid-19 on HIV testing and care at a major hospital in Taiwan in 2020-2021. Method(s): The numbers of clients seeking anonymous HIV voluntary counseling and testing were compared 2 years before (2018-2019) and 2 years after Covid-19 outbreak (2020-2021). People living with HIV (PLWH) who sought care at the hospital during 2018-2021 were included to examine the status of HIV care delivery and disposition. Result(s): The annual number of HIV screening tests performed had significantly decreased from 2507 to 2794 in 2018 and 2019, respectively, to 2161 and 1737 in 2020 and 2021, respectively. The rate of discontinuation of HIV care among PLWH was 3.7% in 2019, which remained unchanged in 2020 (3.7%) and 2021 (3.8%). The respective percentage of annual plasma HIV RNA testing <2 times increased from 8.4% to 7.8% in 2018 and 2019 to 7.0% and 10.7% in 2020 and 2021, so was that of annual syphilis testing <2 times (10.1% and 8.8%-7.9% and 12.0%). The rates of plasma HIV RNA <200 copies/ml ranged from 97.0% to 98.1% in 2018-2021. Conclusion(s): During the Covid-19 pandemic, access to HIV counseling and testing was significantly limited. While the number of HIV-related testing decreased, the impact of Covid-19 on the continuity of antiretroviral therapy and viral suppression among PLWH appeared to be minimal in Taiwan. Copyright © 2022

Contemporary Practice in Telemedicine through Telecommunication Technology during COVID-19 Pandemic in Taiwan - A Single Center Experience

Background: To evaluate the feasibility, baseline characteristics, and satisfaction of patients receiving telemedicine care during the coronavirus 2019 (COVID-19) pandemic in Taiwan. Methods: We retrospectively analyzed patients during the COVID-19 pandemic between May 2021 and December 2021 in a tertiary medical center in northern Taiwan. Information on the distribution of physician divisions, patients' clinical characteristics, and patterns of prescription use in telemedicine care was analyzed. Data were extracted from both the ordinary outpatient department (OPD) and nursing home systems. Results: A total of 6587 patients (55.8% female, mean age: 57.3 +/- 25.8 years) included in our telemedicine care conducted during the pandemic COVID-19 epidemic. Those who were older, female, and patients of Internal Medicine and Family Medicine utilized telemedicine more frequently than ordinary OPD, with a high refill prescription rate (82.6%) and low mail-back prescription use (35.9%). Patients of Family Medicine comprised the majority (40.3%) of nursing home telemedicine, with lower refill pre-scription use (37.3%). Overall satisfaction was high regarding telemedicine care, physicians profession-alism, and medical problem solving (98.3% and 97.7%, respectively). Conclusion: Older age, female sex, and potentially more health conditions were associated with higher willingness to access telemedicine. We identified medical divisional and disease-based differences in prescription patterns. Copyright (c) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.

PERCUTANEOUS GASTROSTOMY PLACEMENT IN PATIENTS WITH COVID-19 INFECTION: CLINICAL OUTCOMES AND THE INFREQUENT NEED FOR LONG-TERM ENTERAL ACCESS

Introduction: The global pandemic caused by SARS-CoV-2 (COVID-19) has caused respiratory failure and prolonged intubation in millions of patients. As rates of new hospitalizations in America for COVID-19 decline, clinicians must now address maintenance management of a prolonged illness. Gastrostomy tubes provide a method for enteral feeding over a prolonged period of critical illness and recovery. Understanding outcomes in COVID-19 infected patients after gastrostomy tube placement and rates of long-term enteral feeding requirements is necessary in order to ensure proper allocation of a limited resource and guide patient decision making, and has not been previously studied. We sought to identify clinical factors associated with in-hospital mortality after gastrostomy tube placement and describe rates of long-term gastrostomy tube requirements. Methods: All adult patients undergoing gastrostomy tube placement admitted with COVID-19 between 1/1/2020-5/1/ 2021 at two of Northwell Health tertiary referral centers in New York were identified. We analyzed medical history, hospital course, procedural details, respiratory status at time of gastrostomy, long-term gastrostomy needs as well as risk factors for mortality. Results: A total of 155 patients underwent gastrostomy tube placement during the study period. The mean age was 64 years old, 61% were male, and mean duration of time from intubation to gastrostomy tube placement was 35 days. 73% of patients were ventilator dependent at time of gastrostomy tube placement. (Table 1) Overall, 27% (n=42) of patients expired during index admission after gastrostomy tube placement. In-hospital mortality was associated with ventilator dependence at time of gastrostomy placement (OR 4.8133, 95% CI, p=0.005). In-hospital mortality was not associated with age, elderly status, obesity, medications, or duration of intubation. (Table 2) Among the 113 patients discharged from index admission, post-discharge follow-up was available for 111 patients, with average follow-up time of 127 days. Among patients with follow-up, 61% (n=68) no longer required gastrostomy tube at follow-up visits. Discussion: Gastrostomy tube placement is often performed in patients with prolonged critical illness. With limited clinical clues to predict recovery from COVID- 19 induced respiratory failure, physicians should attempt to optimize respiratory status prior to gastrostomy tube placement, as ventilator dependence is associated with in-hospital mortality after gastrostomy placement. Families should be counseled that the majority of COVID-19 patients surviving the hospitalization will not require long-term gastrostomy tube feeding.(Table Presented)(Table Presented)

A Hybrid Deep Learning Network for Long-Term Travel Time Prediction in Freeways

Travel time plays a vital role in people's daily lives. It can help them not merely avoid traffic congestion but save time as well. When people need to drive to different cities by taking highways, travel time become more and more important now that they can check it to arrange better routes. Moreover, because COVID-19 are epidemic across Taiwan, people prefer to drive rather than taking public transportation. Therefore, accurate predictions of travel time is of great significance. In order to obtain precise predictions and correspond to situations in real life, we divide data into long and short sequences and create three types of dataset, including the whole year, only national holidays, and non-holidays. Additionally, on account of the interactive influence of time in different segments of the freeway, we exploit data to predict next-hour travel time instead of next 5 minutes. We introduce a deep learning model which hybrids tendency from XGBoost and recency embeddings from a fully-connected neural network, respectively. It can capture crucial features of both long and short sequences and observe implicit correlations between XGBoost and a fully-connected neural network. Extensive experiments on the dataset illustrate that our model achieves eminent performances and outperforms other state-of-the-art models. © 2021 IEEE.

EFFECTIVENESS of COVID-19 VACCINATION among PEOPLE LIVING with HIV during AN OUTBREAK

Background: A large-scale community COVID-19 outbreak occurred between April and August 2021 in Taiwan, where non-pharmaceutical interventions (NPIs) have been strictly implemented and COVID-19 vaccination program was not implemented until 1 March, 2021. Although COVID-19 vaccination is recommended for at-risk populations, the vaccine effectiveness in people living with HIV (PLWH) remains incompletely understood. We evaluated the effectiveness of COVID-19 vaccination among PLWH during a COVID-19 outbreak in Taiwan. Methods: From 1 March to 30 September, 2021, all adult PLWH without previous SARS-CoV-2 infection were included and advised to receive 2 doses of COVID-19 vaccine. The government-funded vaccination campaign provided different types of COVID-19 vaccine, including ChAdOx1 nCoV-19 (AZD1222), BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), and MVC-COV1901 (Medigen) vaccines. The primary endpoint of this study was the vaccine effectiveness in preventing COVID-19 among PLWH, which was estimated by comparing incidence rates between the unvaccinated, partially vaccinated, and fully vaccinated groups in a dynamic cohort. Results: During the study period, 3131 PLWH were included, with 99.9% on antiretroviral therapy, 99.8% being MSM and median CD4 count of 627 cells/mm3. In the dynamic cohort, 3128 PLWH contributed 516892 person-days of follow-up (PDFU) to the unvaccinated group, 2476 PLWH contributed 139163 PDFU to the partially vaccinated group, and 236 PLWH contributed 12011 PDFU to the fully vaccinated group (Table). During the follow-up, 37 PLWH (1.2%) acquired SARS-CoV-2 infections. The incidence rate of SARS-CoV-2 infection was 6.4 per 100,000 PDFU in the unvaccinated group, which decreased to 2.9 and 0 per 100,000 PDFU in the partially and fully vaccinated groups, respectively. The adjusted incidence rate ratios were 0.47 (95% CI, 0.17-1.32) in the partially vaccinated group and <0.01 in the fully vaccinated group compared with the unvaccinated group, resulting in vaccine effectiveness rates of 53.4% and 99.9% for single-and 2-dose COVID-19 vaccination, respectively. Conclusion: COVID-19 vaccination was clinically effective among PLWH during the outbreak setting where NPIs were strictly implemented.

Build Real Estate Evaluation Model based on Customer Requirement after COVID-19

In Taiwan, real estate is not only the high price product but also is necessities. Every family needs real estate to live. Maybe, some citizens decide to rent house in the short period. But, major part of citizen will purchase real estate in the future. In past researches, evaluating performance of real estate mainly consider the function and condition of this house such as location, house type, floor, building age etc. However, the demand of specific consumer is importance factors to evaluate the performance of this customer. Especially, the requirement of real estate for consumer has been changed after COVID-19. The goal of this study is to build the evaluation model and relative criteria to evaluate performance of real estate in order to fit with the requirement of specific real estate consumer. Case study will be implemented for readers realize proposed method. Sensitive analysis will be executed and proposed method will be compared with traditional multi criteria method to justify the usefulness of this method. Some conclusion and future research will be taken over as ending. © 2022, World Scientific and Engineering Academy and Society. All rights reserved.

Perception of youth in East Malaysia (Sabah) towards the Malaysia national covid-19 immunisation programme (PICK)

As a measure to curb the deadly Covid-19 virus, the Malaysian government has implemented the National Covid-19 Immunisation Programme (PICK) in early February 2021 to achieve herd immunity by February 2022. However, several factors have influenced the success of the programme, including accessibility, the role of social media, religious concerns and a variety of other reasons. Therefore, this paper determines the factors that influence the perceptions of the youth in East Malaysia (Sabah) towards PICK. This study uses a self-administered questionnaire through social media applications. A total of 814 respondents consisting of youths in Sabah aged between 18-40 years have been sampled. The raw data have been descriptively analysed (K-Means Clustering, Mean & frequency) and inferentially examined (Mann-Whitney U Test). The respondents’ perceptions are grouped into two clusters: Cluster 1 (54.3%) who exhibited vaccine hesitancy, and Cluster 2 (45.7%), who demonstrated positive perceptions towards the programme. Based on the cluster analysis, this study discovered that most of the respondents in Cluster 1 are inclined to not participate in PICK due to several factors, such as Safety (M=3.25, SD=0.578), Communication (M=3.37, SD=0.441), Psychology (M=3.40, SD=0.568) and Milieu (M=3.32, SD=0.545). The cluster analysis is important to determine different patterns of perceptions of youth in Sabah. This paper argues that if vaccine hesitancy, as indicated in the cluster 1 is not properly addressed, the government’s target to achieve herd immunity will not be successful. Apparently, information issues and management through the mainstream media are extremely important, especially in handling critical matters. As a result, there is a need to revisit the mainstream media's role and determine the causes that contribute to the youths’ rejection of government-sponsored initiatives. The findings will be useful for the government so as to implement the necessary policies, adjustments and improvements to future health regulations or campaigns, especially in addressing issues of misinformation related to health management in the digital era. © 2022, Mahidol University - ASEAN Institute for Health Development. All rights reserved.

CRYO-RALIB - A MODULAR LIBRARY FOR ACCELERATING ALIGNMENT IN CRYO-EM

Thanks to GPU-accelerated processing, cryo-EM has become a rapid structure determination method that permits capture of dynamical structures of molecules in solution, which has been recently demonstrated by the determination of COVID-19 spike protein in March, shortly after its breakout in late January 2020. This rapidity is critical for vaccine development in response to the emerging pandemic. Compared to the Bayesian-based 2D classification widely used in the workflow, the multi-reference alignment (MRA) is less popular. It is time-consuming despite its superior in differentiating structural variations. Interestingly, the Bayesian approach has higher complexity than MRA. We thereby reason that the popularity of Bayesian is gained through GPU acceleration, where a modular acceleration library for MRA is lacking. Here, we introduce a library called Cryo-RALib that expands the functionality of CUDA library used by GPU ISAC. It contains a GPU-accelerated MRA routine for accelerating MRA-based classification algorithms. In addition, we connect the cryo-EM image analysis with the python data science stack to make it easier for users to perform data analysis and visualization. Benchmarking on the TaiWan Computing Cloud (TWCC) shows that our implementation can accelerate the computation by one order of magnitude. The library is available at https://github.com/phonchi/Cryo-RAlib. © 2021 IEEE

A descriptive analysis of 2020 California Occupational Safety and Health Administration COVID-19-related complaints (preprint)

COVID-19 mortality disproportionately affected specific occupations and industries. The Occupational Safety and Health Administration (OSHA) protects the health and safety of workers by setting and enforcing standards for working conditions. Workers may file OSHA complaints about unsafe conditions. Complaints may indicate poor workplace safety during the pandemic. We evaluated COVID-19-related complaints filed with California (Cal)/OSHA between January 1, 2020 and December 14, 2020 across seven industries. To assess whether workers in occupations with high COVID-19-related mortality were also most likely to file Cal/OSHA complaints, we compared industry-specific per-capita COVID-19 confirmed deaths from the California Department of Public Health with COVID-19-related complaints. Although 7,820 COVID-19-related complaints were deemed valid by Cal/OSHA, only 627 onsite inspections occurred and 32 citations were issued. Agricultural workers had the highest per-capita COVID-19 death rates (402 per 100,000 workers) but were least represented among workplace complaints (44 per 100,000 workers). Health Care workers had the highest complaint rates (81 per 100,000 workers) but the second lowest COVID-19 death rate (81 per 100,000 workers). Industries with the highest inspection rates also had high COVID-19 mortality. Our findings suggest complaints are not proportional to COVID-19 risk. Instead, higher complaint rates may reflect worker groups with greater empowerment, resources, or capacity to advocate for better protections. This capacity to advocate for safe workplaces may account for relatively low mortality rates in potentially high-risk occupations. Future research should examine factors determining worker complaints and complaint systems to promote participation of those with the greatest need of protection.

COVID-19, Public Transportation, and Public Health Communication

Although necessary for controlling the COVID-19 pandemic, public health and social measures (PHSMs) that restricted public transportation in cities diverted people to private motorized vehicle use, a trend that persisted despite evidence that public transit represented a low-risk COVID transmission environment. Mass transit and active modes of transportation in cities are key for preventing noncommunicable diseases (NCDs) and injuries and for reducing traffic-related emissions. Under the Partnership for Healthy Cities, Buenos Aires, Bangkok, Cali, Ho Chi Minh City, Istanbul, and Kyiv implemented communication campaigns to encourage and inform citizens how to safely resume use of public transportation and alternative safe, active transportation. Between July 2020 and March 2021, campaigns reinforced adherence to the 3Ws (wash hands, watch distance, wear a mask), and promoted walking and cycling as commuting alternatives. In total, the cities conducted social media campaigns, displayed posters (605), billboards (50), and videos (15) at bus, train, and bike stations, cycling lanes, and hospitals. Posters at bus stops in Buenos Aires were visible to 286,000 passengers/day, 16% of the city's passengers. Cali's social media campaign reached 1.7 million people. 70 km of new cycle lane added 1,527 cycling trips, preventing an estimated 266,920 tons of CO2 emissions. Bangkok's social media campaign reached 511,660 people and videos on television reached 1.75 million people. Ho Chi Minh City reached 48,000 passengers/day on public transport and totaled 4 million impressions on social media. Istanbul's social media campaign reached 20,000 people, promoted messaging on 50 billboards across the city's cycling network, and 4 Turkish cities replicated the campaign. Kyiv reached 800,000 transit passengers with 2,200 posters in metro stations. Simple and clear messaging is key for crisis communication and is essential to address overlapping public health and mobility priorities. Key messages Cities are at the forefront to use communication campaigns to promote PHSMs and transport alternatives when adapting COVID-19 responses to address negative impact on urban transport and mobility. Simple and clear messaging is key for crisis communication and is essential to address overlapping public health and mobility priorities.

A novel pseudovirus-based mouse model of SARS-CoV-2 infection to test COVID-19 interventions

BACKGROUND: The spread of SARS-CoV-2, the virus that causes Coronavirus Disease 2019 (COVID-19), has been characterized as a worldwide pandemic. Currently, there are few preclinical animal models that suitably represent infection, as the main point of entry to human cells is via human angiotensin-converting enzyme 2 (ACE2) which is not present in typical preclinical mouse strains. Additionally, SARS-CoV-2 is highly virulent and unsafe for use in many research facilities. Here we describe the development of a preclinical animal model using intranasal administration of ACE2 followed by non-infectious SARS-CoV-2 pseudovirus (PsV) challenge. METHODS: To specifically generate our SARS-CoV-2 PsV, we used a lentivirus system. Following co-transfection with a packaging plasmid containing HIV Gag and Pol, luciferase-expressing lentiviruses, and a plasmid carrying the SARS-CoV-2 spike protein, SARS-CoV-2 PsVs can be isolated and purified. To better understand and maximize the infectivity of SARS-CoV-2 PsV, we generated PsV carrying spike protein variants known to have varying human ACE2 binding properties, including 19 deletion (19del) and 19del + D614G. RESULTS: Our system demonstrated the ability of PsVs to infect the respiratory passage of mice following intranasal hACE2 transduction. Additionally, we demonstrate in vitro and in vivo manipulability of our system using recombinant receptor-binding domain protein to prevent PsV infection. CONCLUSIONS: Our PsV system is able to model SARS-CoV-2 infections in a preclinical mouse model and can be used to test interventions or preventative treatments. We believe that this method can be extended to work in various mouse strains or to model infection with different coronaviruses. A simple in vivo system such as our model is crucial for rapidly and effectively responding to the current COVID-19 pandemic in addition to preparing for future potential coronavirus outbreaks.