A Dynamic-Static Dual Input Deep Neural Network Algorithm for Diagnosing COVID-19 by Cough

The COVID-19 (corona virus disease 2019) has caused serious impacts worldwide. Many scholars have done a lot of research on the prevention and control of the epidemic. The diagnosis of COVID-19 by cough is non-contact, low-cost, and easy-access, however, such research is still relatively scarce in China. Mel frequency cepstral coefficients (MFCC) feature can only represent the static sound feature, while the first-order differential MFCC feature can also reflect the dynamic feature of sound. In order to better prevent and treat COVID-19, the paper proposes a dynamic-static dual input deep neural network algorithm for diagnosing COVID-19 by cough. Based on Coswara dataset, cough audio is clipped, MFCC and first-order differential MFCC features are extracted, and a dynamic and static feature dual-input neural network model is trained. The model adopts a statistic pooling layer so that different length of MFCC features can be input. The experiment results show the proposed algorithm can significantly improve the recognition accuracy, recall rate, specificity, and F1-score compared with the existing models. © 2023 Chinese Institute of Electronics. All rights reserved.

Research on Chest X-Ray Image Diagnosis of Covid-19 Based on Improved ResNet

With the outbreak of covid-19 in 2020, timely and effective diagnosis and treatment of each covid-19 patient is particularly important. This paper combines the advantages of deep learning in image recognition, takes RESNET as the basic network framework, and carries out the experiment of improving the residual structure on this basis. It is tested on the open source new coronal chest radiograph data set, and the accuracy rate is 82.3%. Through a series of experiments, the training model has the advantages of good generalization, high accuracy and fast convergence. This paper proves the feasibility of the improved residual neural network in the diagnosis of covid-19. © 2023 SPIE.

COVID-19 lockdown anxiety harms newcomers' job satisfaction: A cross-lagged panel analysis during snap lockdowns in China

The COVID-19 pandemic may have been a difficult time to join a new organization. Drawing on the feelings-as-information theory, this study explores how COVID-19 lockdown anxiety influenced newcomers' job satisfaction during their first few months of work. We tested 357 new employees working in 84 cities across China. We conducted a longitudinal study, and participants were invited to complete the same survey at two time points. Cross-lagged panel analysis was conducted to test our hypotheses. We confirmed that COVID-19 lockdown anxiety at Time 1 predicted less job satisfaction at Time 2, whereas the data did not support the idea of reverse causality. These findings suggest public health crises like the pandemic can impact newcomers' job satisfaction, especially during China's Zero-Covid Policy.

Network Public Opinion Detection During the Coronavirus Pandemic: A Short-Text Relational Topic Model

Online social media provides rich and varied information reflecting the significant concerns of the public during the coronavirus pandemic. Analyzing what the public is concerned with from social media information can support policy-makers to maintain the stability of the social economy and life of the society. In this article, we focus on the detection of the network public opinions during the coronavirus pandemic. We propose a novel Relational Topic Model for Short texts (RTMS) to draw opinion topics from social media data. RTMS exploits the feature of texts in online social media and the opinion propagation patterns among individuals. Moreover, a dynamic version of RTMS (DRTMS) is proposed to capture the evolution of public opinions. Our experiment is conducted on a real-world dataset which includes 67,592 comments from 14,992 users. The results demonstrate that, compared with the benchmark methods, the proposed RTMS and DRTMS models can detect meaningful public opinions by leveraging the feature of social media data. It can also effectively capture the evolution of public concerns during different phases of the coronavirus pandemic. © 2021 Association for Computing Machinery.

Application of ultrasound-guided peripheral arterial puncture in severe patients with Coronavirus disease 2019 under three-level protection

Objective To explore the application of ultrasound-guided arterial line placement in severe patients with COVID-19. Methods From February to April 2020, we retrospectively collected and analyzed the clinical data of critical patients with COVID-19 with an indwelling peripheral arterial catheter treated by the medical team of Peking Union Medical College Hospital. Patients with ultrasound-guided peripheral arterial catheterization were taken as the study group, while patients whose arterial catheter was placed by traditional palpation were taken as the control group. The puncture condition and complication rate were compared between the two groups. Results A total of 60 severe patients with COVID-19 who met the inclusion and exclusion criteria were enrolled in this study. There were 30 cases in the study group and 30 cases in the control group. In the study group, the success rate of the first catheterization of the peripheral artery (63.3% vs. 26.7%) and the total puncture success rate [(79.43+/- 25.79)% vs. (53.07+/-30.21)%] were higher than those in the control group (all P < 0.05), the puncture times(1.43+/-0.56 vs. 2.50+/-1.28) were less than those of the control group (P < 0.05). The rates of 24-hour disuse (6.7% vs. 30.0%), local hematoma (10.0% vs. 36.7%), occlusion, and tortuous (3.3% vs. 40.0%) in the study group were lower than those in the control group (all P < 0.05). Conclusion Under the three-level protection, ultrasound-guided arterial catheter placement for severe patients with COVID-19 can improve the success rate of catheter placement, reduce puncture times, and reduce the incidence of complications.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.

Examining the effects of disinformation and trust on social media users' COVID-19 vaccine decision-making

Purpose: Disinformation on social media is a serious issue. This study examines the effects of disinformation on COVID-19 vaccination decision-making to understand how social media users make healthcare decisions when disinformation is presented in their social media feeds. It examines trust in post owners as a moderator on the relationship between information types (i.e. disinformation and factual information) and vaccination decision-making. Design/methodology/approach: This study conducts a scenario-based web survey experiment to collect extensive survey data from social media users. Findings: This study reveals that information types differently affect social media users' COVID-19 vaccination decision-making and finds a moderating effect of trust in post owners on the relationship between information types and vaccination decision-making. For those who have a high degree of trust in post owners, the effect of information types on vaccination decision-making becomes large. In contrast, information types do not affect the decision-making of those who have a very low degree of trust in post owners. Besides, identification and compliance are found to affect trust in post owners. Originality/value: This study contributes to the literature on online disinformation and individual healthcare decision-making by demonstrating the effect of disinformation on vaccination decision-making and providing empirical evidence on how trust in post owners impacts the effects of information types on vaccination decision-making. This study focuses on trust in post owners, unlike prior studies that focus on trust in information or social media platforms. © 2023, Emerald Publishing Limited.

More than a work of art: Exploring restorative experience in tourism at the Net Master's Garden, Suzhou, China

Classical gardens in Suzhou were designed not only as an art of work but also for use in daily life. This study explored the tourist experience in the Net Master's Garden in Suzhou, China, as a restorative environment based on attention restoration theory. Analysis of the results of the on-site questionnaire survey revealed three dimensions of perceived restorative characteristics: "fascination-compatibility", "being away" and "extent". Using multiple correspondence analysis, we also found three types of restorative experiences influenced by different activities and landscape impressions: a salient sightseeing experience, an immersive experience and a low restorative experience. In a salient sightseeing experience, when strolling visitors enjoyed the varying picturesque views, they perceived "fascination-compatibility" and "being away" more strongly. In an immersive experience, the visitors tended to do leisure activities, acquired a holistic sense of the garden, and perceived "extent" and "fascination-compatibility" more strongly. Visitors who acted more passively tended to perceive a low restorative experience. We think this study provides clues to expanding the meaning of garden visits from "appreciation" to "restoration" for both garden management and garden visitors. The classical garden might play a more important role in pleasure-derived leisure experiences in local areas, especially during times of the COVID-19 pandemic.

Covid-19 Bivalent Booster Effectiveness in People with and without Immune Dysfunction

Background: Data on the effectiveness of the bivalent booster vaccine against COVID-19 breakthrough infection and severe outcomes is limited. Method(s): Using patient-level data from 54 sites in the U.S. National COVID Cohort Collaborative (N3C), we estimated bivalent booster effectiveness against breakthrough infection and outcomes between 09/01/2022 (bivalent vaccine approval date) to 12/15/2022 (most recent data release of N3C) among patients completed 2+ doses of mRNA vaccine. Bivalent booster effectiveness was evaluated among all patients and patients with and without immunosuppressed/compromised conditions (ISC;HIV infection, solid organ/ bone marrow transplant, autoimmune diseases, and cancer). We used logistic regression models to compare the odds of breakthrough infection (COVID-19 diagnosis after the last dose of vaccine) and outcomes (hospitalization, ventilation/ECMO use, or death <=28 days after infection) in the bivalent boosted vs. non-bivalent boosted groups. Models controlled for demographics, comorbidities, geographic region, prior SARS-CoV-2 infection, months since the last dose of non-bivalent vaccine, and prior non-bivalent booster. Result(s): By 12/15/2022, 2,414,904 patients had received 2+ doses of mRNA vaccination, 75,873 of them had received a bivalent booster vaccine, and 24,046 of them had a breakthrough infection. At baseline, the median age was 52 (IQR 36-67) years, 40% male, 63% white, 10% Black, 12% Latinx, 3.5% Asian American/Pacific Islander, and 14% were patients with ISC. Patients received a bivalent booster were more likely to be female and had comorbidities. Bivalent booster was significantly associated with reduced odds of breakthrough infection and hospitalization (Figure). The adjusted odds ratios comparing bivalent vs. non-bivalent group were 0.28 (95% CI 0.25, 0.32) for all patients and 0.33 (95% CI: 0.26, 0.41) for patients with ISC. Compared to the nonbivalent group, the bivalent group had a lower incidence of COVID-19-related hospitalization (151 vs. 41 per 100,000 persons), invasive ventilation/ECMO use (7.5 vs. 1.3 per 100,000 persons), or death (11 vs. 1.3 per 100,000 persons) in all patients during the study period;the incidence of severe outcomes after bivalent boosting was similar among patients with and without ISC. Conclusion(s): A bivalent booster vaccine was highly effective against COVID-19 breakthrough infection and severe outcomes among patients received 2+ doses of mRNA vaccine and offered similar protection in patients with and without ISC. (Figure Presented).

Analytical and biomedical applications of microfluidics in traditional Chinese medicine research

Traditional Chinese medicine (TCM) has significant benefits in the prevention and treatment of diseases due to its unique theoretical system and research techniques. However, there are still key issues to be resolved in the full interpretation and use of TCM, such as vague active compounds and mechanism of action. Therefore, it is promising to promote the research on TCM through innovative strategies and advanced cutting-edge technologies. Microfluidic chips have provided controllable unique platforms for biomedical applications in TCM research with flexible composition and large-scale integration. In this review, the analysis and biomedical applications of microfluidics in the field of TCM are highlighted, including quality control of Chinese herbal medicines (CHMs), delivery of CHMs, evaluation of pharmacological activity as well as disease diagnosis. Finally, potential challenges and prospects of existing microfluidic technologies in the inheritance and innovation of TCM are discussed.Copyright © 2022 Elsevier B.V.

Therapeutic Effect of Gegentang Granules on Mouse Model with hCoV-229E Pneumonia and Hanshi Yidu Xifei Syndrome.

Objective:To determine the therapeutic effect of Gegentang granules on a disease-syndrome mouse model combining human coronavirus 229EhCoV-229Epneumonia with Hanshi Yidu Xifei syndrome in vivo. Method(s): Mice were randomly divided into normal group,infection group,cold-dampness group,model group,chloroquine phosphate group0.18 g.kg-1,interferon-alpha2bIFN-alpha2bgroup1.83x106 U.kg-1, Gegentang granules high-dose and low-dose groups6.6,3.3 g.kg-1with 10 mice in each group. Cold-dampness environment and hCoV-229E infection were used for modeling,and the general status and lung index of mice in each group were observed. The viral load in lung tissue was detected by real-time fluorescent quantitative polymerase chain reactionReal-time PCR,the pathological changes in lung tissue were evaluated by hematoxylin-eosinHEstaining,the levels of serum gastrointestinal hormones and inflammatory factors in lung tissue were detected by enzyme-linked immunosorbent assayELISA,and the percentage of peripheral blood lymphocytes was detected by flow cytometry. Result(s):Comparing with model group,Gegentang granules could significantly alleviate the physical signs of Hanshi Yidu Xifei syndrome,including listlessness,weakness of limbs,sticky stool,etc. Comparing with model group,Gegentang granules high-dose group significantly reduced lung index,histopathological score of interstitial lung and bronchus,and the level of serum motilinP< 0.05,P<0.01,two doses of Gegentang granules could significantly increase the level of serum gastrinP< 0.05,P<0.01,the percentage of CD4+ ,CD8+ T lymphocytes in peripheral bloodP<0.05,P<0.01,and the level of tumor necrosis factor-alphaTNF-alphain lung tissue was significantly decreasedP<0.01,and the level of interleukin-6IL-6showed decreasing tendency. Conclusion(s): Gegentang granules has therapeutic effect on model mice. It can improve the appearance and behavior characterization,regulate the level of gastrointestinal hormones,decrease lung index and histopathological score,and possibly play an immunomodulatory role by inhibiting the expression of inflammatory cytokines in lung tissue and restoring the percentage of peripheral blood lymphocytes.Copyright © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Hiv Viral Load and Time-to-Covid-19 Vaccination among People Who Inject Drugs

Background: Structural barriers to care among people who inject drugs (PWID) raise concerns about disproportionate access to essential services like COVID-19 vaccination. Given the heightened risk of serious complications resulting from SARS-CoV-2 infection, particularly among people living with HIV (PWH) with unsuppressed viral load, its critical to understand the role of HIV care among other factors associated with timely vaccination. We aimed to assess the role of HIV care on COVID-19 vaccination uptake among PWID. Method(s): We included 960 adult PWUD participating in the ALIVE (AIDS Linked to the Intravenous Experience) longitudinal study in Baltimore, Maryland, who were alive and in follow up as of April 2020. We ed COVID-19 vaccination data from electronic medical records linked to participants via the regional health information exchange. We conducted survival analysis to estimate time from broad vaccine eligibility (April 6, 2021) to completion of the COVID-19 vaccination primary series by HIV status (uninfected, virally suppressed PWH [HIV-RNA< 400 copies/mL], unsuppressed PWH [HIV-RNA >400 copies/mL]) and Cox Proportional Hazards regression to adjust for potential confounding by health status and substance use variables. Result(s): Our sample (N=960) was primarily black (77%) and male (65%) with 31% reporting recent injection drug use. Among 265 people living with HIV (PWH) in our sample (27%), 84% were virally suppressed. As of February 22, 2022, 539 (56%) completed the primary series, 131 (14%) received a single dose of mRNA vaccine and 290 (30%) remained unvaccinated. Compared to PWID without HIV, virally suppressed PWH were significantly more likely to complete the primary series (Adjusted Hazard Ratio [AHR]:1.23,95% Confidence Interval [95%CI]:1.07,1.50), while PWH with higher viral loads were less likely (AHR:0.72,95%CI:0.45,1.16). Sensitivity analyses with a subsample restricted to PWH confirmed significant differences in time to vaccination by viral load status (log-rank p-value: 0.016) and modeling with an origin of Dec. 12, 2020, yielded similar adjusted results. Conclusion(s): Among PWID with HIV, viral suppression is associated with quicker vaccination uptake, likely due to HIV care engagement. Alongside interventions targeting social determinants (e.g. low income, homelessness) and substance use behaviors (e.g. active injecting, stimulant use), targeted improvements along the HIV care continuum and other efforts to engage PWID may bolster vaccine uptake. Figure 1. Kaplan-Meier survival curve demonstrating time-to-vaccination (completion of COVID-19 primary series) in weeks by HIV status accounting for viral load (HIV-, HIV+ [VL <= 400 cells/muL], HIV+ [VL > 400 cells/muL]), including results for Log-rank tests for homogeneity among strata (p-value).

Evaluation Effectiveness of in Vitro Cultivation of Bezoar on Mouse Model Combining Disease with Syndrome of Coronavirus Pneumonia with Yidu Xifei Syndrome.

Objective:To determine the therapeutic effect of in vitro cultivation of bezoar on a mouse model adding disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome. Method: BALB/c mice were randomly divided into six groups according to their weight grade:normal group,HCoV-229E infection group,cold and damp group,a mouse model combining disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome,and high and low dose group of in vitro cultivation of bezoar. The combination model of human coronavirus pneumonia with Yidu Xifei syndrome mice was established by the method of cold dampness condition stimulation+coronavirus HCoV-229E infection. In vitro cultivation of bezoar (0.128,0.064 g.kg-1 )was administrated by gavage for 3 days from the day of infection. The observation indexes included:general state observation of mice,inhibition rate of lung index and lung index of mice. Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR)was used to detect the viral load in the lung tissues of mice. Serum levels of motilin(MTL),gastrin(GAS),and cytokines interleukin(IL)-10,IL-6, tumor necrosis factor-alpha(TNF-alpha)and interferon-gamma(IFN-gamma)in lung tissue of mice were determined by enzyme-linked immunosorbent assay(ELISA). The percentages of CD4+ T lymphocytes,CD8+ T lymphocytes and B lymphocytes in the blood of mice were determined by flow cytometry. Result:The high and low dose group of in vitro cultivation of bezoar can significantly improve the general condition of model mice. Compared with blank group, model group mice lung index increased significantly(P<0.01), nucleic acids significantly increased expression of lung tissue in mice(P<0.01),significantly higher serum MTL content in mice,GAS content significantly decreased(P<0.05,P<0.01),lung tissue cells in the immune factor TNF-alpha,IL-10 and IL-6 were significantly increased(P<0.01),peripheral blood lymphocyte CD4+ T cells in mice,The percentages of CD8+ T cells and B cells were significantly decreased(P<0.01). Compared with model group, in vitro cultivation bezoar mice lung index of high and low dose group were significantly lower(P<0.01),the lung tissue of mice express nucleic acid decreased significantly(P<0.01),MTL content decreased significantly(P< 0.01),the lung tissue of mice in the IL-6,IL-10,the TNF-alpha,IFN-gamma levels were significantly lower(P<0.01), in vitro cultivation bezoar high dose group can significantly increase the CD4+ T cell percentage(P<0.05),in vitro cultivation bezoar can to a certain extent reduce model mice lung inflammatory exudation,pulmonary interstitial edema,as well as blood stasis symptoms. Conclusion:In vitro cultivation of bezoar has a significant therapeutic effect on a mice model adding disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome. It can be treated by reducing the lung index of the model mice,improving the pathological damage of the lung tissue,adjusting the immune effective and inhibiting the clearing of inflammatory factors,and to provide a laboratory basis for clinical medication.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Analysis of environmental performance and interactivity of ports and regions

The port is the basic support for regional economic development and the global allocation of resources. With the rapid development of China's economy and growing ecological awareness, the assessment of port and regional efficiency has received unprecedented attention. In the current context of the COVID-19 pandemic, how the port and its region will be coordinated under the common goal of development has become a hot topic. In this study, the port subsystem (P-subsystem) and the regional subsystem (R-subsystem) are unified into the port–region system (PR system), and a new meta-frontier two-stage data envelopment analysis model is constructed to evaluate the P-subsystem efficiency and the environmental efficiency of the PR system. This research also measures the port–regional coordination level using the coordination index and explores the inefficiency of the PR system with the help of management improvement and technology improvement indices. Main results show that the overall efficiency of the Chinese PR system is increasing. The technological level of the PR system in coastal areas is close to the optimal level. The inefficiency of the Chinese PR system is mainly affected by management inefficiency. The coordination of regional and port development in China is also poor. Finally, on the basis of the research findings, this study provides targeted countermeasure suggestions to promote the efficiency enhancement and coordinated development of the PR system. © 2023 Elsevier Ltd

Seeing the Patient as a Person: Reflections from the Implementation of the Meet My Loved One Project (Sch459)

Outcomes: 1. Utilizing a discussion-based approach, participants will self-report the ability to inject humanism and dignity into patient care by utilizing and incorporating initiatives like the MMLO into their practice. 2. Evaluate and analyze the impact of initiatives such as the MMLO project on patients' families and on healthcare workers. Purpose(s): As COVID-19 surged, patients and healthcare workers (HCWs) experienced diminished recognition of patient personhood and increased burnout. Adapted from the University of Alabama's MMLO initiative, the UNC palliative care team implemented the MMLO initiative in the early stages of the COVID-19 pandemic to elicit personhood, restore patient dignity, and provide patient-centered care. The team also aimed to understand the MMLO's effect on HCWs and patient care. Method(s): Primary teams identified candidates and made referrals. The MMLO team called patients' loved ones to explain the initiative and ask questions from the MMLO form. Respondents' answers were posted at patients' bedsides along with collected patient photos. Survey data were collected from participants immediately prior to and 2-7 days after form completion. Quantitative and qualitative data from HCWs' experiences with MMLO were also collected after implementation. Result(s): Using a Mann-Whitney test, there is a significant improvement in median satisfactory level between the pre- and post-MMLO surveys of patients' loved ones regarding their perception of the care provided. Of the 21 HCWs surveyed, 96% agreed they learned something about their patients, and 58% stated they learned something about themselves after taking care of patients with a completed MMLO. Additionally, 90% of the HCWs stated that the MMLO increased their connectedness to their patients, and 76% stated that this project will positively change their future care of patients. Implications: The MMLO revealed the importance of connectedness and reflection. For HCWs, the connectedness to patients at a time of heightened stress reinforced a sense of purpose. Reflections concluded that the MMLO "visualized that people care" and provided a new lens for how others see the medical profession. Given these positive outcomes, we hope to universally implement the MMLO throughout the UNC Health Care system and promote it more broadly.Copyright © 2023

Assessment of respiratory disease infection risk and natural ventilation intervention countermeasures in teaching spaces: A campus case study

The risk of indoor respiratory disease transmission can be significantly reduced through interventions that target the built environment. Several studies have successfully developed theoretical models to calculate the effects of built environment parameters on infection rates. However, current studies have mainly focused on calculating infection rate values and comparing pre- and post-optimization values, lacking a discussion of safe baseline values for infection rates with risk class classification. The purpose of this paper is to explore the design of interventions in the built environment to improve the ability of buildings to prevent virus transmission, with a university campus as an example. The study integrates the Wells-Riley model and basic reproduction number to identify teaching spaces with high infection risk on campus and proposes targeted intervention countermeasures based on the analysis of critical parameters. The results showed that teaching buildings with a grid layout pattern had a higher potential risk of infection under natural ventilation. By a diversity of building environment interventions designed, the internal airflow field of classrooms can be effectively organized, and the indoor virus concentration can be reduced. We can find that after optimizing the building mentioned above and environment intervention countermeasures, the maximum indoor virus infection probability can be reduced by 22.88%, and the basic reproduction number can be reduced by 25.98%, finally reaching a safe level of less than 1.0. In this paper, we support university campuses' respiratory disease prevention and control programs by constructing theoretical models and developing parametric platforms. © 2023 Elsevier Ltd

Analysis on occurrence and risk factors of drug-induced liver injury in patients with novel coronavirus pneumonia.

Objective: To analyze the occurrence and risk factors of drug-induced liver injury (DILI) in patients with novel coronavirus pneumonia (COVID-19). Method(s): The medical records of patients with COVID-19 who were discharged from the First Hospital of Changsha from January 15 to March 7, 2020 were collected and the patients were divided into the DILI group and the non-DILI group based on DILI diagnostic criteria. Basic information of patients in the 2 groups including gender, age, underlying diseases, classification of COVID-19, liver function test results on admission and after medication, drug use, time to DILI onset after medication, and treatments and outcomes of DILI were recorded and compared. The incidence of DILI in patients with COVID-19 was calculated, and the factors whose P<0.05 in inter-group comparison were included in the multivariate logistic regression analysis to calculate the odds ratio (OR) and95% confidence interval (CI). Result(s): A total of 203 discharged patients with COVID-19 met the inclusion criteria. Of them, 36 patients developed DILI, the incidence was 17.73%. Between the DILI group and the non-DILI group (167 patients), the differences were statistically significant in gender distribution, proportion of patients with underlying diseases such as hypertension, fatty liver, and cholelithiasis, clinical classification of COVID-19, and the kinds of drug use (P<0.05 for all), but not statistically significant in levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) on admission (P>0.05 for all). The levels of ALT and AST in patients in the DILI group after medication were higher than those before medication, and the differences were statistically significant (P<0.001 for all). The median time for time to DILI onset after medication was 8 (6, 11) days and none of the patients had obvious clinical signs and symptoms. After the occurrence of DILI, 16 patients stopped the suspicious drugs and received liver-protective treatments, 6 patients only stopped the suspicious drug without additional treatments, and 14 patients received liver-protective treatments without drug withdrawal. Among the 36 patients in the DILI group, liver function were improved in 34 patients but did not returned to normal in 2 patients when they were discharged from the hospital. Multivariate logistic regression analysis showed that male (OR=3.939, 95%CI: 1.426-10.883, P=0.008), being severe and critical in clinical classification (OR=6.433, 95%CI: 2.411-17.162, P<0.001), fatty liver (OR=3.815, 95%CI: 1.298-11.215, P=0.015), cholelithiasis (OR=16.347, 95%CI: 1.267-210.990, P=0.032), and the kinds of drug use >8 (OR=10.181, 95%CI: 3.606-28.744, P<0.001) were the independent risk factors of DILI in patients with COVID-19. Conclusion(s): The incidence of DILI in COVID-19 patients discharged from the First Hospital of Changsha is 17.73%. Male, being severe and critical in clinical classification of COVID-19, fatty liver, cholelithiasis, and the kinds of drug use >8 are the independent risk factors for DILI patients with COVID-19.Copyright © 2020 by the Chinese Medical Association.

An improved method for determining frequency of multiple variants of SARS-CoV-2 in wastewater using qPCR assays.

Wastewater-based surveillance has become an effective tool around the globe for indirect monitoring of COVID-19 in communities. Variants of Concern (VOCs) have been detected in wastewater by use of reverse transcription polymerase chain reaction (RT-PCR) or whole genome sequencing (WGS). Rapid, reliable RT-PCR assays continue to be needed to determine the relative frequencies of VOCs and sub-lineages in wastewater-based surveillance programs. The presence of multiple mutations in a single region of the N-gene allowed for the design of a single amplicon, multiple probe assay, that can distinguish among several VOCs in wastewater RNA extracts. This approach which multiplexes probes designed to target mutations associated with specific VOC's along with an intra-amplicon universal probe (non-mutated region) was validated in singleplex and multiplex. The prevalence of each mutation (i.e. VOC) is estimated by comparing the abundance of the targeted mutation with a non-mutated and highly conserved region within the same amplicon. This is advantageous for the accurate and rapid estimation of variant frequencies in wastewater. The N200 assay was applied to monitor frequencies of VOCs in wastewater extracts from several communities in Ontario, Canada in near real time from November 28, 2021 to January 4, 2022. This includes the period of the rapid replacement of the Delta variant with the introduction of the Omicron variant in these Ontario communities in early December 2021. The frequency estimates using this assay were highly reflective of clinical WGS estimates for the same communities. This style of qPCR assay, which simultaneously measures signal from a non-mutated comparator probe and multiple mutation-specific probes contained within a single qPCR amplicon, can be applied to future assay development for rapid and accurate estimations of variant frequencies.

Evaluation Effectiveness of in Vitro Cultivation of Bezoar on Mouse Model Combining Disease with Syndrome of Coronavirus Pneumonia with Yidu Xifei Syndrome.

Objective:To determine the therapeutic effect of in vitro cultivation of bezoar on a mouse model adding disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome. Method: BALB/c mice were randomly divided into six groups according to their weight grade:normal group,HCoV-229E infection group,cold and damp group,a mouse model combining disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome,and high and low dose group of in vitro cultivation of bezoar. The combination model of human coronavirus pneumonia with Yidu Xifei syndrome mice was established by the method of cold dampness condition stimulation+coronavirus HCoV-229E infection. In vitro cultivation of bezoar (0.128,0.064 g.kg-1 )was administrated by gavage for 3 days from the day of infection. The observation indexes included:general state observation of mice,inhibition rate of lung index and lung index of mice. Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR)was used to detect the viral load in the lung tissues of mice. Serum levels of motilin(MTL),gastrin(GAS),and cytokines interleukin(IL)-10,IL-6, tumor necrosis factor-alpha(TNF-alpha)and interferon-gamma(IFN-gamma)in lung tissue of mice were determined by enzyme-linked immunosorbent assay(ELISA). The percentages of CD4+ T lymphocytes,CD8+ T lymphocytes and B lymphocytes in the blood of mice were determined by flow cytometry. Result:The high and low dose group of in vitro cultivation of bezoar can significantly improve the general condition of model mice. Compared with blank group, model group mice lung index increased significantly(P<0.01), nucleic acids significantly increased expression of lung tissue in mice(P<0.01),significantly higher serum MTL content in mice,GAS content significantly decreased(P<0.05,P<0.01),lung tissue cells in the immune factor TNF-alpha,IL-10 and IL-6 were significantly increased(P<0.01),peripheral blood lymphocyte CD4+ T cells in mice,The percentages of CD8+ T cells and B cells were significantly decreased(P<0.01). Compared with model group, in vitro cultivation bezoar mice lung index of high and low dose group were significantly lower(P<0.01),the lung tissue of mice express nucleic acid decreased significantly(P<0.01),MTL content decreased significantly(P< 0.01),the lung tissue of mice in the IL-6,IL-10,the TNF-alpha,IFN-gamma levels were significantly lower(P<0.01), in vitro cultivation bezoar high dose group can significantly increase the CD4+ T cell percentage(P<0.05),in vitro cultivation bezoar can to a certain extent reduce model mice lung inflammatory exudation,pulmonary interstitial edema,as well as blood stasis symptoms. Conclusion:In vitro cultivation of bezoar has a significant therapeutic effect on a mice model adding disease with syndrome of coronavirus pneumonia with Yidu Xifei syndrome. It can be treated by reducing the lung index of the model mice,improving the pathological damage of the lung tissue,adjusting the immune effective and inhibiting the clearing of inflammatory factors,and to provide a laboratory basis for clinical medication.Copyright © 2021, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Treatment Effects of Integrated TCM and Western Medicine Treatment Scheme on COVID-19: A Single-armed Clinical Trial

Backgroud: The outbreak of COVID-19 has brought unprecedented perils to human health and raised public health concerns in more than two hundred countries. Safe and effective treatment scheme is needed urgently. Objective(s): To evaluate the effects of integratedTCM and western medicine treatment scheme on COVID-19. Method(s): A single-armed clinical trial was carried out in Hangzhou Xixi Hospital, an affiliated hospital with Zhejiang Chinese Medical University. 102 confirmed cases were screened out from 725 suspected cases and 93 of them were treated with integrated TCM and western medicine treatment scheme. Result(s): 83 cases were cured, 5 cases deteriorated, and 5 cases withdrew from the study. No deaths were reported. The mean relief time of fever, cough, diarrhea, and fatigue were (4.78 +/- 4.61) days, (7.22 +/- 4.99) days, (5.28 +/- 3.39) days, and (5.28 +/- 3.39) days, respectively. It took (14.84 +/- 5.50) days for SARS-CoV-2 by nucleic acid amplification-based testing to turn negative. Multivariable cox regression analysis revealed that age, BMI, PISCT, BPC, AST, CK, BS, and UPRO were independent risk factors for COVID-19 treatment. Conclusion(s): Our study suggested that integrated TCM and western medicine treatment scheme was effective for COVID-19.Copyright © 2021