Understand Delegates Risk Attitudes and Behaviour: The Moderating Effect of Trust in COVID-19 Vaccination.

The continuing COVID-19 pandemic has prompted many people to receive the needed vaccines. However, how trust in vaccination affects the attitude and behavior of delegates attending a convention in Macau has yet to be determined. Accordingly, we applied quantitative method in conducting a survey involving 514 participants and analysed the data using AMOS and SPSS. The results showed that trust in vaccines has a significant impact on moderating the relationship between risk attitude and satisfaction. Trust in vaccines has a significant positive effect on involvement. Risk attitude negatively affects involvement, satisfaction, and loyalty. The major contribution of this research is the introduction of a model based on trust in vaccination. To boost delegates' confidence to attend convention activities, governments and organizations should deliver accurate information on vaccines and pandemic risks, and that delegates should obtain accurate information about it. Lastly, unbiased and professional operators of the MICE industry also can offer precise COVID-19 vaccination information to reduce misperception and increase the security.

How generativity affects organic dining intention: Case study of Shanghai.

With people's concerns about the environment growing, the demand for organic food has increased. However, few studies have focused on organic dining intention. Therefore, this study examined generativity, which is defined as the direction and care for the growth of future generations through self-expanding forms, and its influence on attitude toward organic food, environment concern and dining intention. The moderating effect of age was also examined. A total of 418 responses were collected through a face-to-face survey from Shanghai respondents. PLS-SEM was utilized to verify the model and test the relationships among the constructs. The results show that generativity directly influences environmental concerns, attitudes toward organic food and dining intentions. Furthermore, environmental concerns and attitudes toward organic food are mediating variables for generativity to affect dining intentions. The older the age group, the more likely it is for generativity to have a positive influence on attitude toward organic food and environmental concerns. Theoretical and practical implications are also discussed in this study.

Effect of parasocial relationship on tourist's destination attitude and visit intention.

BACKGROUND: Along with the rapid development of the Internet, the form of destination marketing is becoming increasingly innovative and diverse. Celebrity endorsement via social media, as an effective marketing strategy, has been widely used by various tourism companies to attract and engage with their customers. Previous studies have investigated the various aspects of such endorsement (e.g. the effect of endorser's attributes) in different contexts (e.g. Hotel, Restaurant, Airline). However, little research has focused on the influence of the tourists' parasocial relationship with endorsers on destination marketing. Accordingly, the current study aims to explore the role of parasocial relationships on tourists' destination attitude and visit intention. METHOD: This study adopted quantitative method and conducted Partial Least Square-Structural Equation Modelling (PLS-SEM) for data analysis. 498 valid questionnaires were collected from Weibo (One of China's most popuar social media platforms). RESULTS: Results suggested that endorser's credibility positively influenced follower's parasocial relationship (p<0.001), which in turn positively influenced destination attitude and visit intention (p<0.001). Additionally, the parasocial relationship significantly mediated the relationship between credibility and destination attitude as well as visit intention (p<0.001). CONCLUSION: The emerging trend of celerbity endorsement via live-streaming makes tourism destination marketing more diverse and even effective. Through exploring the underlying mechanism of celebrity endorsement, this study can provide destination marketers with insights about how to build and strengthen the tourist's attitude and visit intention towards destiantion by developing their parasocial relationships with endorsers. This study also adds to the literature of using Partial Least Square-Structural Equation Modelling (PLS-SEM) in tourism and hospiatlity research.

How Fear of COVID-19 Affects Service Experience and Recommendation Intention in Theme Parks: An Approach of Integrating Protection Motivation Theory and Experience Economy Theory.

The unprecedented public panic caused by COVID-19 will affect the recovery of tourism, especially the theme parks, which are generally crowded due to high visitor volume. The purpose of this study is to discuss the effect of the COVID-19 on the theme park industry. This study aims to predict recommendation intentions of theme park visitors by exploring the complicated mechanism derived from the fear of COVID-19. This study uses a quantitative research method, and SPSS 20.0 and AMOS 22.0 were used for data analysis. An online survey was conducted with 420 Chinese respondents who visited Shanghai Disneyland after its reopening. The study explored the relationship between Fear of COVID-19, perceived risk, participation, service experience, and revisit intention. Results indicated the perceived risk of theme park visitors will not directly ruin their recommendation intention. Visitors' fear of COVID-19 enhanced their perceived risk, reduced their desire for active participation and impaired their service experience, which consequently affected their recommendation intention. We provide theoretical and managerial implications.

How Fear of COVID-19 Affects the Behavioral Intention of Festival Participants-A Case of the HANFU Festival.

The recovery of the tourism industry is an important issue that has attracted much attention during the COVID-19 pandemic. Sustainable and safe festival tourism is considered an effective way of aiding in the recovery of the industry. A face-to-face survey of participants in the Guangzhou Hanfu Festival was conducted to examine the relationship between fears of COVID-19, perceived risks, perceptual evaluations, festival attitudes, behavioral intentions, and crowding during this difficult time. Results clarified how fear affects behavioral intentions in festival research, and the mediation role of perceived risk and the moderation role of crowding was confirmed. A timely set of recommendations was provided to festival operators and local governments.

An empirical study on cultural identity measurement and its influence mechanism among heritage tourists.

In the effort to integrate culture and tourism, an important strategy for the prosperity and sustainability of tourism, it is necessary to factor in tourists' cultural identity and emotional interaction with cultural heritage to keep pace with the trends of cultural heritage tourism. Drawing on in-depth interviews and software such as Nvivo and Smart-PLS, this study aims to develop and verify cultural identity measures for cultural heritage tourists, construct a theoretical model of cultural identity, travel experience, place attachment, satisfaction, and revisit intention, and verify the theoretical relationship between these dimensions in the Archaeological Ruins of Liangzhu City. The results show that cultural identity is positively associated with travel experience and place attachment but not significantly associated with satisfaction; travel experience is positively associated with place attachment and revisit intention; place attachment is positively associated with satisfaction; place attachment is positively associated with revisit intention; satisfaction is positively associated with revisit intention. This qualitative and quantitative research enriches the theoretical achievements concerning cultural identity among cultural heritage tourists and proposes recommendations for management practice accordingly.

Modeling of the Impact of the Credibility of the Destination Endorser on the Place Attachment of Potential Tourists.

Place attachment has been identified as effective marketing strength to enhance destination competitiveness. However, little research explored the formation mechanism of the place attachment of potential tourists and the role of celebrity endorsers. This study aims to identify the influence mechanism of the credibility of endorsers on place attachment. Various theories from different research fields were introduced to explore the mediating effect of destination attitude, para-social relationships, and destination source credibility between endorser credibility and the place attachment of potential tourists. The famous destination endorser in China, Tenzin, was chosen as the case. A quantitative method was adopted. The research model was examined by a survey sampling size of 367 respondents. The covariance-based structural equation model analysis revealed that the credibility of the endorser exerts a positive influence on the destination attitude of potential tourists, para-social relationship with the endorser, and destination source credibility. These three constructs have a positive effect on their place attachment. The results showed that the credibility of the endorser has a significant indirect influence on place attachment. This study extends the current literature of forming the place attachment of potential tourists from the perspective of the personal characteristics of the destination endorser. The findings shed light on how the credibility of the endorser could form place attachment through enhancing the destination attitude, credibility, and para-social relationships of potential tourists. This study provides several practical implications for destination marketing.

Travel Anxiety, Risk Attitude and Travel Intentions towards "Travel Bubble" Destinations in Hong Kong: Effect of the Fear of COVID-19.

The impacts of COVID-19 are massive. Global tourism is one of the industries that is heavily affected. "Travel bubble", a recent term initiated by travel operators, is a programme that allows tourists to travel to countries nearby without quarantine requirements. This study investigates the relationship amongst fear of COVID-19, travel anxiety, risk attitude and travel intention towards "travel bubble" destinations. Results show that fear of COVID-19, travel anxiety and risk attitude negatively impact travel intention. Furthermore, travel anxiety and risk attitude moderate the indirect impacts between fear of COVID-19 and travel intention. Future research and implications of practices are presented.

[Association between BIM gene and glucocorticoid resistance in children with acute lymphoblastic leukemia].

Acute lymphoblastic leukemia (ALL) is the most common malignant hematological disease in childhood. Glucocorticoids are frequently used in the chemoradiotherapy regimen for ALL and can induce the apoptosis of ALL cells through several signaling pathways, but about 10% of ALL children have poor response to glucocorticoids. Studies have revealed that glucocorticoids induce the apoptosis of ALL cells by upregulating the expression of BIM gene, and BIM gene is associated with glucocorticoid resistance in childhood ALL. This article reviews the recent studies on glucocorticoid resistance in childhood ALL, especially the role of BIM and its expression products in this process.

Prognostic factors of early outcome in pediatric hemophagocytic lymphohistiocytosis: an analysis of 116 cases.

Early mortality remains a major challenge for the treatment of hemophagocytic lymphohistiocytosis (HLH), which warrants the need for prompt risk stratification in the early phase of the disease. We retrospectively analyzed clinical features of a cohort of pediatric patients managed at a tertiary hospital in southern China from 2005 to 2015. A total of 116 patients (median age 27.5 months) with predominantly secondary HLH were included. In a multivariate Cox regression model, neutrophils <0.5 × 10(9)/L (risk ratio (RR) = 5.01; 95 % confidence interval (CI) 1.55-16.20; P = 0.007), total bilirubin over twofold upper limit of normal value (RR = 2.86; 95 % CI 0.83-9.88; P = 0.097), and albumin ≤20 g/L (RR = 5.79; 95 % CI 1.70-19.73; P = 0.005) at diagnosis were independent risk factors for 30-day mortality. The 30-day overall survival rate (OS) of patients with three risk factors was significantly lower than that of patients with zero to two risk factors (0 vs 90.7 %; P<0.001). Patients with three risk factors were 64-fold more likely to have early adverse outcome as compared to patients with zero to two risk factors (RR = 64.45; 95 % CI 18.35-226.33; P<0.001). Platelet count normalization in 2 weeks was an independent predictor for resolution after initial therapy with an odds ratio (OR) of 18.4 (95 % CI 2.7-122.9; P = 0.003). Our results indicate that severe neutropenia and liver function damage are prognostic factors for early death in HLH and platelet count normalization in 2 weeks is a critical predictor for resolution after initial therapy.

Systolic aortic pressure-time area is a useful index describing arterial wave properties in rats with diabetes.

The accurate measurement of arterial wave properties in terms of arterial wave transit time (τw) and wave reflection factor (Rf) requires simultaneous records of aortic pressure and flow signals. However, in clinical practice, it will be helpful to describe the pulsatile ventricular afterload using less-invasive parameters if possible. We investigated the possibility of systolic aortic pressure-time area (PTAs), calculated from the measured aortic pressure alone, acting as systolic workload imposed on the rat diabetic heart. Arterial wave reflections were derived using the impulse response function of the filtered aortic input impedance spectra. The cardiovascular condition in the rats with either type 1 or type 2 diabetes was characterized by (1) an elevation in PTAs; and (2) an increase in Rf and decrease in τw. We found that an inverse linear correlation between PTAs and arterial τw reached significance (τw = 38.5462 - 0.0022 × PTAs; r = 0.7708, P < 0.0001). By contrast, as the PTAs increased, the reflection intensity increased: Rf = -0.5439 + 0.0002 × PTAs; r = 0.8701; P <0 .0001. All these findings suggested that as diabetes stiffened aortas, the augmented aortic PTAs might act as a useful index describing the diabetes-related deterioration in systolic ventricular workload.

[Clinical features of sinusoidal obstruction syndrome: report of 12 cases].

OBJECTIVE: To summarize the clinical features of sinusoidal obstruction syndrome (SOS) and to improve the understanding of this disease. METHODS: A retrospective study was performed on the clinical data of 12 children with SOS including clinical manifestations, laboratory results, imaging findings, treatment, and prognosis. RESULTS: Of the 12 cases, 8 were secondary to acute lymphoblastic leukemia, and 4 had undergone hematopoietic stem cell transplantation. Manifestations mainly included abdominal distention (4 cases), hepatomegaly with tenderness (9 cases), splenomegaly (6 cases), and weight increase (10 cases). Biochemical tests revealed varying degrees of liver damage in all cases. In the coagulation function test, the activated partial thromboplastin time (APTT) was prolonged in 7 cases. Out of the 7 patients who underwent serum D-dimer test, 4 showed elevated serum level of D-dimer. In routine blood tests, 4 cases showed decreases in both white blood cells and neutrophils. In addition, varying degrees of thrombocytopenia were observed in 9 cases. Eight patients were subjected to color Doppler ultrasound examination, and diffuse hepatomegaly, inhomogeneous liver parenchyma, unclear or thinner hepatic veins, hydrothorax/ascites, or splenomegaly was observed. Sinusoidal dilatation or hepatic cell infiltration was observed in 2 patients who underwent liver biopsy. Treatments were basically symptomatic and supportive therapies, and the prognosis was good in all patients. CONCLUSIONS: SOS should be considered in children who present with hepatomegaly, sudden weight gain, liver dysfunction and coagulation dysfunction after they have received chemotherapy for leukemia and hematopoietic stem cell transplantation.

[Association between gene polymorphisms of Perforin 1 and hemophagocytic lymphohistiocytosis].

OBJECTIVE: To investigate frequency distribution of gene polymorphisms of PRF1 gene in children with hemophagocytic lymphohistiocytosis (HLH), and to explore whether the possible gene polymorphisms of PRF1 gene confer an increased risk of susceptibility to HLH. METHODS: Forty-eight children who were diagnosed with HLH between January 2009 and December 2013 (HLH group) and 100 healthy children (control group) were enrolled in this study. The gene polymorphisms in the coding region of PRF1 gene, which consists of three exons and two introns, were genotyped by PCR, followed by direct sequencing. RESULTS: Three single nucleotide polymorphisms (SNPs) were revealed in the coding sequence of PRF1 in the 48 children with HLH. Seven SNPs were detected in the noncoding sequence. Other two SNPs in the noncoding sequence including rs10999426 and rs10999427 were detected only in 5 healthy children (5%). There was no significant difference in allelic frequencies of all the SNPs above between the HLH and control groups (P>0.05). Haplotype analysis showed there was a pair-wise linkage disequilibrium between rs10999426 and rs10999427 (D=1, r2=1), but there was no significant difference in the distribution of A-T haplotype between the HLH and control groups (P>0.05). CONCLUSIONS: There is no association between gene polymorphisms of PRF1 gene and the susceptibility to HLH. There is a pair-wise linkage disequilibrium between rs10999426 and rs10999427, but a low detection rate of A-T haplotype in healthy children indicates that it might not play a protective role in the development of HLH.

Two symptomatic cases of dysfibrinogenemia in China: one with gamma-chain Arg275Cys mutation and another without detectable mutation in fibrinogen genes.

The aim of this study was to investigate causative mutations of two unrelated symptomatic Chinese children with dysfibrinogenemia and their family members.Fibrinogen genes, including FGA, FGB and FGG of all participants were PCR-amplified, followed by direct sequencing. Precipitated plasma fibrinogen of some family members was analyzed by western blotting, fibrin polymerization and scanning electron microscopy (SEM).Proband 1 associated with frequent epistaxis was identified to harbor a heterozygous Arg275Cys mutation in FGG, along with a polymorphism Arg448Lys in FGB. Proband 2 with apparently prolonged thrombin time and very low functional fibrinogen had undergone both spontaneous intracranial hemorrhages and deep venous thrombosis. Sequencing of all proximal promoters, coding regions, introns and 3'-untranslated region using genomic DNA of Proband 2 yielded no mutation in three fibrinogen genes. Western blotting of this patient's precipitated plasma fibrinogen detected no truncated protein. Fibrinogen polymerization curve showed prolonged lag phase and severely decreased final turbidity, and SEM observations of fibrin clots made from Proband 2 revealed an abnormal sponge-like mass with large pores. We speculate that other underlying mechanisms responsible for dysfibrinogenemia such as abnormal posttranscriptional processing or posttranslational modification, which are independent of detectable mutations in the genomic DNA sequence, may exist.

[Association of CCR2 gene rs1799864 polymorphism with hemophagocytic lymphohistiocytosis in children].

OBJECTIVE: To investigate the association between rs1799864 single nucleotide polymorphism (SNP) of the C-C chemokine receptor 2 (CCR2) gene and susceptibility of hemophagocytic lymphohistiocytosis (HLH) in children. METHODS: The clinical and laboratory data of 86 children diagnosed with HLH between January 2007 and December 2013 were retrospectively reviewed. The CCR2 gene rs1799864 was genotyped by SNaPshot technique in 86 HLH children and 128 healthy controls. The genotypic and allelic frequencies in the two groups were comparatively analyzed. RESULTS: No significant difference either in genotypic or allelic frequencies of rs1799864 polymorphism of the CCR2 gene was observed between HLH patients and controls (P>0.05), but there were significant differences in the age of onset and the periods of temperature and platelet returning to normal after treatment (P<0.05). CONCLUSIONS: There is no association between CCR2 gene rs1799864 polymorphism and the risk for HLH in children. However, the genotypic differences of this polymorphism might be associated with clinical characteristics and prognosis of HLH.

CD20 and Outcome of Childhood Precursor B-cell Acute Lymphoblastic Leukemia: A Meta-analysis.

CD20 is a B-cell differentiation antigen that is expressed variably in precursor B-cell acute lymphoblastic leukemia (BCP-ALL). The prognostic significance of CD20 expression in childhood BCP-ALL remains controversial. Some studies have demonstrated that CD20 overexpression correlates with worse survival in pediatric patients with BCP-ALL, but some other studies suggest a better outcome. To explore the prognostic role of high CD20 expression in pediatric BCP-ALL, we performed a meta-analysis of the previous studies that provided survival information according to CD20 expression status. Pooled hazard ratios (HRs) indicated that high CD20 expression had no inferior impact on the prognosis of pediatric BCP-ALL. The summary HR for overall survival was 0.70 and combined HR for event-free survival was 1.01. These findings suggest that high CD20 expression does not influence the outcome for pediatric BCP-ALL. CD20 may lack prognostic value in children with BCP-ALL.

[XIAP gene mutation screening in children with hemophagocytic lymphohistiocytosis].

OBJECTIVE: To investigate the prevalence of mutations and sequence variations in X-linked inhibitor of apoptosis (XIAP) gene among Chinese pediatric patients with hemophagocytic lymphohistiocytosis (HLH). METHODS: Sixty-five children who were diagnosed with HLH between January 2009 and December 2012 (case group), as well as 70 healthy children (control group), were enrolled in the study. The exons of XIAP gene (1-1, 1-2, 2-6) were amplified by PCR and directly sequenced. The genotypic and allelic frequencies of single nucleotide polymorphism (SNP) were analyzed. RESULTS: None of the HLH patients showed mutations in these exons of XIAP gene. Only one nonsynonymous SNP, rs5956583 located in exon 5, was observed, but there were no significant differences in the genotypic and allelic frequencies of this SNP between the case and control groups (P>0.05). CONCLUSIONS: HLH caused by XIAP mutations may be rare in children. SNP rs5956583 of XIAP gene may have little contribution to the development of childhood HLH.

[Prognostic factors for hemophagocytic lymphohistiocytosis in children].

OBJECTIVE: To study the main factors influencing prognosis of hemophagocytic lymphohistiocytosis (HLH) in children by summarizing the clinical features of HLH and investigating the relationship between relevant factors and prognosis. METHODS: The medical data of 63 children with HLH were retrospectively reviewed. Kaplan-Meier method was employed to draw survival curves. Factors influencing prognosis were assessed with Cox univariate analysis, and Cox multivariate analysis was done on statistically significant factors. RESULTS: The 3-year and 5-year survival rates were both 62.9%. The survival rate decreased from 98.4% at 1 day after definite diagnosis to 73.2% at 4 months. Univariate analysis demonstrated only one factor, which was that the condition of platelet recovery after treatment of 2 to 3 weeks was significantly related to prognosis (P=0.002). In children receiving etoposide therapy, temperature recovery after one day of treatment was significantly related to prognosis (P=0.016). CONCLUSIONS: Children with HLH have a satisfactory prognosis, but the survival rate reduces rapidly in the first 4 months after definite diagnosis. Platelet recovery after treatment of 2 to 3 weeks and temperature recovery after one day of treatment are factors influencing prognosis of HLH in children.