Effectiveness of nirmatrelvir-ritonavir versus azvudine for adult inpatients with severe or critical COVID-19.

BACKGROUND: In China, both nirmatrelvir-ritonavir (Paxlovid) and azvudine have been granted approval to treat adult SARS-CoV-2-infected patients with moderate symptoms. Information about the clinical effect of the two available agents among inpatients with severe or critical COVID-19 is scarce. PURPOSE: To compare the clinical outcomes of Paxlovid and azvudine among adult inpatients with severe or critical COVID-19. METHOD: We conducted a retrospective cohort study in two large medical centres after the epidemic control measures were lifted in China. A new propensity score matched-inverse probability of treatment weighting cohort was constructed to evaluate the in-hospital all-cause mortality, hospital length of stay, Sequential Organ Failure Assessment (SOFA) score and safety. RESULTS: A total of 955 individuals were in the cohort. The antiviral therapy strategies were decided by the senior physician and the supplies of the pharmacy. A total of 451 patients were in the Paxlovid group, and 504 patients were in the azvudine group. Compared with Paxlovid, the effects of azvudine on in-hospital all-cause mortality were not significantly different, and the OR (95% CI) was 1.084 (0.822 to 1.430), and the average hospital length of stay of patients discharged alive was also similar in the azvudine group, and the difference (day) and (95% CI) was 0.530 (-0.334 to 1.393). After 7 days of therapy, the degree of decline in the SOFA score was greater in the Paxlovid group than in the azvudine group (p<0.001). The change in glomerular filtration rate was not significantly different (p=0.824). CONCLUSION: Paxlovid and azvudine had similar effectiveness on in-hospital all-cause mortality and hospital length of stay. Compared with the azvudine group, after 7 days of therapy, the degree of decline in SOFA score was significantly higher in the Paxlovid group. These findings need to be verified in larger prospective studies or randomised controlled trials.

The active ingredients in Chinese peony pods synergize with antibiotics to inhibit MRSA growth and biofilm formation.

Staphylococcus aureus (S. aureus) is a zoonotic pathogen that infects both humans and animals. The rapid spread of methicillin-resistant S. aureus (MRSA) and its resistance to antibiotics, along with its ability to form biofilms, poses a serious challenge to the clinical application of traditional antibiotics. Peony (Paeonia lactiflora Pall.) is a traditional Chinese medicine with multiple pharmacological effects. This study observed the strong antibacterial and antibiofilm activity of the water extract (WE) and ethyl acetate extract (EA) of Chinese peony pods against MRSA. The combination of EA and vancomycin, cefotaxime, penicillin G or methicillin showed a synergistic or additive antibacterial and antibiofilm effects on MRSA, which is closely related to the interaction of 1,2,3,4,6-penta-O-galloyl-ß-D-glucose (PG) and methyl gallate (MG). The active ingredients in peony pods have been found to increase the sensitivity of MRSA to antibiotics and demonstrate antibiofilm activity, which is mainly related to the down-regulation of global regulatory factors sarA and sigB, extracellular PIA and eDNA encoding genes icaA and cdiA, quorum sensing related genes agrA, luxS, rnaIII, hld, biofilm virulence genes psma and sspA, and genes encoding clotting factors coa and vwb, but is not related to genes that inhibit cell wall anchoring. In vivo test showed that both WE and EA were non-toxic and significantly prolonged the lifespan of G. mellonella larvae infected with MRSA. This study provides a theoretical basis for further exploration of the combined use of PG, MG and antibiotics to combat MRSA infections.

Why Good Employees Do Bad Things: The Link between Pro-Environmental Behavior and Workplace Deviance.

Despite the significance of pro-environmental behavior (PEB) in the workplace, most of the existing studies have neglected its negative work outcomes. Drawing upon moral licensing theory and cognitive dissonance theory, we construct a conceptual model of the influence mechanism of employees' PEB (i.e., public-sphere PEB, private-sphere PEB) on workplace deviance through psychological entitlement, and the moderating effect of rationalization of workplace deviance on the relationship between psychological entitlement and workplace deviance. Using two-stage survey data from 216 employees in China, we performed hierarchical regression analysis and structural equation modeling method to test our hypotheses. Our findings reveal that public-sphere PEB positively affects psychological entitlement, while private-sphere PEB negatively affects psychological entitlement. Psychological entitlement further positively affects workplace deviance. In addition, rationalization of workplace deviance strengthens the positive impact of psychological entitlement on workplace deviance. This study offers novel insights into the dark side of PEB literature by exploring the PEB-workplace deviance relationship. This study also contributes to managerial implications of how PEB leads to workplace deviance and how to address this issue.

Hidden benefits of electric vehicles for addressing climate change.

There is an increasingly hot debate on whether the replacement of conventional vehicles (CVs) by electric vehicles (EVs) should be delayed or accelerated since EVs require higher cost and cause more pollution than CVs in the manufacturing process. Here we reveal two hidden benefits of EVs for addressing climate change to support the imperative acceleration of replacing CVs with EVs. As EVs emit much less heat than CVs within the same mileage, the replacement can mitigate urban heat island effect (UHIE) to reduce the energy consumption of air conditioners, benefitting local and global climates. To demonstrate these effects brought by the replacement of CVs by EVs, we take Beijing, China, as an example. EVs emit only 19.8% of the total heat emitted by CVs per mile. The replacement of CVs by EVs in 2012 could have mitigated the summer heat island intensity (HII) by about 0.94°C, reduced the amount of electricity consumed daily by air conditioners in buildings by 14.44 million kilowatt-hours (kWh), and reduced daily CO2 emissions by 10,686 tonnes.