Increased Yangtze finless porpoise presence in urban Wuhan waters of the Yangtze River during fishing closures

Wuhan, a highly urbanized and rapidly growing region within China's Yangtze Economic Zone, has historically been identified as a gap area for the critically endangered Yangtze finless porpoise (Neophocaena asiaeorientalis asiaeorientalis) based on daytime visual surveys. However, there has been a noticeable increase in porpoise sightings since 2020. This study employed passive acoustic monitoring to investigate porpoise distribution in Wuhan between 2020 and 2022. Generalized linear models were used to explore the relationship between shipping, hydrological patterns, light intensity, and porpoise biosonar activity. Over 603 days of effective monitoring, the daily positive rate for porpoise biosonar detection reached 43%, with feeding-related buzz signals accounting for 55% of all porpoise biosonar signals. However, the proportion of minutes during which porpoise presence was detected was 0.18%, suggesting that while porpoises may frequent the area, their visits were brief and mainly focused on feeding. A significant temporal trend emerged, showing higher porpoise biosonar detection during winter (especially in February) and 2022. Additionally, periods without boat traffic correlated with increased porpoise activity. Hydrological conditions and light levels exhibited significant negative correlations with porpoise activity. Specifically, porpoise sonar detections were notably higher during the night, twilight, and new moon phases. It is highly conceivable that both fishing bans and COVID-19 pandemic-related lockdowns contributed to the heightened presence of porpoises in Wuhan. The rapid development of municipal transportation and shipping in Wuhan and resulting underwater noise pollution have emerged as a significant threat to the local porpoise population. Accordingly, it is imperative for regulatory bodies to effectively address this environmental stressor and formulate targeted protection measures to ensure the conservation of the finless porpoise.

Revisiting the impact of public spaces on the mental health of rural migrants in Wuhan: an integrated multi-source data analysis

Current research on public spaces and mental health often focuses on the independent relationship of one or more social mediators, neglecting the nuanced implications and serial mechanisms inherent in the progressive social process. Using Wuhan city, China, as a study case with multi-source data, this research applies Multilevel Generalized Structural Equation Modeling and deep learning techniques to explore the differential effects of public spaces with varying degrees of publicness (i.e., typical, semi-, and privately owned) on rural migrants' mental health. Crucially, this study scrutinizes both explicit (social interaction) and implicit (perceived integration) social mechanisms to revisit the relationships. The findings reveal that not all public spaces equally influence mental health, with typical and privately owned public spaces conferring profound benefits. Notably, public spaces impact mental health chiefly through perceived integration instead of through direct social interaction. Social interaction improves mental health primarily by enhancing perceived integration, suggesting that meaningful connections beyond superficial encounters are critical. In particular, we observed significant social effects in typical and privately owned public spaces but limited social functionality in semi-public spaces. This evidence contributes to the knowledge required to create supportive social environments within public spaces, integral to nurturing inclusive urban development.

Acceptance of peer physical examination in medical students in Wuhan, China: A cross-sectional study

Background

Peer physical examination (PPE) is an essential part of the education of medical students. This study aimed to assess the acceptance level of PPE in Chinese society as well as other related factors. While there have been numerous studies on PPE acceptance in Western societies, there have been relatively few studies on this topic in China.

Methods

A questionnaire was distributed via social media to clinical-year medical students in China. With 1890 students participating overall, the response rate was 86.9%. The questionnaire collected demographic information and previous experience with PPE, and utilized a 5-point Likert scale to assess acceptance of PPE and factors influencing it.

Results

One thousand six hundred and forty-four percent of Chinese medical students accepted PPE, with 13% rejecting it and 19% neutral. Males were more accepting of PPE than females, and females were less accepting of being examined by someone of the opposite gender. The groin/thigh and breast areas were the most rejected for examination. There were no significant differences in acceptance rates between universities or academic performance groups. However, society had a significant impact on the acceptance of PPE.

Conclusions

With a 67% acceptance rate of PPE among Chinese medical students, it could be considered a viable alternative to absent life models in Chinses universities. However, implementing PPE may come with its own set of difficulties, so it is recommended that a supervisor is present and that single-gender groups are formed, with friends paired together if possible.

Research on evaluation of Wuhan air pollution emission level based on entropy weight method

For the lack of precise monitoring and accurate assessment models for air quality, this paper fully considers such constraints and establishes an evaluation model of air pollution emission level to evaluate the air pollution emission level of Wuhan-a city in central China. The model uses entropy weight method including important indicators of air pollution into the integrated optimization of air quality assessment, laying the basis for sources of pollution and the reasonable and effective city development. The total emissions of air pollution for Wuhan shows a gradual upward trend over time, mainly coming from industrial pollution. The government can reduce air pollution by focusing on detecting major polluting industries, promoting industrial technological progress and innovation, and strengthening the effective implementation of emission trading system.

Plaque Reduction Neutralization Test (PRNT) Accuracy in Evaluating Humoral Immune Response to SARS-CoV-2

Massive vaccination positively impacted the SARS-CoV-2 pandemic, being a strategy to increase the titers of neutralizing antibodies (NAbs) in the population. Assessing NAb levels and understanding the kinetics of NAb responses is critical for evaluating immune protection. In this study, we optimized and validated a PRNT50 assay to assess 50% virus neutralization and evaluated its accuracy to measure NAbs to the original strain or variant of SARS-CoV-2. The optimal settings were selected, such as the cell (2 × 105 cells/well) and CMC (1.5%) concentrations and the viral input (~60 PFU/well) for PRNT-SARS-CoV-2 with cut-off point = 1.64 log5 based on the ROC curve (AUC = 0.999). The validated PRNT-SARS-CoV-2 assay presented high accuracy with an intraassay precision of 100% for testing samples with different NAb levels (low, medium, and high titers). The method displays high selectivity without cross-reactivity with dengue (DENV), measles (MV), zika (ZIKV), and yellow fever (YFV) viruses. In addition, the standardized PRNT-SARS-CoV-2 assay presented robustness when submitted to controlled variations. The validated PRNT assay was employed to test over 1000 specimens from subjects with positive or negative diagnoses for SARS-CoV-2 infection. Patients with severe COVID-19 exhibited higher levels of NAbs than those presenting mild symptoms for both the Wuhan strain and Omicron. In conclusion, this study provides a detailed description of an optimized and validated PRNT50 assay to monitor immune protection and to subsidize surveillance policies applied to epidemiologic studies of COVID-19.

Evaluation of air quality changes in a Chinese megacity over a 15-year period (2006-2021) using PM2.5 receptor modelling

Air quality impairment has a massive impact on human health, with atmospheric particulate matter (PM) playing a major role. The People's Republic of China experienced a trend of increasing PM2.5 concentrations from 2000 to 2013. However, after the application of the Air Pollution Prevention and Control Action Plan and other related control measures, sharp decreases in air pollutant concentrations were particularly evident in the city of Wuhan (central China). This study analysed major changes in PM2.5 concentrations, composition and source apportionment (using receptor modelling) based on Wuhan's PM2.5 chemical speciation datasets from 2006 to 2007, 2019-2021 and contemporaneous gaseous pollutant values. Average SO2 concentrations decreased by 88%, from the first to the second period, mostly due to measures that reduced coal combustion. However, NO2 only declined by 25%, with policy measures likely being undermined by an increased number of vehicles. PM2.5 concentrations decreased by 65%, with the PM constituents each being affected differently. Coal combustion-related element concentrations, OC, SO42-, NH4+, EC, Cl-, Al, Ca, Cu, Fe, Co and NO3- decreased by 22-90%. Secondary inorganic aerosol (SIA) was initially dominated by (NH4)2SO4 (73%) in 2006, but later dominated by NH4NO3 (52%) in 2021. Receptor modelling identified major sources contributing to PM2.5: Mineral, road and desert dust (MRDD), Secondary sulphate (SECS), Secondary nitrate (SECN), Tungsten industry (W), Toxic Elements of Coal (TEC), Iron and Steel (IRONS), Coal Combustion (CC), Residential Heating (RH), Refinery (REF) and Traffic (TRF). In relative proportions, TEC (-83%), SECS (-64%) and SECN (-48%) reduced their contributions to PM2.5 whilst MRDD increased (+62.5%). Thus, the results indicate not only a drastic abatement of PM pollution in Wuhan but also a change in the sources of pollution, which requires further actions to reduce PM2.5 concentrations to health protective values. Secondary PM and fugitive emissions are key components to abate.

What we can and cannot learn from SARS-CoV-2 and animals in metagenomic samples from the Huanan market

While the exact context of the emergence of SARS-CoV-2 remains uncertain, data accumulated since 2020 have provided an increasingly more precise picture of Wuhan's Huanan Seafood Wholesale Market, to which the earliest clusters of human cases of Covid-19 were linked. After the market closed on January 1st 2020, teams from the Chinese Center for Disease Control and Prevention collected environmental samples, and sequenced them. Metagenomic sequencing data from these samples were shared in early 2023. These data confirmed that non-human animals susceptible to SARS-CoV-2 were present in the market before it closed, but also that these animals were located in the side of the market with most human cases, and in a corner with comparatively more SARS-CoV-2-positive environmental samples. The environmental samples were however collected after abundant human-to-human transmission had taken place in the market, precluding any identification of a non-human animal host. Jesse Bloom recently investigated associations between SARS-CoV-2 and non-human animals, concluding that the data failed to indicate whether non-human animals were infected by SARS-CoV-2, despite this being an already acknowledged limitation of the data. Here I explain why a correlation analysis could not confidently conclude which hosts(s) may have shed SARS-CoV-2 in the market, and I rebut the suggestion that such analyses had been encouraged. I show that Bloom's investigation ignores the temporal and spatial structure of the data, which led to incorrect interpretations. Finally, I show that criteria put forward by Bloom to identify the host(s) that shed environmental SARS-CoV-2 would also exclude humans. Progress on the topic of SARS-CoV-2's origin requires a clear distinction between scientific studies and news articles (mis)interpreting them.

Design guidelines for healing gardens in the general hospital

Introduction

Despite being recognized as a cost-effective method to enhance physical and mental health, Healing Gardens remain insufficiently popularized in outdoor spaces of hospitals. This paper aims to introduce a new perspective and offer guidelines for their implementation within general hospitals.

Methods

A methodology is proposed for formulating hospital-specific guidelines, encompassing the extraction of successful Healing Garden features from case studies, definition of key components grounded in theoretical frameworks, validation of essential features through user questionnaires, and comprehensive site analyses.

Results

The methodology was applied in a case study at Zhongnan Hospital in Wuhan. This research presents a novel perspective and robust methodology for implementing Healing Gardens in general hospital settings, potentially improving physical and mental health in a cost-efficient manner.

Discussion

This work aims to encourage the adoption of Healing Gardens as preventive medical tools in more healthcare settings. By providing a comprehensive methodology and a case study illustration, this research endeavors to stimulate broader acceptance and utilization of Healing Gardens in healthcare environments.

Incorporating carbon sequestration into lake management: A potential perspective on climate change

Exploring the carbon sequestration capacity of water ecosystems would contribute to coping with climate change. This study conducted an integrated method framework to achieve an improved understanding of the relationship between carbon sequestration and lake ecosystem components, as well as provide a new perspective on climate change for policymakers. The vertically generalized production model revealed the carbon sequestration capacity of lakes. The hierarchical linear model identified the cross-scale factors affecting phytoplankton. Then a developed multi-agents-based model with scenario analysis provided adaptive management strategies for carbon sequestration. Furthermore, we applied the integrated framework in the 63 polluted lakes of Wuhan. The results showed that the average carbon sequestration per unit area was at 0.87 kgC·m-2·a-1, which was greater than that of the ocean and forest ecosystems, indicating that the lakes had a potential capacity for carbon sequestration. Total phosphorus had the strongest effect on the Chl-a (chlorophyll a) concentration (fixed effect (γ) =6.82, P < 0.1), followed by total nitrogen (γ = 6.38, P < 0.05), Rotifer biomass (γ = 1.95, P < 0.01) and water temperature (γ = 1.27, P < 0.05). These results indicated that the bottom-up effect of chemical factors on phytoplankton was greater than the top-down effect of zooplankton. The proportion of grassland at the whole-lakes level would have a negative synergistic impact on the Chl-a with changing the micro water temperature at the part-lakes level (γ = -46.64, P < 0.05). There was no significant interaction effect between land cover change and total nitrogen (phosphorus) on the Chl-a. Therefore, we could indirectly confirm that point source pollution emissions would synergistically affect the Chl-a and carbon sequestration along with the effects of physical-chemical conditions. The coordinated proportional control of nitrogen and phosphorus and the artificial controlling biomass of zooplankton-feeding fish were proposed to improve carbon sequestration and water quality for lake management.

A Survey of Airborne Fungi and Their Sensitization Profile in Wuhan, China

INTRODUCTION

Airborne fungi induce allergic symptoms in 3-10% of the population worldwide. To better prevent and manage fungi-related allergic diseases, it is essential to identify the genus and the distribution profile of airborne fungi.

METHODS

With this purpose in mind, we carried out a 12-month volumetric sampling study to monitor the airborne fungi and retrospectively analyzed the sensitization profile of four dominant fungi (Cladosporium, Alternaria, Aspergillus, and Penicillium) among respiratory allergies during the same study period in Wuhan, China.

RESULTS

A total of 29 different fungal genuses were identified, and the peak fungal concentration period was found to be in September and October, followed by May and June. The most prevalent fungi in this area were Cladosporium (36.36%), Ustilago (20.12%), and Alternaria (13.87%). In addition, the skin prick test data from 1,365 respiratory allergies patients showed that 202 (14.80%) of them were sensitized to fungi. The sensitization rates to Cladosporium, Alternaria, Aspergillus, and Penicillium were 11.72%, 4.69%, 1.98%, and 4.76%, respectively. The seasonal fluctuation of Alternaria and Aspergillus correlated with their sensitization rates. Among the fungal sensitized patients, 76 (37.62%) were sensitized to two or more kinds of fungi. The serum-specific IgE tests suggested low to high correlations existed between these fungi; however, these correlations were not found between fungi and other allergens.

CONCLUSION

Our study provides the distribution profile and reveals the clinical significance of the airborne fungi in Wuhan, which will facilitate the precise management of fungal allergy.

Urban growth boundaries optimization under low-carbon development: Combining multi-objective programming and patch cellular automata models

Urban Growth Boundaries (UGBs) are a tool to control urban sprawl. However, the way to optimize future urban land uses and fix their boundaries is not clear. This paper presents a new framework to delimit UGBs while accounting for ecological, economic, and carbon storage benefits. Aggregate land-use constraints are included in a multi-objective optimization algorithm to capture non-inferior solutions on the Pareto Surface (PS) under different objective scenarios. A patch-level cellular automata simulation model is then used to spatially allocate these land uses, followed by a new two-step adjustment method to delineate the UGBs. This modeling is applied to Wuhan, China. The results show that: (1) One district (Caidian) will have a strong economic growth under low-carbon development. (2) The maximization of carbon storage reduces losses in ecological benefits, suggesting that carbon storage be considered in urban growth planning. (3) The combined model framework and two-step boundary adjustment method can help urban planners define different UGB scenarios and make science-based policy decisions.

Urban epidemic governance: An event system analysis of the outbreak and control of COVID-19 in Wuhan, China

The outbreak of a virus such as COVID-19 is composed of a series of seemingly random incidents which are nevertheless interconnected. In a novel approach, this article adopts the event system theory (EST), established in organisational behaviour science, to investigate the mechanism of epidemic governance in Wuhan, the city which reported the first case of COVID-19 and thereafter successfully controlled the outbreak. The event system analysis divided Wuhan's response mechanism to COVID-19 into four dimensions: the graded response systems, the interactive relationship between multilevel entities of epidemic governance, the quarantine regulations and the governance of public sentiment. There are numerous lessons learned and effective measures developed from the 'Wuhan experience'. These lessons and measures can assist other cities around the world to cope with the current COVID-19 crisis and prepare their urban governance systems for similar infectious diseases in the future. We urgently advocate the addition of more scholarly discussion on urban epidemic governance by incorporating interdisciplinary approaches like EST in particular.

Neighborhood Governance and Happiness during the COVID-19 Pandemic: An Empirical Analysis of Wuhan's Lockdown

The outbreak of COVID-19 posed a challenge to global governance, residents' happiness, and economic systems around the world. Since the crux of previous research centers on the reactions of both local and national governments, studies on how governance arrangement at the neighborhood level influences people's happiness during the crisis response remain insufficient. This paper aims to explore the relationship between neighborhood governance and residents' happiness based on first-hand data collected during Wuhan's first lockdown. This study highlights the significance of neighborhood governance in crisis response, which includes providing diverse public services, ensuring access to life's necessities, and offering prompt medical treatment. All of these factors are essential for maintaining overall satisfaction with governance and contributing to the happiness of individuals within the community. However, active governance actions do not always lead to favorable results. For example, increased group participation may lead to social conflicts among those involved, ultimately diminishing one's happiness. Furthermore, the COVID-19 pandemic has acted as a risk 'amplifier', exposing and exacerbating pre-existing hukou-based social inequalities in the governance process. The impact of the pandemic on citizen happiness is the cumulative effect of both the immediate social crisis brought on by the pandemic and long-standing structural inequalities. To improve people's happiness and establish inclusive policies, this paper advocates for a 'people-centered' urban governance that enhances public satisfaction and addresses the needs and priorities of migrant populations.

SARS-CoV-2 Omicron variant causes brain infection with lymphoid depletion in a mouse COVID-19 model

BACKGROUND

The Omicron variant has become the most prevalent SARS-CoV-2 variant. Omicron is known to induce milder lesions compared to the original Wuhan strain. Fatal infection of the Wuhan strain into the brain has been well documented in COVID-19 mouse models and human COVID-19 cases, but apparent infections into the brain by Omicron have not been reported in human adult cases or animal models. In this study, we investigated whether Omicron could spread to the brain using K18-hACE2 mice susceptible to SARS-CoV-2 infection.

RESULTS

K18-hACE2 mice were intranasally infected with 1 × 10⁵ PFU of the original Wuhan strain and the Omicron variant of SARS-CoV-2. A follow-up was conducted 7 days post infection. All Wuhan-infected mice showed > 20% body weight loss, defined as the lethal condition, whereas two out of five Omicron-infected mice (40%) lost > 20% body weight. Histopathological analysis based on H&E staining revealed inflammatory responses in the brains of these two Omicron-infected mice. Immunostaining analysis of viral nucleocapsid protein revealed severe infection of neuron cells in the brains of these two Omicron-infected mice. Lymphoid depletion and apoptosis were observed in the spleen of Omicron-infected mice with brain infection.

CONCLUSION

Lethal conditions, such as severe body weight loss and encephalopathy, can occur in Omicron-infected K18-hACE2 mice. Our study reports, for the first time, that Omicron can induce brain infection with lymphoid depletion in the mouse COVID-19 model.

Characterization of red eye cases presented to the eye emergency clinic at a tertiary care hospital during COVID-19 Pandemic

BACKGROUND

The World Health Organization (WHO) was notified by China on December 31, 2019, of a pneumonia outbreak severe acute respiratory syndrome-associated coronavirus-19 virus infection in Wuhan. This outbreak was declared by the WHO from the Public Health Emergency of International Concern to formal declaration as a pandemic on March 11, 2020. Because the public health measures like lockdown, the eye care delivery system was markedly impacted. The aim of this study was to find out if any pattern change of red eye cases among patients who attended eye accident and emergency (A and E) in a tertiary care hospital during COVID-19 pandemic in 2020 compared to 2019 and 2018.

MATERIALS AND METHODS

This was a cohort retrospective study which included all patients who presented to eye A and E clinic with red eye from March 1 to July 31 in 2018, 2019, and 2020. Data were analyzed using statistical tools in the SPSS software. Furthermore, the clinical records of 578 inpatients with proven COVID-19 were reviewed for any red eye problem.

RESULTS

Out of 7895 eye patients attended eye A and E clinic during March-July of 2018, 2019, and 2020, 1573 (19.9%) patients had red eye. Males were slightly dominant with 59%, and unilateral cases were the majority among them. The most common causes of red eye in 2018 and 2019 were injury, conjunctivitis, and keratitis; whereas in 2020, a clear dominance of injury and keratitis cases was found. Only 10 (2.03%) patients out of the 493 outpatients with red eye during the 5-month period in 2020 reported a prior contact to a COVID-19 positive case; of whom nine patients had conjunctivitis, and one had a right eye open globe injury. Of the 578 inpatients with proven COVID-19, only 1 (0.17%) patient had red eye with the diagnosis of conjunctivitis.

CONCLUSION

There was relatively increased number of adults reporting with red eye in 2020. Eye injuries were the most common among all years, followed by conjunctivitis and keratitis. Ocular problems, however, might be a primary or secondary COVID-19 complaint and seem to be relatively uncommon in COVID-19 individuals.

Betel Nut Consumption and the Reasons for Its Rise among Chinese Migrant Workers

Background: In China, betel nut users were initially concentrated in specific regions and ethnic groups. However, in recent years, public health concerns have been raised because betel nuts, addictive substances, have become largely used by Chinese migrant workers. Methods: This study adopts an anthropological fieldwork research methodology to investigate the rise in betel nut consumption among Chinese migrant workers. We observe the everyday lives of migrant workers in the rural-urban area of Wuhan. We use in-depth interviews to understand their psychology and behaviors toward betel nut consumption. Discussion: The study's results indicate that the observed increase in betel nut consumption among migrant workers is not only the result of the spread of betel nuts across regions and groups, but more importantly, it is related to the working and living conditions, social interaction, consumption culture, and masculinity image of migrant workers. The consumption of betel nuts reflects the political-economic structure and socio-cultural background to which Chinese migrant workers belong. Conclusion: The increasing consumption of betel nuts is a social issue that requires thorough research and government engagement. We contend that anthropology research may help identify the social mechanisms incentivizing betel nut consumption and solve the related public health issues among Chinese migrant workers from public policy and social governance perspectives.

Equity evaluation of urban green space in the main urban area of Wuhan based on green view index

Green space is a kind of resource welfare. The evaluation of green space equity based on green view index (GVI) is important to ensure the equitable distribution of green resources. Taking the central urban area of Wuhan as the research object, based on multi-source data such as Baidu Street View Map, Baidu Thermal Map, and satellite remote sensing images, we evaluated the equity of spatial distribution of GVI in Wuhan by using the locational entropy, Gini coefficient and Lorenz curve. The results showed that 87.6% of the points in the central urban area of Wuhan were below the level of poor green vision, which mainly concentrated in Wuhan Iron and Steel Industrial Base of Qingshan District and south of Yandong Lake. The number of points reaching an excellent level was the least (0.4%), mainly concentrated around the East Lake. The overall Gini coefficient of GVI in the central urban area of Wuhan was 0.49, which indicated that the distribution of GVI was heterogeneous. The Gini coefficient of Hongshan District was the largest at 0.64, indicating a huge gap in the distribution of GVI, while the Gini coefficient of Jianghan District was the smallest at 0.47, with a large gap in the distribution. The central urban area of Wuhan had the most low-entropy areas for 29.7% and the least high-entropy areas for 15.4%. There were two-level differences in entropy distribution within Hongshan District, Qingshan District, and Wuchang District. The nature of land use and the role of linear greenery were the main factors affecting the equity of green space in the study area. Our results could provide theoretical basis and planning reference for optimizing urban green space layout.

Epidemiological features of traumatic spinal cord injury in Wuhan, China

BACKGROUND

Spinal cord injuries are extremely debilitating and fatal injuries. There is currently little research focusing on traumatic spinal cord injuries, and there is little information available about the epidemiological characteristics of patients with traumatic spinal cord injury (TSCI).

OBJECTIVE

To describe the epidemiological features of traumatic spinal cord injury in Wuhan, China.

DESIGN

A retrospective hospital-based study.

SETTING

Rehabilitation department of Wuhan's Tongji Hospital.

PARTICIPANTS

People who had been diagnosed with a traumatic spinal cord injury (TSCI) were admitted to Tongji Hospital from 2016 to 2021 (n = 463).

INTERVENTIONS

Not applicable.

OUTCOME MEASURES

Epidemiological features such as sex, age, marital status, etiology, occupation, neurological level of injury, and the American Spinal Injury Association Impairment Scale on admission, hospitalization, and concomitant injuries were collected.

RESULTS

The mean age of patients with TSCI was 39.4 ± 14.3 years, and the male/female ratio was 3:1. The leading causes of TSCIs were traffic accidents (38.4%), followed by falls (low falls 24.0%, high falls 13.2%). The most common injury site was the cervical spinal cord, followed by the thoracolumbar level. Of all patients, 463 patients (67.2%) had complications and other injuries. During the hospitalization period, a total of 217 patients experienced complications, with a percentage of 46.9%. Urinary tract infection was the most common (15.6%), followed by pulmonary infection (14.0%).

CONCLUSION

The results found that the proportion of males was greater, and the first two main reasons were falls and traffic accidents. Farmers and workers are the occupations most vulnerable to SCI. We need to pay more attention to the elderly's risk of falling. These findings suggested that preventive strategies should be based on the features of different types of TSCI patients. Finally, the importance of SCI rehabilitation must be highlighted.

Analysing the global and local spatial associations of medical resources across Wuhan city using POI data

BACKGROUND

There is a sharp contradiction between the supply and demand of medical resources in the provincial capitals of China. Understanding the spatial patterns of medical resources and identifying their spatial association and heterogeneity is a prerequisite to ensuring that limited resources are allocated fairly and optimally, which, along with improvements to urban residents' quality of life, is a key aim of healthy city planning. However, the existing studies on medical resources pattern mainly focus on their spatial distribution and evolution characteristics, and lack the analyses of the spatial co-location between medical resources from the global and local perspectives. It is worth noting that the research on the spatial relationship between medical resources is an important way to realize the spatial equity and operation efficiency of urban medical resources.

METHODS

Localized colocation quotient (LCLQ) analysis has been used successfully to measure directional spatial associations and heterogeneity between categorical point data. Using point of interest (POI) data and the LCLQ method, this paper presents the first analysis of spatial patterns and directional spatial associations between six medical resources across Wuhan city.

RESULTS

(1) Pharmacies, clinics and community hospitals show "multicentre + multicircle", "centre + axis + dot" and "banded" distribution characteristics, respectively, but specialized hospitals and general hospitals present "single core" and "double core" modes. (2) Overall, medical resources show agglomeration characteristics. The degrees of spatial agglomeration of the five medical resources, are ranked from high to low as follows: pharmacy, clinic, community hospital, special hospital, general hospital and 3A hospital. (3) Although pharmacies, clinics, and community hospitals of basic medical resources are interdependent, specialized hospitals, general hospitals and 3A hospitals of professional medical resources are also interdependent; furthermore, basic medical resources and professional medical resources are mutually exclusive.

CONCLUSIONS

Government and urban planners should pay great attention to the spatial distribution characteristics and association intensity of medical resources when formulating relevant policies. The findings of this study contribute to health equity and health policy discussions around basic medical services and professional medical services.

Secular Trends of Liver Cancer Mortality and Years of Life Lost in Wuhan, China 2010-2019

BACKGROUND

Liver cancer has caused a heavy burden worldwide. This study aimed to estimate the trends in the mortality and years of life lost (YLL) due to liver cancer and decompose the total deaths into three contributors: population growth, population aging, and mortality change.

METHODS

Our study used data from the cause-of-death surveillance system in Wuhan. The mortality and YLL rates were standardized according to the sixth national population census in China. This study calculated the estimated annual percentage change (EAPC) to estimate the trends in the age-standardized mortality rate (ASMR) and age-standardized YLL rate (ASYR). Meanwhile, a decomposition analysis was used to explore the effect of population growth, population aging, and age-specific mortality change on the change in liver cancer deaths.

RESULTS

The ASMR of liver cancer declined at an annual rate of 4.6% from 30.87 per 100,000 people in 2010 to 20.29 per 100,000 people in 2019, while the ASYR was at an annual rate of 5.6% from 969.35 per 100,000 people in 2010 to 581.82 per 100,000 people in 2019. Similar downward trends were seen in men and women. The decomposition analysis found that total deaths number changed by -12.42% from 2010 to 2019, of which population growth and population aging caused the total death numbers to increase by 9.75% and 21.15%, while the age-specific mortality change caused the total death numbers to decrease by 43.32%.

CONCLUSION

Although the ASMR of liver cancer has declined in recent years in Wuhan, it still causes a heavy burden with the increasing population and rapid population aging and remains an essential public health issue. The government should take measures to reduce the burden of liver cancer, especially among men.

Joint Exposure to Ambient Air Pollutants Might Elevate the Risk of Small for Gestational Age (SGA) Infants in Wuhan: Evidence From a Cross-Sectional Study

Objective: To investigate the effect of exposure to multiple ambient air pollutants during pregnancy on the risk of children being born small for gestational age (SGA). Methods: An Air Pollution Score (APS) was constructed to assess the effects of being exposed to six air pollutants simultaneously, PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃ (referred to as joint exposure). A logistic regression model was applied to estimate the associations of APS and SGA. Results: The adjusted odds ratios (ORs) of SGA per 10 ug/m³ increased in APS during the first and second trimesters and the entire pregnancy were 1.003 [95% confidence intervals (CIs): 1.000, 1.007], 1.018 (1.012, 1.025), and 1.020 (1.009, 1.031), respectively. The ORs of SGA for each 10 μg/m³ elevated in APS during the whole pregnancy were 1.025 (1.005, 1.046) for mothers aged over 35 years old vs. 1.018 (1.005, 1.031) for mothers aged under 35 years old. Women who were pregnant for the first time were more vulnerable to joint ambient air pollution. Conclusion: In summary, the results of the present study suggested that joint exposure to ambient air pollutants was associated with the increment in the risks of SGA.

Technology challenges among deaf and hard of hearing elders in China during COVID-19 pandemic emergency isolation: A qualitative study

Digital technology can be an effective tool to facilitate emergency assistance in a pandemic, but many deaf and hard-of-hearing elders may experience challenges in using and adopting these technologies. In the context of the second wave of the COVID-19 outbreak, this study employs a qualitative research method based on in-depth interviews to explore technology challenges among deaf and hard-of-hearing elders in China. The results showed that this group's technology challenges arose mainly from barriers to the mastery of digital technology tools, among which barriers to the use of smartphones, to the accessibility of online medical consultations, and to the presentation of health codes, were most noteworthy. For the informants, these barriers led to social isolation and technology avoidance. What's more, the expectation of individuals to adopt certain types of digital intelligence technologies can inadvertently create inequities for disadvantaged groups and exacerbate the "digital divide." This study highlights the need for emergency management systems to be inclusive of elders with hearing loss in times of public health crises, by providing effective technology support and training to facilitate individuals' access to services and to safeguard their health, interests, and livelihood.

The Impact of Urban Construction Land Change on Carbon Emissions-A Case Study of Wuhan City

Urban construction land (UCL) change is a significant cause of changes in urban carbon emissions. However, as the extent of this effect is currently unclear, cities cannot easily formulate reasonable carbon reduction policies in terms of land use. Taking the city of Wuhan, China, as an example, this paper combines data on land use and carbon emissions from 1995 to 2019 and uses spatial analysis, curve estimation, and correlation evaluation to explore the direct and indirect effects of the UCL changes on carbon emissions. The results show that: (1) Between 1995 and 2019, the UCL area in Wuhan increased by 193.44%, and carbon emissions increased by 78.63%; moreover, both changes showed a gradually increasing spatial correlation, and the quantitative relationship could be better fitted with a composite function model; (2) The UCL change had mainly an indirect impact on carbon emissions via factors such as population and energy use intensity per unit of carbon emissions; (3) The maximum value of carbon emissions inside a unit area decreased during the study period, with an average annual decrease of about 2.02%. Therefore, the city of Wuhan can promote the achievement of its carbon emissions reduction targets by improving the existing land use policies, for example, by dividing the city into multiple functional zones.

The impact of COVID-19 on the economic performance of Wuhan, China (2019-2021)

This paper attempts to evaluate the impact of massive infectious and contagious diseases and its final impact on the economic performance anywhere and anytime. We are considering to evaluate the case of Wuhan, China. We are taking in consideration the case of COVID-19 to be evaluated under a domestic, national, and international level impact. In this paper, we also propose a new simulator to evaluate the impact of massive infections and contagious diseases on the economic performance subsequently. This simulator is entitled "The Impact of Pandemics on the Economic Performance Simulator (IPEP-Simulator)" Hence, this simulator tries to show a macro and micro analysis with different possible scenarios simultaneously. Finally, the IPEP-Simulator was applied to the case of Wuhan-China respectively.

Compound Optimization of Territorial Spatial Structure and Layout at the City Scale from "Production-Living-Ecological" Perspectives

Land-use optimization, as an important resource-allocation method, can be defined as the process of allocating various activities to different geographic units. How to manage and control land expansion has become an urgent issue, leading a series of problems such as environmental damage and a sharp decrease in cultivated land, leading to unfavorable phenomena such as excessive urban expansion, occupation of cultivated land and important ecological spaces, and overheating of real estate development. Based on the land-use data of Wuhan city in 2020, a coupling MOP (Multi-Objective Programming) and FLUS (Future Land-Use Simulation) model was used to examine the national spatial structure and the optimization of the spatial layout. Our results showed that (1) in terms of quantitative optimal allocation, the ecological space and urban space increased, while the agricultural space greatly decreased under the three development scenarios. (2) In the simulation of spatial layout, the urban space mainly expanded vertically in the north-south direction. In the ecological space scenario, the ecological space occupied part of the cultivated land in the northeast of the city, resulting in a high degree of landscape fragmentation, which is not conducive to large-scale agricultural management. However, under optimal comprehensive benefit, part of the fragmented ecological space in the western part of Wuhan was transformed into an agricultural space. (3) A combination of the MOP and FLUS models could effectively determine land-use structure and address spatial layout optimization problems and can project space in the future urban resource configuration mode. This finding can provide a reference for the optimization of the spatial structure and layout of similar cities.

Association between maternal family history of hypertension and preterm birth: modification by noise exposure and multivitamin intake

OBJECTIVE

To measure the effect of maternal family history of hypertension on preterm birth (PTB) and to identify factors that modified this association.

METHODS

A case-control study was nested in a prospective cohort of the entire pregnant population in Wuhan, China, from 2011 to 2013. Home-visit interviews were scheduled for all PTBs and their controls, to collect extensive information on maternal exposures to behavioral, environmental, and intergenerational risk factors of PTB. The effects of maternal family history of hypertension on PTB were measured by logistic regression analyses, controlling for potential confounders. Potential effect modifiers were examined using stratified analyses.

RESULTS

There were 2393 PTBs and 4263 full-term births out of all eligible births. A positive association was observed between maternal family history of hypertension and PTB, after adjusted for potential confounders (adjusted odds ratio: 1.17 [1.03, 1.33]). A higher effect was observed when mothers were exposed to certain noise during pregnancy (adjusted odds ratio: 1.37 [1.14, 1.65]) and/or when they did not take multivitamins during pregnancy (adjusted odds ratio: 1.46 [1.20, 1.78]), whereas, this association was weaker and no longer significant when mothers took multivitamins during pregnancy (adjusted odds ratio: 1.00 [0.84, 1.19]) and/or when they were not exposed to certain noise during pregnancy (adjusted odds ratio: 1.01 [0.85, 1.12]). The modification effect from maternal multivitamin intake was significant on both spontaneous and medically indicated PTBs, and the modification effect from maternal exposure to certain noise was only significant on spontaneous PTB.

CONCLUSIONS

Increased PTB risk was observed for pregnant women with a family history of hypertension in Wuhan, China. This effect was stronger when pregnant women did not take multivitamin and/or exposed to certain noise during pregnancy, than those who took multivitamin and/or unexposed to certain noise.

Long-COVID Symptoms in Individuals Infected with Different SARS-CoV-2 Variants of Concern: A Systematic Review of the Literature

The association of SARS-CoV-2 variants with long-COVID symptoms is still scarce, but new data are appearing at a fast pace. This systematic review compares the prevalence of long-COVID symptoms according to relevant SARS-CoV-2 variants in COVID-19 survivors. The MEDLINE, CINAHL, PubMed, EMBASE and Web of Science databases, as well as the medRxiv and bioRxiv preprint servers, were searched up to 25 October 2022. Case-control and cohort studies analyzing the presence of post-COVID symptoms appearing after an acute SARS-CoV-2 infection by the Alpha (B.1.1.7), Delta (B.1.617.2) or Omicron (B.1.1.529/BA.1) variants were included. Methodological quality was assessed using the Newcastle-Ottawa Scale. From 430 studies identified, 5 peer-reviewed studies and 1 preprint met the inclusion criteria. The sample included 355 patients infected with the historical variant, 512 infected with the Alpha variant, 41,563 infected with the Delta variant, and 57,616 infected with the Omicron variant. The methodological quality of all studies was high. The prevalence of long-COVID was higher in individuals infected with the historical variant (50%) compared to those infected with the Alpha, Delta or Omicron variants. It seems that the prevalence of long-COVID in individuals infected with the Omicron variant is the smallest, but current data are heterogeneous, and long-term data have, at this stage, an obviously shorter follow-up compared with the earlier variants. Fatigue is the most prevalent long-COVID symptom in all SARS-CoV-2 variants, but pain is likewise prevalent. The available data suggest that the infection with the Omicron variant results in fewer long-COVID symptoms compared to previous variants; however, the small number of studies and the lack of the control of cofounders, e.g., reinfections or vaccine status, in some studies limit the generality of the results. It appears that individuals infected with the historical variant are more likely to develop long-COVID symptomatology.

Dynamic simulation and conflict identification analysis of production-living-ecological space in Wuhan, Central China

Under the current rapid urbanization and industrialization in China, competition for production, living, and ecological spaces is becoming fierce. Improving production-living-ecological spaces (PLESs) has become a core issue in China's land-space development strategy. In this study, the multiple linear logistic regression (MLLR)-multicriteria evaluation (MCE)-cellular automata (CA)-Markov hybrid model was used to predict the land-use pattern for 2030, and the spatial conflict model was established based on landscape indices to measure the evolution characteristics of spatial conflicts. The results demonstrated that, from 2005 to 2030, the production-ecological space (PES) will have front-runner status in Wuhan, followed by the ecological-production space (EPS). In 2005-2015, the living-production space (LPS) and PES occupied large amounts of EPS and ecological space (ES), especially in the main urban areas and near rivers, and the spatial transformation was the most significant. By 2030, there will be less transformation of each space type, but the conversion amount of LPS will still be relatively large. With the passage of time, the LPS will increase, the EPS will decrease slightly, and the ES will fluctuate. During the period 2005-2030, the conflict level will change gradually from seriously out of control to controllable, and the hot spot of PLES will show a scattering distribution. The cold spot area will be distributed mainly in the southern part of Wuhan, which will be expanded greatly by 2030. Our research indicates that analyzing the reasonable utilization of PLES is of great value by identifying spatial conflicts; differentiated sustainable development strategies should be formulated according to the future spatial and temporal patterns of PLES, which can help in scientific judgments on the spatial matching of land use and provide early warnings of spatial conflicts. Integr Environ Assess Manag 2022;18:1578-1596. © 2021 SETAC.

Prediction of COVID-19 Infections for Municipalities in the Netherlands: Algorithm Development and Interpretation

Background

COVID-19 was first identified in December 2019 in the city of Wuhan, China. The virus quickly spread and was declared a pandemic on March 11, 2020. After infection, symptoms such as fever, a (dry) cough, nasal congestion, and fatigue can develop. In some cases, the virus causes severe complications such as pneumonia and dyspnea and could result in death. The virus also spread rapidly in the Netherlands, a small and densely populated country with an aging population. Health care in the Netherlands is of a high standard, but there were nevertheless problems with hospital capacity, such as the number of available beds and staff. There were also regions and municipalities that were hit harder than others. In the Netherlands, there are important data sources available for daily COVID-19 numbers and information about municipalities.

Objective

We aimed to predict the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants per municipality in the Netherlands, using a data set with the properties of 355 municipalities in the Netherlands and advanced modeling techniques.

Methods

We collected relevant static data per municipality from data sources that were available in the Dutch public domain and merged these data with the dynamic daily number of infections from January 1, 2020, to May 9, 2021, resulting in a data set with 355 municipalities in the Netherlands and variables grouped into 20 topics. The modeling techniques random forest and multiple fractional polynomials were used to construct a prediction model for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants per municipality in the Netherlands.

Results

The final prediction model had an R² of 0.63. Important properties for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants in a municipality in the Netherlands were exposure to particulate matter with diameters <10 μm (PM10) in the air, the percentage of Labour party voters, and the number of children in a household.

Conclusions

Data about municipality properties in relation to the cumulative number of confirmed infections in a municipality in the Netherlands can give insight into the most important properties of a municipality for predicting the cumulative number of confirmed COVID-19 infections per 10,000 inhabitants in a municipality. This insight can provide policy makers with tools to cope with COVID-19 and may also be of value in the event of a future pandemic, so that municipalities are better prepared.

Secular Trends of Mortality and Years of Life Lost Due to Chronic Obstructive Pulmonary Disease in Wuhan, China from 2010 to 2019: Age-Period-Cohort Analysis

BACKGROUND

Chronic obstructive pulmonary disease (COPD) has been an important public health issue in China. This study aimed to analyze the temporal trends in mortality and years of life lost (YLL) from COPD, and explore the effects of age, period, and cohort in Wuhan, China from 2010 to 2019.

METHODS

Data were collected from the cause of death surveillance system in Wuhan. Age-standardized mortality rate (ASMR), age-standardized YLL rate (ASYR) and the estimated annual percent changes (EAPC) were calculated to evaluate the temporal trends. The age-period-cohort (APC) model was adopted to estimate the age, period, and cohort effects.

RESULTS

From 2010 to 2019, COPD accounted for 26,051.15 deaths and 394,659.58 person years YLL in Wuhan. Recently, the death burden of COPD in Wuhan has somewhat improved, especially after 2015, with declining trends in ASMR and ASYR. Additionally, the ASMR and ASYR of COPD was higher in males. And these of males showed the overall upward trends, with EAPCs of 1.06 (0.13, 2.00) and 1.21 (0.12, 2.31), respectively, while females showed downward trends since 2010. According to APC model, the age effect of COPD increased with age, and the cohort risk ratios (RRs) followed the overall downward trends. Period RRs for the Wuhan population generally tended to rise and then fall, with females showing a clear downward trend after 2015, while period RRs for males maintained an upward trend throughout the study period.

CONCLUSIONS

Recently, the death burden from COPD in Wuhan has improved, especially after 2015, with improvements in ASMR, ASYR and period RRs. Sex differences still exist. COPD posed a greater threat to the elderly, especially males. Public health managers should continue to execute more targeted programs to lessen the death burden of COPD in Wuhan.

Identifying Key Factors Associated with Green Justice in Accessibility: A Gradient Boosting Decision Tree Analysis

Park green space (PGS) provides numerous environmental and health benefits for urban residents, and raises the issue of green justice for its uneven distribution in cities. Previous studies focus more on the measurements of spatial equity in accessibility, but are limited in exploring its impacts-especially the nonlinear influence. This study first measures accessibility and equity in two traffic modes, and then explores the nonlinear influence of multidimensional factors by using the gradient boosting decision tree (GBDT) model across the central urban area of Wuhan. The results show significant spatial disparities in spatial accessibility and equity by walking and driving within 15 min. Multidimensional factors-including characteristics of PGS, the built environment, and socioeconomic factors-present stronger nonlinear influences on spatial accessibility and equity, and the nonlinear influence indicates that the contributions of the built environment and socioeconomic factors are greater than those of park characteristics, accounting for at least 79.76%. The key variables affecting the accessibility and equity are not completely consistent, leading to synergistic and heterogeneous effects, which may provide policy implications for streets where accessibility and equity are mismatched. These findings could provide guidance for PGS planning by decision-makers to improve the living environment and urban health.

A Questionnaire Survey on the Prevalence and Parents' Perceptions of Respiratory Allergies in a 3- to 16-Year-Old Population in Wuhan, China

(1) Background: The prevalence of allergic rhinitis (AR) and asthma has increased rapidly in China. However, perceptions of respiratory allergies and barriers to their management have not attracted enough attention. (2) Objective: To investigate the prevalence of, parents’ perceptions of and their unmet needs for information concerning respiratory allergies in a 3- to 16-year-old children population. (3) Methods: A cross-sectional survey was conducted from June to July 2021 in three schools in Wuhan, China. A total of 1963 participants were recruited through cluster sampling for their parents to complete an online questionnaire regarding respiratory allergic symptoms. The diagnosis of respiratory allergies was based on self-reported symptoms and face-to-face physician evaluation. All the participants with respiratory allergies were asked to complete the Brief Illness Perception Questionnaire (B-IPQ), the Asthma Knowledge Questionnaire (AKQ) and a questionnaire regarding their unmet needs for disease management. (4) Results: The prevalence of respiratory allergies was 29.3% (576/1963) in the 3- to 16-year-old population, among whom AR accounted for 25.7%; asthma, 1.8% and AR-complicated asthma (AR&Asthma), 1.9%. The total B-IPQ score was 40.2 ± 10.9 in the participants with respiratory allergies, and there were no differences among the AR, asthma and AR&Asthma groups (all p > 0.05). The B-IPQ score correlated significantly with symptom onset time and a history of atopic dermatitis (p < 0.01). Nearly one fifth, 18.9%, of the participants with respiratory allergies never went to hospital for treatment, but those with higher B-IPQ scores were more likely to seek professional treatment (p < 0.001). The accuracy rates of AKQ were 72.5% in the participants with asthma and 76.7% in those without asthma (p = 0.147). Among the 576 participants with respiratory allergies, 568 (98.6%) had tried to obtain disease-management information from online platforms, and 55.5% (315/568) were dissatisfied with current platforms; the reasons included incomprehensive contents of illness (45.7%), lack of voice from leading experts (40.3%), too many advertisements (37.5%) and similar contents on different platforms (36.8%). (5) Conclusions: The prevalence of respiratory allergies is high in the 3- to 16-years old population in Wuhan, China. Yet the parents’ perceptions of respiratory allergies and knowledge of asthma are insufficient. It is crucial to increase parents’ awareness of the illness and facilitate their access to truly informative and professional platforms.

Differential Impact of SARS-CoV-2 Isolates, Namely, the Wuhan Strain, Delta, and Omicron Variants on Erythropoiesis

SARS-CoV-2 variants exhibit different viral transmissibility and disease severity. However, their impact on erythropoiesis has not been investigated. Here, we show SARS-CoV-2 variants differentially affect erythropoiesis. This is illustrated by the abundance of CD71⁺ erythroid cells (CECs) in the blood circulation of COVID-19 patients infected with the original Wuhan strain followed by the Delta and Omicron variants. We observed the CD45⁺CECs are the dominant subpopulation of CECs expressing the receptor, ACE2, and coreceptor, TMPRSS2, and thus, can be targeted by SARS-CoV-2. Also, we found CECs exhibit immunosuppressive properties, specifically CD45⁺CECs are the dominant immunosuppressive cells and via reactive oxygen species (ROS) and arginase I expression can impair CD8⁺ T cell functions. In agreement, we observed CECs suppress CD8⁺ T cell effector (e.g., Granzyme B expression and degranulation capacity [CD107]), which was partially but significantly reversed with l-arginine supplementation. In light of the enriched frequency of CECs, in particular, CD45⁺CECs in patients infected with the original (Wuhan) strain, we believe this strain has a more prominent impact on hematopoiesis compared with the Delta and Omicron variants. Therefore, our study provides an important insight into the differential impact of SARS-CoV-2 variants on erythropoiesis in COVID-19 patients.

IMPORTANCE Silent hypoxia has been the hallmark of SARS-CoV-2 infection. Red blood cells (RBCs) work as gas cargo delivering oxygen to different tissues. However, their immature counterparts reside in the bone marrow and normally absent in the blood circulation. We show SARS-CoV-2 infection is associated with the emergence of immature RBCs so called CD71⁺ erythroid cells (CECs) in the blood. In particular, we found these cells were more prevalent in the blood of those infected with the SARS-CoV-2 original strain (Wuhan) followed by the Delta and Omicron variants. This suggests SARS-CoV-2 directly or indirectly impacts RBC production. In agreement, we observed immature RBCs express the receptor (ACE2) and coreceptor (TMPRSS2) for SARS-CoV-2. CECs suppress T cells functions (e.g., Granzyme B and degranulation capacity) in vitro. Therefore, our study provides a novel insight into the differential impact of SARS-CoV-2 variants on erythropoiesis and subsequently the hypoxia commonly observed in COVID-19 patients.

A community-level study on COVID-19 transmission and policy interventions in Wuhan, China

The specific factors and response strategies that affect COVID-19 transmission in local communities remain under-explored in the current literature due to a lack of data. Based on primary COVID-19 data collected at the community level in Wuhan, China, our study contributes a community-level investigation on COVID-19 transmission and response strategies by addressing two research questions: 1) What community factors are associated with viral transmission? and 2) What are the key mechanisms behind policy interventions towards controlling viral transmission within local communities? We conducted two sets of analyses to address these two questions-quantitative analyses of the relationship between community factors and viral transmission and qualitative analyses of policy interventions on community transmission. Our findings show that the viral spread in local communities is irrelevant to the built environment of a community and its socioeconomic position but is related to its demographic composition. Specifically, groups under the age of 18 play an important role in viral transmission. Moreover, a series of community shutdown management initiatives (e.g., group buying, delivering supplies, and self-reporting of health conditions) play an important role in curbing viral transmission at the local level that can be applied to other geographic contexts.

The disaster resilience trajectory of the first batch front-line nurses at fighting the Novel Coronavirus Disease 2019 in Wuhan: A qualitative study

AIM

It is widely accepted that resilience is an essential solution to the challenges caused by disasters or crisis. The resilient individual can actively cope with challenges and maintain a good performance in facing of disastrous events. After the outbreak of Novel Coronavirus Disease 2019 (COVID-19) in Wuhan, China, numerous researchers have engaged in studying the experiences of front-line nurses in Wuhan from different perspectives. However, little is known on how the first batch front-line nurses developed their resilience trajectories during the disastrous events. The purpose of the present study is to explore the disaster resilience trajectory of the first batch front-line nurses at the early-stage of COVID-19 outbreak in Wuhan, Hubei province.

METHOD

Qualitative research method was employed using purposive sampling. Nurses from Sichuan who had anti-epidemic experiences in Wuhan were selected to be conducted in-depth phone interviews. The interviews were transcribed verbatim, and data was analysed by adopting Colaizzi phenomenological approach.

RESULTS

Three theme categories emerged through the data analysis: (1) Challenges and difficulties; (2) Overcoming difficulties; (3) and Personal growth.

CONCLUSION

Nurses have accumulated relevant experiences in dealing with sudden public health events after the rescue task, which can provide psychological and material supports for coping with similar situation in the future. Additionally, multiple support systems were critical elements for front-line nurses to recover from the disaster. Through uncovering front-line nurses' disaster resilience trajectories, it is significant for health care organizations and managers to establish more comprehensive system in handling with public health emergency events.

Associated-Onset Symptoms and Post-COVID-19 Symptoms in Hospitalized COVID-19 Survivors Infected with Wuhan, Alpha or Delta SARS-CoV-2 Variant

This study compared associated-symptoms at the acute phase of infection and post-COVID-19 symptoms between individuals hospitalized with the Wuhan, Alpha or Delta SARS-CoV-2 variant. Non-vaccinated individuals hospitalized because of SARS-CoV-2 infection in one hospital during three different waves of the pandemic (Wuhan, Alpha or Delta) were scheduled for a telephone interview. The presence of post-COVID-19 symptoms was systematically assessed. Hospitalization and clinical data were collected from medical records. A total of 201 patients infected with the Wuhan variant, 211 with the Alpha variant and 202 with Delta variant were assessed six months after hospitalization. Patients infected with the Wuhan variant had a greater number of symptoms at hospital admission (higher prevalence of fever, dyspnea or gastrointestinal problems) than those infected with Alpha or Delta variant (p < 0.01). A greater proportion of patients infected with the Delta variant reported headache, anosmia or ageusia as onset symptoms (p < 0.01). The mean number of post-COVID-19 symptoms was higher (p < 0.001) in individuals infected with the Wuhan variant (mean: 2.7 ± 1.3) than in those infected with the Alpha (mean: 1.8 ± 1.1) or Delta (mean: 2.1 ± 1.5) variant. Post-COVID-19 dyspnea was more prevalent (p < 0.001) in people infected with the Wuhan variant, whereas hair loss was higher in those infected with the Delta variant (p = 0.002). No differences in post-COVID-19 fatigue by SARS-CoV-2 variant were found (p = 0.594). Differences in COVID-19 associated onset symptoms and post-COVID-19 dyspnea were observed depending on the SARS-CoV-2 variant. The presence of fatigue was a common post-COVID-19 symptom to all SARS-CoV-2 variants.

Online information and support seeking during COVID-19 lockdown in Wuhan: implications for health promotion

The lockdown that was deployed in Wuhan, China to combat the COVID-19 pandemic curbed the infection but also created great information challenges for people in social isolation. This resulted in surge in online health information seeking (OHIS) behaviors of the patients and their families. While the Internet has been widely used by Chinese public to access and search health information, there is relatively little research in the context of pandemic outbreaks, especially at the onset of a strong lockdown while many people were panicking. From a total of 10 908 ‘#COVID-19 Patient Seeking Help’ posts on Weibo in a period of 20 days when the lockdown policy was first initiated, we identified 1496 unique patients living in or with family in Wuhan, China. Using textual analysis, we explored OHIS behaviors at the onset of the pandemic. Many faced increased difficulties accessing offline healthcare services and such turned to social media for help and information. In particular, the findings highlight the following themes: ‘OHIS for medical treatment’, ‘OHIS to manage self-quarantine’, ‘OHIS for tangible support’ and ‘OHIS to navigate information discrepancy’. Overall, our findings provide important insights into health information seeking behaviors and the role of social media during a pandemic. Our findings also highlight the importance of considering people’s information need and challenges created due to the lockdown policies in the future pandemic communication and preparedness.

DBSCAN Spatial Clustering Analysis of Urban "Production-Living-Ecological" Space Based on POI Data: A Case Study of Central Urban Wuhan, China

As urban spatial patterns are the prerequisite and foundation of urban planning, spatial pattern research will enable its improvement. The formation mechanism and definition of an urban "production-living-ecological" space is used here to construct a classification system for POI (points of interests) data, crawl POI data in Python, and DBSCAN (density-based spatial clustering of application with noise) to perform cluster analysis. This mechanism helps to determine the cluster density and to study the overall and component spatial patterns of the "production-living-ecological" space in the central urban area of Wuhan. The research results are as follows. (1) The spatial patterns of "production-living-ecological" space have significant spatial hierarchical characteristics. Among them, the spatial polarizations of "living" and "production" are significant, while the "ecological" spatial distribution is more balanced. (2) The "living" space and "production" space noise points account for a small proportion of the total and are locally clustered to easily become areas with development potential. The "ecological" space noise points account for a large proportion of the total. (3) The traffic accessibility has an important influence on the spatial patterns of "production-living-ecological" space. (4) The important spatial nodes of each element are consistent with the overall plan of Wuhan, but the distribution of the nodes for some elements is inconsistent. The research results show that the POI big data can accurately reveal the characteristics of urban spatial patterns, which is scientific and practical and provides a useful reference for the sustainable development of territorial and spatial planning.

Effects of Urban Vibrancy on an Urban Eco-Environment: Case Study on Wuhan City

In the context of rapid urbanisation and an emerging need for a healthy urban environment, revitalising urban spaces and its effects on the urban eco-environment in Chinese cities have attracted widespread attention. This study assessed urban vibrancy from the dimensions of density, accessibility, liveability, diversity, and human activity, with various indicators using an adjusted spatial TOPSIS (technique for order preference by similarity to an ideal solution) method. The study also explored the effects of urban vibrancy on the urban eco-environment by interpreting PM 2.5 and land surface temperature using “big” and “dynamic” data, such as those from mobile and social network data. Thereafter, spatial modelling was performed to investigate the influence of urban vibrancy on air pollution and temperature with inverted and extracted remote sensing data. This process identified spatial heterogeneity and spatial autocorrelation. The majority of the dimensions, such as density, accessibility, liveability, and diversity, are negatively correlated with PM 2.5, thereby indicating that the advancement of urban vibrancy in these dimensions potentially improves air quality. Conversely, improved accessibility increases the surface temperature in most of the districts, and large-scale infrastructure construction generally contributes to the increase. Diversity and human activity appear to have a cooling effect. In the future, applying spatial heterogeneity is advised to assess urban vibrancy and its effect on the urban eco-environment, to provide valuable references for spatial urban planning, improve public health and human wellbeing, and ensure sustainable urban development.

In silico and in vitro evaluation of imatinib as an inhibitor for SARS-CoV-2

The rapid geographic expansion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infectious agent of Coronavirus Disease 2019 (COVID-19) pandemic, poses an immediate need for potent drugs. Enveloped viruses infect the host cell by cellular membrane fusion, a crucial mechanism required for virus replication. The SARS-CoV-2 spike glycoprotein, due to its primary interaction with the human angiotensin-converting enzyme 2 (ACE2) cell-surface receptor, is considered a potential target for drug development. In this study, around 5,800 molecules were virtually screened using molecular docking. Five molecules were selected for in vitro experiments from those that reported docking scores lower than -6 kcal/mol. Imatinib, a Bcr-Abl tyrosine kinase inhibitor, showed maximum antiviral activity in Vero cells. We further investigated the interaction of imatinib, a compound under clinical trials for the treatment of COVID-19, with SARS-CoV-2 RBD, using in silico methods. Molecular dynamics simulations verified that imatinib interacts with RBD residues that are critical for ACE2 binding. This study also provides significant molecular insights on potential repurposable small-molecule drugs and chemical scaffolds for the development of novel drugs targeting the SARS-CoV-2 spike RBD.Communicated by Ramaswamy H. Sarma.

Comparative Study on Residents' Health-Promoting Lifestyle and Life Satisfaction in Wuhan Before and After the COVID-19 Pandemic

The Coronavirus Disease-19 (COVID-19) pandemic has dramatically affected residents' life. Whether the COVID-19 pandemic has significantly influenced the residents' health-promoting lifestyle, and life satisfaction is an urgent problem to be studied. Based on Health Belief Model (HBM), this paper explored and compared the responses of residents' health-promoting lifestyle and life satisfaction on the influence of the COVID-19 pandemic. Data were collected from a sample of 2,054 residents in Wuhan by questionnaire survey. The results show that the total score of health-promoting lifestyle after the COVID-19 pandemic has increased significantly compared with that before the COVID-19 pandemic, and the scores of all dimensions of health-promoting lifestyle have improved. Among them, the scores of exercises, self-actualization, and stress management are significantly higher than those before the COVID-19 pandemic. However, the score of residents' life satisfaction has shown a downward trend. There were also significant differences in life satisfaction on the demographic variables, such as gender, age, education level, marital status, and family average income. The findings are of great significance in promoting residents' health-promoting lifestyles and life satisfaction in the context of the extraordinary pandemic.

Travel changes and equitable access to urban parks in the post COVID-19 pandemic period: Evidence from Wuhan, China

COVID-19 has spread worldwide, leading to a significant impact on daily life. Numerous studies have confirmed that people have changed their travel to urban green spaces during the COVID-19 pandemic. However, in China, where COVID-19 has been effectively controlled, how the travel behavior of visitors to urban parks has changed under different risk levels (RLs) of COVID-19 is unclear. Faced with these gaps, we took a highly developed city, Wuhan, as a case study and a questionnaire survey was conducted with 3276 respondents to analyze the changes in park visitors' travel behaviors under different COVID-19 RLs. Using a stated preference (SP) survey method, four RLs were assigned: new cases in other provinces (RL1), Hubei province (RL2), Wuhan (RL3), and in the district of the park (RL4). The results indicated that visitors reduced their willingness to visit urban parks, with 78.39%, 37.97%, and 13.34% of visitors remaining under RL2, RL3, and RL4, respectively. Furthermore, the service radius of urban parks also shrank from 4230 m under no new cases of COVID-19 to approximately 3000 m under RL3. A higher impact was found for visitors using public transport, those with a higher income and higher education, and female visitors. Based on the modified travel behaviors, the Gaussian-based two-step floating catchment area (2SFCA) method was used to evaluate the accessibility and the Gini coefficient was calculated to represent the equality of the urban parks. A higher RL led to lower accessibility and greater inequitable access. The results should help the government guide residents' travel behaviors after COVID-19.

[Pollution Characteristics and Risk Assessment of DBPs in Typical Drinking Water Sources in Wuhan Under the COVID-19 Pandemic]

In order to reveal the pollution characteristics and risk levels of DBPs in typical drinking water sources in Wuhan under the COVID-19 pandemic, 26 sampling sites were selected in typical drinking water sources in Wuhan. N,N-diethyl-1,4-phenylenediamine spectrophotometry and gas chromatograph-micro-cell electron capture detector (GC-μECD) methods were used to detect residual chlorine disinfectants and DBPs in water, respectively, and their health and ecology risks were assessed. The results showed that free chlorine or total residual chlorine were detected in 16 of the 26 water samples, and the maximum concentration was 0.04 mg·L^-1, which exceeded the limit of the surface water standard in China. The concentration of residual chlorine was higher in sampling sites near the outfall of a municipal sewage plant. There were 34 types of DBPs measured in 10 sampling sites, and 24 types of substances were detected with the detection rate of 10.00%-100.00%. The ρ (total DBPs) was in the range of 0.11-104.73 μg·L^-1, with an average value of 7.26 μg·L^-1. The concentration of chloroform was the highest among all the DBPs, ranging from 9.98 μg·L^-1 to 11.15 μg·L^-1, with an average value of 10.47 μg·L^-1. The concentration of 2-bromo-2-iodoacetamide was the lowest, ranging from ND-0.11 μg·L^-1, with an average value of 0.01 μg·L^-1. The overall detection level of the DBPs area was low in this study area, and the result of the health risk assessment showed that the DBPs had no carcinogenic or non-carcinogenic health risks to human body. However, the results of the ecological risk assessment showed that chloroform presented a high ecological risk to aquatic organisms.

Impact of the coronavirus disease 2019 lockdown on Schistosoma host Oncomelania hupensis density in Wuhan

BACKGROUND

Snails that host the parasitic worm Schistosoma were once controlled or eliminated in Wuhan, China. However, safety measures associated with the outbreak of novel coronavirus disease 2019 (COVID-19) halted snail detection and extermination efforts. The impact of the COVID-19 pandemic on urban schistosomiasis transmission remains unclear. This study aimed to investigate snail density and the associated risk of a schistosomiasis outbreak in Wuhan.

METHODS

The density and infection status of snails were monitored by global positioning system satellites, and outbreak risk was calculated by adjusting the Kaiser model. SigmaPlot was used to create a three-dimensional risk matrix.

RESULTS

The living snail frame occurrence rate was 1.48%, and the average living snail density was 0.054/0.11 m² in 2020, indicating an increase relative to the respective 2019 values (0.019/0.11 m²). No infectious snails were observed in the survey area. The possibility, harmfulness, and uncontrollability indicator values were 0.842, 0.870, and 0.866, respectively. The areas at greatest risk were the northern bank of Tianxingzhou and the Tianxingzhou and Hongshan districts overall. The existing snail sites in the northern bank of Tianxingzhou exhibited the highest risk scores, followed by those in Pak Sha Chau, with the highest risk score found in Yangsiji Village. The events likely to occur in Hongshan District were also likely to have high severity.

CONCLUSIONS

During the COVID-19 outbreak, the risk of schistosomiasis increased due to snail colonies returning to their sites of origin in Wuhan, suggesting a need for strengthened infection control and prevention measures.

Environmental surveillance of SARS-CoV-2 RNA in wastewater systems and related environments in Wuhan: April to May of 2020

Wastewater-based epidemiology (WBE) has emerged as an effective environmental surveillance tool in monitoring fecal-oral pathogen infections within a community. Congruently, SARS-CoV-2, the etiologic agent of COVID-19, has been demonstrated to infect the gastrointestinal tissues, and be shed in feces. In the present study, SARS-CoV-2 RNA was concentrated from wastewater, sludge, surface water, ground water, sediment, and soil samples of municipal and hospital wastewater systems and related environments in Wuhan during the COVID-19 middle and low risk periods, and the viral RNA copies quantified using reverse transcription quantitative polymerase chain reaction (RT-qPCR). From the findings of this study, during the middle risk period, one influent sample and three secondary effluents collected from waste water treatment plant 2, as well as two samples from Jinyintan Hospital wastewater system influent were SARS-CoV-2 RNA positive. One sludge sample collected from Guanggu Branch of Tongji Hospital, which was obtained during the low risk period, was also positive for SARS-CoV-2 RNA. These study findings demonstrate the significance of WBE in continuous surveillance of SARS-CoV-2 at the community level, even when the COVID-19 prevalence is low. Overall, this study can be used as an important reference for contingency management of wastewater treatment plants and COVID-19 prevention and control departments of Wuhan.

The impacts of urban land expansion on ecosystem services in Wuhan, China

A clear understanding of the impacts of urban land expansion on ecosystem services is crucial for sustainable urban planning. Although various studies have shown that urban land expansion caused a degradation of ecosystem services, the relationship between the spatial variation of urban land expansion and ecosystem services still remains unclear. This study quantified the ecosystem services and urban land expansion indicators of Wuhan for 1990-2015 and analyzed the spatial and temporal variation characteristics of ecosystem service values (ESVs) and urban land expansion indicators. Using spatial autocorrelation analysis and linear regression, the quantitative and qualitative correlations between ecosystem services and urban land expansion indicators were explored. The total ESV of Wuhan decreased by 16.47%, representing a loss of 1636.19 million yuan. Areas with extremely low ESVs continuously expanded outward from the urban center. During 2010-2015, the urban land expansion area, intensity, damage weight, and distance peaked, which caused an enormous decrease of the total ESV. Negative correlations were found between urban land expansion and all ecosystem services; the correlation with food production was most significant, indicating that urban land expansion had the strongest impact on food production. The expansion area is the main factor causing the decline of each ecosystem service among urban land expansion indicators. This study presents the impact characteristics of urban land expansion on ecosystem services, and the results provide a reference for reasonable decision making in urban planning.

Environmental surveillance of SARS-CoV-2 RNA in wastewater systems and related environments in Wuhan: April to May of 2020

Wastewater-based epidemiology (WBE) has emerged as an effective environmental surveillance tool in monitoring fecal-oral pathogen infections within a community. Congruently, SARS-CoV-2, the etiologic agent of COVID-19, has been demonstrated to infect the gastrointestinal tissues, and be shed in feces. In the present study, SARS-CoV-2 RNA was concentrated from wastewater, sludge, surface water, ground water, sediment, and soil samples of municipal and hospital wastewater systems and related environments in Wuhan during the COVID-19 middle and low risk periods, and the viral RNA copies quantified using reverse transcription quantitative polymerase chain reaction (RT-qPCR). From the findings of this study, during the middle risk period, one influent sample and three secondary effluents collected from waste water treatment plant 2, as well as two samples from Jinyintan Hospital wastewater system influent were SARS-CoV-2 RNA positive. One sludge sample collected from Guanggu Branch of Tongji Hospital, which was obtained during the low risk period, was also positive for SARS-CoV-2 RNA. These study findings demonstrate the significance of WBE in continuous surveillance of SARS-CoV-2 at the community level, even when the COVID-19 prevalence is low. Overall, this study can be used as an important reference for contingency management of wastewater treatment plants and COVID-19 prevention and control departments of Wuhan.

Wuhan College Students' Self-Directed Learning and Academic Performance: Chain-Mediating Roles of Optimism and Mental Health

This study explored the chain-mediating roles of optimism and mental health in the relation of self-directed learning with academic performance among college students in Wuhan during long-term online teaching. In total, 473 valid responses were obtained from students at three Wuhan universities. Self-directed learning, optimism, mental health, and academic performance scales were used as measurement instruments; a 5-point Likert scale was employed for all items. To examine the instruments' reliability and validity, a measurement model was constructed; moreover, structural models were employed for assessing the chain mediation model. This study confirmed that self-directed learning was a positive predictor of academic performance in Wuhan college students. Optimism and mental health were two mediators and partially jointly mediated the relation of self-directed learning with academic performance. The results revealed that self-directed learning only partially positively predicted academic performance. The aforementioned relationship was partially mediated by optimism and mental health, highlighting the essential roles of optimism and mental health in the learning and learning outcomes of Wuhan college students.

[Real-time Source Apportionment of PM2.5 and Potential Geographic Origins of Each Source During Winter in Wuhan]

China has always suffered from serious atmospheric fine particle (PM_2.5) pollution in winter, and PM_2.5 in Wuhan is particularly affected by regional transportation. Based on the hourly monitoring dataset of chemical components during the winter period, this study identified the real-time sources of PM_2.5 in Wuhan using a positive matrix factorization (PMF) model. A cluster analysis of backward trajectories and the concentration weighted trajectory were applied to obtain the potential source regions and transportation routes. During the observation period, ρ(PM_2.5) was (75.1±29.2) μg·m^-3, and there were two pollution episodes, one of which was mainly affected by the air masses coming from the northwest direction. In the first pollution episode, the increasing concentration of water-soluble ions was the main reason for the high PM_2.5 value, and the concentrations of NH₄⁺, NO₃^-, and SO₄^2- were 1.6, 1.7, and 2.1 times those during the cleaning period, respectively. The other episode was affected by the air masses coming from the east direction, and the secondary organic components were clearly formed. Secondary inorganic aerosol contributed the most (34.1%) to PM_2.5, followed by vehicular exhaust (23.7%), coal combustion (11.5%), road dust (10.9%), iron- and steel-producing processes (8.7%), and firework displays (5.7%). Biomass burning contributed the least (5.3%). Our examination of the diurnal variation revealed that the maximum contribution of iron- and steel-producing processes appeared at 08:00[(17.5±18.8) μg·m^-3], and the lowest was at 01:00[(10.4±10.9) μg·m^-3], which stayed high in the daytime and low at night. The contribution of vehicular exhaust showed a double peak at 09:00[(42.1±24.8) μg·m^-3] and 20:00[(41.6±19.5) μg·m^-3]. In the first pollution period, the contribution rate of secondary inorganic aerosol increased significantly, indicating that the long-distance transport under the northwest air mass promoted the generation of secondary components. In the second pollution period, the contribution rates of vehicular exhaust, coal combustion, iron- and steel-producing processes, and road dust increased, mainly located in the local area, the northwest of Jiangxi and the south of Anhui province. This reflected the influence of industrial processes, road transportation, and dust contribution along the Yangtze River on PM_2.5. Biomass burning had a relatively high contribution for air masses from the northern regions, including Henan, Anhui, the south of Hebei, and the southwest of Shanxi provinces. The regional transport of pollutants from biomass combustion in the North China Plain during the winter would have an impact on Wuhan. This study can provide scientific and technological support for identifying the causes of atmospheric haze pollution in Wuhan during the winter and for the joint prevention and control of atmospheric particulate matter.

Climate indicators and COVID-19 recovery: A case of Wuhan during the lockdown

The world needs to get out of the COVID-19 pandemic smoothly through a thorough socio-economic recovery. The first and the foremost step forward in this direction is the health recovery of the people infected. Our empirical study addresses this neglected point in the recent research on COVID-19 and specifically aims at exploring the impact of the environment on health recovery from COVID-19. The sample data are taken during the lockdown period in Wuhan, i.e., from 23rd January 2020 to 8th April 2020. The recently developed econometric technique of Quantile-on-Quantile regression, proposed by Shin and Zhu (2016) is employed to capture the asymmetric association between environmental factors (TEMP, HUM, PM_2.5, PM₁₀, CO, SO₂, NO₂, and O₃) and the number of recovered patients from COVID-19. We observe significant heterogeneity in the association among variables across various quantiles. The findings suggest that TEMP, PM_2.5, PM₁₀, CO, NO_2, and O₃ are negatively related to the COVID-19 recovery, while HUM and SO₂ show a positive association at most quantiles. The study recommends that maintaining a safe and comfortable environment for the patients may increase the chances of recovery from COVID-19. The success story of Wuhan, the initial epicenter of the novel coronavirus in China, can serve as an important case study for other countries to bring the outbreak under control. The current study could be conducive for the policymakers of those countries where the COVID-19 pandemic is still unrestrained.