The public's considerations about implementing non-pharmaceutical interventions to manage a novel COVID-19 epidemic

In the future, new variants of the SARS-CoV-2 virus might emerge and cause outbreaks. If this occurs, the implementation of non-pharmaceutical interventions (NPIs) can be reconsidered. Consideration of the potential benefits and harms of implementing NPIs, and ultimately deciding about implementing NPIs, is currently mainly executed by experts and governments. However, general literature on public engagement suggests that integrating public perspectives into decision-making can enhance the quality of decisions and foster greater public understanding of them. In this study, a deliberative mini-public was conducted to integrate this public perspective. The aim was to elicit public considerations regarding non-pharmaceutical interventions by asking a diverse group of citizens to participate as decision-makers and convene, learn and deliberate about implementing non-pharmaceutical interventions during a hypothetical outbreak of a new SARS-CoV-2 variant. Participants emphasized the importance of early implementation during the outbreak, to prevent exceeding healthcare capacity, long-term mental health issues, educational deficits, and bankruptcies. Additionally, participants stressed taking public support into account, and shared ideas on maintaining support. Furthermore, participants wanted to give citizens personal responsibility and freedom in making their own assessment regarding adherence to interventions and how much risk of infection they would be willing to accept. Participants also expressed the need for the government to adopt a learning attitude towards improvements in pandemic response, and to generate more focus on long-term strategies. The deliberative mini-public, revealed public considerations that reflected public values and needs. These considerations might be helpful in better aligning epidemic management policies with public perspectives. Regarding the deliberative mini-public, uncertainties remain about the design and impact on a bigger scale.

Driving factors of urban community epidemic prevention and control capability: QCA analysis based on typical cases of 20 anti-epidemic communities in China

Introduction

In the wake of the COVID-19 outbreak, urban communities have emerged as the frontline defenders in epidemic prevention and control, providing the most effective means of curbing the spread of virus both inward and outward. This study attempts to explain the underlying factors and mechanisms that shape the community epidemic prevention and control capacity (CEPCC).

Methods

We adopted a resilience-based perspective and drew on a sample of 20 exemplary anti-epidemic communities in China. By constructing an analytical framework and employing the fuzzy set qualitative comparative analysis method (fsQCA), we explored how four conditional variables-infrastructure completeness, community self-organizing ability, redundancy of community resources, and stability of regional economic development-and their various configurations impact the CEPCC.

Results

Our findings reveal that the four conditional variables, when considered in isolation, cannot effectively enhance the CEPCC. Instead, four configuration pathways with mixed conditional variables exist. Notably, community self-organizing ability emerges as a vital condition for effectively strengthening the CEPCC.

Discussion

This study identifies four pathways to improve the CEPCC and confirms the validity of the data results through case studies. Conclusions of this research contribute to a more nuanced understanding of the factors influencing the CEPCC, which can help communities to better plan and prepare for future epidemics and ensure better response and adaptation to the impacts of future emergencies.

A temporary regulation to manage an impending shortage due to extraordinary prescribing patterns of chloroquines observed during early phase of COVID-19 epidemic

Background

Chloroquine and hydroxychloroquine (C/HC) received considerable international media attention due to anticipated treatment effect in COVID-19. This led to increased prescriptions threatening to generate product shortages for patients prescribed within approved indications.We evaluated effects of a temporary regulation mandating pharmacies to only dispense C/HC prescribed by physicians with defined specialties.

Methods

Data from Region Stockholm, which include 2.4 out of 10 million Sweden's population, were used. Weekly time trends of prescriptions and requisitions of C/HC by prescriber's workplace during January to April 2020 were followed.

Results

Numbers of unique individuals with filled prescriptions of chloroquine increased tenfold and of hydroxychloroquine more than threefold from January to March. In the first week of April, filled prescriptions of C/HC dropped. In the later weeks of April, the number of filled prescriptions was back at similar levels as before the SARS-CoV-2 outbreak.During January and February, specialists in rheumatology accounted for 686 out of all 979 prescriptions dispensed (70.1%) of C/HC. In March, a large proportion of prescriptions dispensed were from specialists not usually prescribing C/HC, and rheumatology accounted for 628 out of all 1,639 prescriptions (38.3%). In April, specialists in rheumatology accounted for 386 out of all 641 prescriptions dispensed (60.0%).

Conclusion

After an observed increase in prescriptions of C/HC, a temporary regulation was introduced on 2nd April 2020 to reduce prescriptions from specialists not usually prescribing C/HC to avoid shortages for patients within approved indications. Subsequently, dispensed prescriptions decreased from April and remained at pre-COVID-19 levels thereafter.

Seasonal correlation of meteorological parameters and PM2.5 with the COVID-19 confirmed cases and deaths in Baghdad, Iraq

The COVID-19 pandemic was a serious global health emergency in 2020 and 2021. This study analyzed the seasonal association of weekly averages of meteorological parameters, such as wind speed, solar radiation, temperature, relative humidity, and air pollutant PM2.5, with confirmed COVID-19 cases and deaths in Baghdad, Iraq, a major megacity of the Middle East, for the period June 2020 to August 2021. Spearman and Kendall correlation coefficients were used to investigate the association. The results showed that wind speed, air temperature, and solar radiation have positive and strong correlations with the confirmed cases and deaths in the cold season (autumn and winter 2020-2021). The total COVID-19 cases negatively correlated with relative humidity but were not significant in all seasons. Besides, PM2.5 strongly correlated with COVID-19 confirmed cases for the summer of 2020. The death distribution by age group showed the highest deaths for those aged 60-69. The highest number of deaths was 41% in the summer of 2020. The study provided useful information about the COVID-19 health emergency and meteorological parameters, which can be used for future health disaster planning, adopting prevention strategies and providing healthcare procedures to protect against future infraction transmission.

Stress and Coping Strategies of Online Nursing Practicum Courses for Taiwanese Nursing Students during the COVID-19 Pandemic: A Qualitative Study

BACKGROUND

The coronavirus disease (COVID-19) pandemic has resulted in significant changes in nursing education. Maintaining social distance could slow down the spread of COVID-19, and it was necessary, but it significantly reduced students' hands-on clinical practice experience in healthcare settings. Traditional classroom teaching in schools has transitioned to distance or online learning methods, which significantly reduced students' hands-on clinical practice experience in healthcare settings. Although distance education had been implemented for a long time, there are many problems and challenges to be resolved. The experiences and needs of nursing students in remote clinical training urgently require further understanding.

PURPOSE

To understand the stress and coping strategies of online nursing practicum courses for Taiwanese nursing students during the COVID-19 pandemic.

METHODS

A qualitative research approach with purposive sampling was supplemented by snowball sampling. Semi-structured interviews were conducted, and the data were collected following the eight-step process outlined by Waltz, Strickland, and Lenz (2010). The participants were 12 nursing students on a two-year nursing RN-to-BSN program at a university in Eastern Taiwan, consisting of 11 females and 1 male student.

FINDINGS

The stress and coping behaviors of nursing students consist of four main themes, each with three subthemes, including "urgent changes", "the gaps between online courses and practical operations", "mixed feelings of joy and anxiety" and "unexpected gains".

CONCLUSIONS

The pandemic has impacted nursing students' learning and living. Engaging in online nursing practicum brought about significant stress; nevertheless, students employed various coping strategies to navigate through this challenging period. The findings of this study would also help nursing educators understand the learning gaps in clinical practicum among students.

[Characteristics of VOCs and Assessment of Emission Reduction Effect During the Epidemic Lockdown Period in Shenzhen Urban Area]

To prevent disease spreading during the COVID-19 epidemic, Shenzhen adopted lockdown measures in March of 2022. This provided an opportunity to study the response of changes in anthropogenic volatile organic compounds (AVOCs) in Shenzhen to emission reduction and to evaluate the effectiveness of current emission reduction measures. This study analyzed the variety of AVOCs before, during, and after the epidemic lockdown based on the online observation data of pollutants at Lianhua Station in Shenzhen from March 7, 2022 to March 27, 2022. Additionally, the sensitivity of ozone formation and the assessment of the reduction effect of precursors was conducted by an observation based model(OBM). The results showed that:affected by regional influences and the interference of meteorological conditions, the average value of AVOCs in Shenzhen urban areas did not drop significantly during the lockdown period compared to that before the lockdown. However, the peak of AVOCs at the morning peak time under the influence of "sea and land wind" during the epidemic lockdown period dropped by 46% on average compared with that during the non-lockdown period, and the aromatic hydrocarbon component dropped the most by 59%. Additionally, under the influence of continuous easterly wind, or during the accumulation and increase of AVOCs affected by regional transmission, aromatic components also decreased by an average of 25% and 21%, respectively. During the lockdown period of the epidemic in Shenzhen, the O₃ formation in urban areas was still AVOCs-limited. Increasing the emission reduction ratio of AVOCs was the most effective measure to reduce O₃ in the short term. In order to ensure the effectiveness of emission reduction, it was recommended that the coordinated emission reduction ratio of AVOCs and NO_x should be greater than 1:2. It was only possible to enter the downward channel of O₃ if the deep emission reduction was more than 60%. This study revealed that the emission reduction of AVOCs during the morning traffic peak during the epidemic lockdown period was conducive to inhibiting the formation of O₃, whereas the control of NO_x would promote it. Strengthening the control of local aromatic hydrocarbon components during the regional impact process could also significantly reduce O₃ production. At this stage, Shenzhen should strengthen the management and control of industrial solvents, especially to reduce the aromatic hydrocarbon components in the solvent source that have a greater impact on the generation of O₃. Further, Shenzhen should continue to promote the reform of the energy structure of motor vehicles to reduce the emission of VOCs in fuel combustion.

Anxiety as a mediator in the relationship between the socioeconomic impact of COVID-19 and quality of life: a cross-sectional study in Vietnam

Previous studies have investigated the effects of the pandemic on quality of life; both economical and psychosocial effects were explored. Some studies also mentioned mediating factors as mechanisms in this relationship; however, the mediating role of anxiety has not been examined. The present study examined the mediating effects of anxiety on the relationship between socioeconomic impact of COVID-19 and quality of life. An online survey of 280 Vietnamese residents was conducted in the context of the pandemic outbreak. Anxiety was found to be a completely mediating variable in the association between the socioeconomic impact of the pandemic and quality of life during the lockdown period. This finding contributes to a better understanding of how the pandemic affects people's quality of life and serves as the foundation for lessening the negative effects of the epidemic on people's lives.

Dynamics of parainfluenza virus among hospitalized children with acute respiratory tract infection under two-child policy and COVID-19 pandemic in Hubei Province, China, 2014-2022

To analyze changes in the detection of parainfluenza virus (PIV) in children hospitalized with acute respiratory tract infection (ARTI) during 2014-2022 in Hubei Province, and explore the impact of the universal two-child policy and the public health measures against COVID-19 epidemic on the prevalence of PIV in China. The study was conducted at the Maternal and Child Health Hospital of Hubei Province. Children aged <18 years with ARTI admitted from January 2014 to June 2022 were enrolled. The infection of PIV was confirmed by the direct immunofluorescence method in nasopharyngeal specimens. Adjusted logistic regression models were used to analyze the influence of the universal two-child policy implementation and public health measurements against COVID-19 on PIV detection. Totally 75 128 inpatients meeting the criteria were enrolled in this study from January 2014 to June 2022 with an overall PIV positive rate of 5.5%. The epidemic seasons of PIV prevalence lagged substantially in 2020. A statistically significant higher positive rate of PIV was observed in 2017-2019 compared to that in 2014-2015 (6.12% vs 2.89%, risk ratio = 2.12, p < 0.001) after the implementation of the universal two-child policy in 2016. A steep decline occurred in PIV positive rate during the COVID-19 epidemic in 2020 (0.92% vs 6.92%, p < 0.001) and it rebounded during the regular epidemic prevention and control period in 2021-2022 (6.35%, p = 0.104). In Hubei Province, the implementation of the universal two-child policy might have led to an increase of PIV prevalence, and public health measures during the COVID-19 epidemic might have influenced the fluctuation in PIV detection since 2020.

Supply chain planning of vaccine and pharmaceutical clusters under uncertainty: The case of COVID-19

As an abrupt epidemic occurs, healthcare systems are shocked by the surge in the number of susceptible patients' demands, and decision-makers mostly rely on their frame of reference for urgent decision-making. Many reports have declared the COVID-19 impediments to trading and global economic growth. This study aims to provide a mathematical model to support pharmaceutical supply chain planning during the COVID-19 epidemic. Additionally, it aims to offer new insights into hospital supply chain problems by unifying cold and non-cold chains and considering a wide range of pharmaceuticals and vaccines. This approach is unprecedented and includes an analysis of various pharmaceutical features such as temperature, shelf life, priority, and clustering. To propose a model for planning the pharmaceutical supply chains, a mixed-integer linear programming (MILP) model is used for a four-echelon supply chain design. This model aims to minimize the costs involved in the pharmaceutical supply chain by maintaining an acceptable service level. Also, this paper considers uncertainty as an intrinsic part of the problem and addresses it through the wait-and-see method. Furthermore, an unexplored unsupervised learning method in the realm of supply chain planning has been used to cluster the pharmaceuticals and the vaccines and its merits and drawbacks are proposed. A case of Tehran hospitals with real data has been used to show the model's capabilities, as well. Based on the obtained results, the proposed approach is able to reach the optimum service level in the COVID conditions while maintaining a reduced cost. The experiment illustrates that the hospitals' adjacency and emergency orders alleviated the service level significantly. The proposed MILP model has proven to be efficient in providing a practical intuition for decision-makers. The clustering technique reduced the size of the problem and the time required to solve the model considerably.

Psychological distress and academic self-efficacy of nursing undergraduates under the normalization of COVID-19: multiple mediating roles of social support and mindfulness

BACKGROUND

Nursing undergraduates' academic self-efficacy is a significant factor in determining their learning motivation, cognition, and emotions. It has a significant impact on improving academic performance and achieving learning goals.

METHODS

To explore the mechanism of psychological distress affecting the academic self-efficacy of nursing undergraduates, the generalized anxiety disorder scale-7, patient health questionnaire-9, academic self-efficacy scale, perceived social support scale and mindful attention awareness scale were conducted.

RESULTS

Model fitness indexes of the structural equation model is good (CMIN/DF = 1.404, RMSEA = 0.042, GFI = 0.977, IFI = 0.977, TLI = 0.954, CFI = 0.975, NFI = 0.923). Structural equation model analysis showed that social support and mindfulness were the mediating variables of psychological distress on academic self-efficacy. Mediating variables accounted for 44% of the total effect value (- 0.3) with a value of - 0.132. Three paths were verified: psychological distress indirectly affected academic self-efficacy through social support (- 0.064); psychological distress indirectly affected academic self-efficacy through mindfulness (- 0.053); psychological distress indirectly affected academic self-efficacy through social support and mindfulness (- 0.015).

CONCLUSIONS

Social support and mindfulness play significant mediating roles in the effect of psychological distress on academic self-efficacy, and the chain mediating role of social support and mindfulness is also significant. Educators may mitigate the impact of psychological distress on academic self-efficacy by enhancing students' social support and mindfulness.

The Role of Mobility in the Dynamics of the COVID-19 Epidemic in Andalusia

Metapopulation models have been a popular tool for the study of epidemic spread over a network of highly populated nodes (cities, provinces, countries) and have been extensively used in the context of the ongoing COVID-19 pandemic. In the present work, we revisit such a model, bearing a particular case example in mind, namely that of the region of Andalusia in Spain during the period of the summer-fall of 2020 (i.e., between the first and second pandemic waves). Our aim is to consider the possibility of incorporation of mobility across the province nodes focusing on mobile-phone time-dependent data, but also discussing the comparison for our case example with a gravity model, as well as with the dynamics in the absence of mobility. Our main finding is that mobility is key toward a quantitative understanding of the emergence of the second wave of the pandemic and that the most accurate way to capture it involves dynamic (rather than static) inclusion of time-dependent mobility matrices based on cell-phone data. Alternatives bearing no mobility are unable to capture the trends revealed by the data in the context of the metapopulation model considered herein.

Monitoring COVID-19 spread in selected Prague's schools based on the presence of SARS-CoV-2 RNA in wastewater

The COVID-19 pandemic has demanded a broad range of techniques to better monitor its extent. Owing to its consistency, non-invasiveness, and cost effectiveness, wastewater-based epidemiology has emerged as a relevant approach to monitor the pandemic's course. In this work, we analyzed the extent of the COVID-19 pandemic in five primary schools in Prague, the Czech Republic, and how different preventive measures impact the presence of SARS-CoV-2 RNA copy numbers in wastewaters. Copy numbers were measured by reverse transcription-multiplex quantitative real-time PCR. These copy numbers were compared to the number of infected individuals in each school identified through regular clinical tests. Each school had a different monitoring regime and subsequent application of preventive measures to thwart the spread of COVID-19. The schools that constantly identified and swiftly quarantined infected individuals exhibited persistently low amounts of SARS-CoV-2 RNA copies in their wastewaters. In one school, a consistent monitoring of infected individuals, coupled with a delayed action to quarantine, allowed for the estimation of a linear model to predict the number of infected individuals based on the presence of SARS-CoV-2 RNA in the wastewater. The results show the importance of case detection and quarantining to stop the spread of the pandemic and its impact on the presence of SARS-CoV-2 RNA in wastewaters. This work also shows that wastewater-based epidemiological models can be reliably used even in small water catchments, but difficulties arise to fit models due to the nonconstant input of viral particles into the wastewater systems.

Effectiveness of and Inequalities in COVID-19 Epidemic Control Strategies in Hungary: A Nationwide Cross-Sectional Study

INTRODUCTION

Before the mass vaccination, epidemiological control measures were the only means of containing the COVID-19 epidemic. Their effectiveness determined the consequences of the COVID-19 epidemic. Our study evaluated the impact of sociodemographic, lifestyle, and clinical factors on patient-reported epidemiological control measures.

METHODS

A nationwide representative sample of 1008 randomly selected adults were interviewed in person between 15 March and 30 May 2021. The prevalence of test-confirmed SARS-CoV-2 infection was 12.1%, of testing was 33.7%, and of contact tracing among test-confirmed infected subjects was 67.9%. The vaccination coverage was 52.4%.

RESULTS

According to the multivariable logistic regression models, the occurrence of infection was not influenced by sociodemographic and lifestyle factors or by the presence of chronic disease. Testing was more frequent among middle-aged adults (aOR = 1.53, 95% CI 1.10-2.13) and employed adults (aOR = 2.06, 95% CI 1.42-3.00), and was more frequent among adults with a higher education (aOR_secondary = 1.93, 95% CI 1.20-3.13; aOR_tertiary = 3.19, 95% CI 1.81-5.63). Contact tracing was more frequently implemented among middle-aged (aOR41-7y = 3.33, 95% CI 1.17-9.45) and employed (aOR = 4.58, 95% CI 1.38-15.22), and those with chronic diseases (aOR = 5.92, 95% CI 1.56-22.47). Positive correlation was observed between age groups and vaccination frequency (aOR41-70y = 2.94, 95% CI 2.09-4.15; aOR71+y = 14.52, 95% CI 7.33-28.77). Higher than primary education (aOR_secondary = 1.69, 95% CI 1.08-2.63; aOR_tertiary = 4.36, 95% CI 2.46-7.73) and the presence of a chronic disease (aOR = 2.58, 95% CI 1.75-3.80) positively impacted vaccination. Regular smoking was inversely correlated with vaccination (aOR = 0.60; 95% CI 0.44-0.83).

CONCLUSIONS

The survey indicated that testing, contact tracing, and vaccination were seriously influenced by socioeconomic position; less so by chronic disease prevalence and very minimally by lifestyle. The etiological role of socioeconomic inequalities in epidemic measure implementation likely generated socioeconomic inequality in COVID-19-related complication and death rates.

The importance of quarantine: modelling the COVID-19 testing process

We incorporate the disease state and testing state into the formulation of a COVID-19 epidemic model. For this model, the basic reproduction number is identified and its dependence on model parameters related to the testing process and isolation efficacy is discussed. The relations between the basic reproduction number, the final epidemic and peak sizes, and the model parameters are further explored numerically. We find that fast test reporting does not always benefit the control of the COVID-19 epidemic if good quarantine while awaiting test results is implemented. Moreover, the final epidemic and peak sizes do not always increase along with the basic reproduction number. Under some circumstances, lowering the basic reproduction number increases the final epidemic and peak sizes. Our findings suggest that properly implementing isolation for individuals who are waiting for their testing results would lower the basic reproduction number as well as the final epidemic and peak sizes.

Changes in healthy effects and economic burden of PM2.5 in Beijing after COVID-19

The COVID-19 lockdown had a positive control effect on urban air quality. However, this effect remains uncertain after the epidemic enters regular management, and furthermore, only limited data are available regarding urban PM_2.5 (aerodynamic diameter ≤ 2.5μm) under the impact of the epidemic. We used daily ambient PM_2.5 concentration data in Beijing to compare and analyze the changes in urban PM_2.5 concentrations before and after the COVID-19 epidemic and to estimate the healthy effects and economic burden associated with PM_2.5 before and after the epidemic. The study found that COVID-19 has a significant impact on the urban environmental PM_2.5 concentration, which is manifested by the decrease in the PM_2.5 concentration in Beijing during the epidemic by 27.8%. Exposure-response models estimated 56.443 (95% CI: 43.084-69.893) thousand people die prematurely in Beijing during the COVID-19 epidemic attributed to long-term PM_2.5 exposure, with a 13.3% decrease in the number of premature deaths year-on-year. The total healthy economic losses attributable to PM_2.5 in Beijing during the COVID-19 epidemic were 35.76 (95% CI: 28.41-42.44) billion yuan, with a per capita loss of 816.8 yuan. Strict control measures throughout the COVID-19 epidemic had a positive impact on air quality in Beijing, with a decrease in both premature deaths and economic healthy losses attributable to fine particles. This paper helps to enrich and expand the research on the impact of COVID-19 on the urban environment and provides a basis for formulating policies related to air quality improvement in the post-epidemic era.

Impacts of the COVID-19 epidemic on carbon emissions from international shipping

The COVID-19 epidemic made the most countries to take strict lockdown measures, what has seriously caused an unprecedented impact in the shipping industries, whereas these measures have also played a significant impact to control carbon emissions from international shipping. Here, we try to use the threshold generalized autoregressive conditional heteroscedasticity and the exponential generalized autoregressive heteroscedasticity to investigate whether the fluctuations of the control variable on carbon emissions from international shipping are asymmetric or not. On this basis, the GARCH-MIDAS model is introduced to discuss whether the newly confirmed cases are independent of control variables and have an impact on the fluctuation of carbon emissions. From the results, we find that the information contained in the newly confirmed cases cannot be covered when adding the other control variables. In addition, the newly confirmed cases have a negative impact on the volatility of carbon emissions, while the other control variables significantly increase carbon emissions. This study provides a quantitative research method for the analysis of the volatility and impact factors on international shipping carbon emissions, which helps to formulate more reasonable emission reduction measures and promote the low-carbon transformations of the global shipping industry.

Relationship between Anxiety, Depression and Learning Burnout of Nursing Undergraduates after the COVID-19 Epidemic: The Mediating Role of Academic Self-Efficacy

BACKGROUND

Although cross-sectional studies on the learning status of nursing undergraduates during the COVID-19 epidemic have surged, few studies have explored the normalization of COVID-19 on students' learning burnout and mental health. The study was designed to investigate the learning burnout of nursing undergraduates in school under the normalization of the COVID-19 epidemic and explore the hypothesized mediation effect of academic self-efficacy in the relationship between anxiety, depression and learning burnout in Chinese nursing undergraduates.

METHODS

A cross-sectional study was conducted among nursing undergraduates in the school of nursing of a university in Jiangsu Province, China (n = 227). A general information questionnaire, College Students' Learning Burnout Questionnaire, Generalized Anxiety Disorder Scale (GAD-7), and Patient Health Questionnaire depression scale (PHQ-9) were administered. Descriptive statistical analysis, Pearson correlation analysis, and multiple linear regression analysis were performed via SPSS 26.0. Process plug-in (Model 4) was used to test the mediating effect of academic self-efficacy (bootstrap 5000 iterations, α = 0.05).

RESULTS

Learning burnout (54.1 ± 0.656) was positively correlated with anxiety (4.6 ± 0.283) and depression (5.3 ± 0.366) (p < 0.01) and was negatively correlated with academic self-efficacy (74.41 ± 0.674) (p < 0.01). Academic self-efficacy plays a mediating role between anxiety and learning burnout (0.395/0.493, 80.12%) and a mediating role between depression and learning burnout (0.332/0.503, 66.00%).

CONCLUSION

Academic self-efficacy has a significant predictive effect on learning burnout. Schools and teachers should strengthen the screening and counselling of students' psychological problems, detect learning burnout caused by emotional problems in advance and improve students' initiative and enthusiasm for learning.

Impact of the COVID-19 epidemic on medical product imports from china from outbreak to stabilization: Monthly panel data regression and instrumental variable test

This study conduct regressions of panal data with OLS and test with IV, empirically examines the COVID-19 epidemic's impact on the import of medical products from China from the perspective of the importing countries, exporting country, and other trading partners, and analyzes the inter-temporal impact across different product categories. The empirical results reveal that, in importing countries, the COVID-19 epidemic increased the import of medical products from China. In China, as an exporting country, the epidemic inhibited the export of medical products; by contrast, for other trading partners, it promoted the import of medical products from China. Among them, key medical products were most affected by the epidemic, followed by general medical products and medical equipment. However, the effect was generally found to wane after the outbreak period. Additionally, we focus on how political relations shape China's medical product export pattern and how the Chinese government is using trade means to improve external relations. In the post-COVID-19 era, countries should prioritize the stability of supply chains for key medical products and actively engage in international cooperation on health governance to further combat the epidemic.

Short- and long-term impacts of the COVID-19 epidemic on urban PM2.5 variations: Evidence from a megacity, Chengdu

As the new coronavirus pandemic enters its third year, its long-term impact on the urban environment cannot be ignored, especially in megacities with more than millions of people. Here, we analyzed the changes in the concentration levels, emission sources, temporal variations and holiday effects of ambient fine particulate matter (PM_2.5) and its chemical components in the pre- and post-epidemic eras based on high-resolution, long time-series datasets of PM_2.5 and its chemical components in Chengdu. In the post-epidemic era, the PM_2.5 concentration in Chengdu decreased by 7.4%, with the components of PM_2.5 decreasing to varying degrees. The positive matrix factorization (PMF) results indicated that the emissions from soil dust and industrial production were significantly lower during the COVID-19 lockdown period and post-epidemic era than those in the pre-epidemic era. In contrast, the contribution of secondary aerosols to PM_2.5 during these two periods increased by 2.7% and 6.6%, respectively. Notably, we found that PM_2.5 and its components substantially decreased on workdays and holidays in the post-epidemic era due to the reduced traffic volume and outdoor activities. This provides direct evidence that changes in the habitual behavior patterns of urban residents in the post-epidemic era could exert an evident positive impact on the urban environment. However, the higher PM_2.5 concentration was observed due to the increased consumption of regular (As₄S₄, Xionghuang in Chinese) and "sulfur incense" during the Dragon Boat Festival holiday in the post-epidemic era. Finally, we examined the potential effects of sporadic COVID-19 outbreaks on the PM_2.5 concentration in Chengdu, and there was no decrease in PM_2.5 during two local COVID-19 outbreak events due to the strong influence of secondary pollution processes.

The research progress, hotspots, challenges and outlooks of solid-phase denitrification process

Nitrogen pollution is one of the main reasons for water eutrophication. The difficulty of nitrogen removal in low-carbon wastewater poses a huge potential threat to the ecological environment and human health. As a clean biological nitrogen removal process, solid-phase denitrification (SPD) was proposed for long-term operation of low-carbon wastewater. In this paper, the progress, hotspots, and challenges of the SPD process based on different solid carbon sources (SCSs) are reviewed. Compared with synthetic SCS and natural SCS, blended SCSs have more application potential and have achieved pilot-scale application. Differences in SCSs will lead to changes in the enrichment of hydrolytic microorganisms and hydrolytic genes, which indirectly affect denitrification performance. Moreover, the denitrification performance of the SPD process is also affected by the physical and chemical properties of SCSs, pH of wastewater, hydraulic retention time, filling ratio, and temperature. In addition, the strengthening of the SPD process is an inevitable trend. The strengthening measures including SCSs modification and coupled electrochemical technology are regarded as the current research hotspots. It is worth noting that the outbreak of the COVID-19 epidemic has led to the increase of disinfection by-products and antibiotics in wastewater, which makes the SPD process face challenges. Finally, this review proposes prospects to provide a theoretical basis for promoting the efficient application of the SPD process and coping with the challenge of the COVID-19 epidemic.

A Study of Public Attitudes toward Shanghai's Image under the Influence of COVID-19: Evidence from Comments on Sina Weibo

With the advent of the Internet era, Chinese users tend to choose to express their opinions on social media platforms represented by Sina Weibo. The changes in people's emotions toward cities from the microblogging texts can reflect the image of cities presented on mainstream social media, and thus target a good image of cities. In this paper, we collected microblog data containing "Shanghai" from 1 January 2019 to 1 September 2022 by Python technology, and we used three methods: Term Frequency-Inverse Document Frequency keyword statistics, Latent Dirichlet Allocation theme model construction, and sentiment analysis by Zhiwang Sentiment Dictionary. We also explore the impact of the COVID-19 epidemic on Shanghai's urban image in the context of the "Shanghai Territorial Static Management", an important public opinion topic during the COVID-19 epidemic. The results of the study show that the "Shanghai-wide static management" of COVID-19 epidemic has significantly reduced the public's perception of Shanghai and negatively affected the city's image. By analyzing the data results, we summarize the basic characteristics of Shanghai's city image and provide strategies for communicating Shanghai's city image in the post-epidemic era.

The COVID-19 epidemic in Poland and its influence on the quality of life of university students (young adults) in the context of restricted access to public spaces

Aim

The aim of this study was to determine the impact of social distancing, self-isolation and limited access to public spaces during the COVID-19 pandemic on the quality of life and psychological well-being of young people.

Subject and methods

The coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus posed a new global challenge in 2020. The new coronavirus emerged locally, but it rapidly spread to all continents and also reached Poland. On 24 March, the Polish Ministry of Health enforced self-isolation measures to contain the transmission of the disease. The new regulations imposed restrictions on civic freedoms, including access to public spaces. These measures significantly affected the daily lives of Polish citizens. Public spaces play a fundamental role in catering to the citizens' basic needs. Access to public spaces is directly correlated with the quality of life, human relations and spontaneous interactions. Young people are highly socially active, and they are frequent users of public spaces. University students (young adults) who transitioned to online learning on 12 March were surveyed remotely with the Microsoft Forms online tool. The questionnaire contained several questions to elicit demographic information about the respondents, as well as 25 closed-ended questions relating to university students' quality of life and access to public spaces during the epidemic. The survey was carried out during the first Polish lockdown in April 2020. The study group was composed of 132 respondents who were university students aged 19-26.

Results

The results revealed a strong correlation between the severity of lockdown measures during the epidemic and the students' activity levels in public spaces, a considerable deterioration in their physical and psychological well-being, and the overall quality of life.

Conclusion

The respondents were significantly affected by the absence of direct social interactions which, in their opinion, can be only partially compensated for by remote contact.

Comparative analysis of prevention and control measures toward COVID-19 epidemic between Shanghai and Beijing

Purpose

By serving and providing a guide for other regional places, this study aims to advance and guide the epidemic prevention and control methods, and practices and strengthen people's ability to respond to COVID-19 and other future potential public health risks.

Design/methodology/approach

A comparative analysis was conducted that the COVID-19 epidemic development trend and prevention and control effects both in Beijing and Shanghai. In fact, regarding the COVID-19 policy and strategic areas, the differences between governmental, social, and professional management were discussed and explored. To prevent and be ready for potential pandemics, experience and knowledge were used and summarized.

Findings

The strong attack of the Omicron variant in early 2022 has posed challenges to epidemic prevention and control practices in many Chinese cities. Shanghai, which had achieved relatively good performance in the fight against the epidemic, has exposed limitations in its epidemic prevention and control system in the face of Omicron. In fact, the city of Beijing has undertaken prompt and severe lockdown measures and achieved rather good results in epidemic prevention and control because of learning from Shanghai's experience and lessons; adhering to the overall concept of "dynamic clearing," implementing precise prevention and monitoring, enhancing community control, and making emergency plans and preparations. All these actions and measures are still essential in the shift from pandemic response to pandemic control.

Research limitations/implications

Different places have introduced different urgent policies to control the spread of the pandemic. Strategies to control COVID-19 have often been based on preliminary and limited data and have tended to be slow to evolve as new evidence emerges. Hence, the effects of these anti-epidemic policies need to be further tested.

Impact of human capital and social capital on employability of Chinese college students under COVID-19 epidemic-Joint moderating effects of perception reduction of employment opportunities and future career clarity

This research constructed a relationship model between human capital, social capital, and the employability of college students. With two moderating variables introduced, the perception reduction of employment opportunities under the COVID-19 epidemic and future career clarity, this research studied the direct impact of human capital and social capital on the employability of college students and boundary conditions. Research data from 810 employed Chinese college graduates shows that both human capital and social capital have a positive and significant impact on the employability; the perception reduction of employment opportunities under the COVID-19 epidemic negatively regulates the relationship between human capital and the employability of college students; the future career clarity positively regulates the relationship between human capital and the employability of college students; the perception reduction of employment opportunities under COVID-19 epidemic and the future career clarity jointly regulate the relationship between human capital, social capital and the employability of college students. These conclusions enrich the relevant theoretical and practical research on the employability of college students under the COVID-19 epidemic.

Emergency response ability training of nursing students in the emergency department under COVID-19 epidemic situation-expert consensus of evidence-based practice and Delphi method

OBJECTIVE

To construct standardized training procedures and measures for emergency nursing students in COVID-19 epidemic setting so as to improve their ability to deal with emergencies.

METHODS

A total of 75 nursing students who were interns in the emergency department of Lu'an People's Hospital of Anhui Province from August 2021 to July 2022 were prospectively selected. Based on the evidence-based methodology and Delphi method, the best evidence for improving the emergency ability of nursing students in emergency department was obtained by systematically retrieving databases such as Web of Science, Cochrane Library and China Knowledge Network. Through two rounds of Delphi expert consultation and consulting experts' opinions, the training plan for emergency ability of nursing students in emergency department under COVID-19 epidemic situation was finally determined, and the effect of the training plan after its implementation was evaluated.

RESULTS

The scores of prevention ability, preparation ability and rescue ability of nursing students increased after training (P<0.05). After training, the nursing students' humanistic care ability, theory test score, operation skill score and condition grading ability score also increased (P<0.05). Additionally, task analysis, self-motivated belief, self-evaluation, self-monitoring and regulation, and total score of nursing students all increased after training (P<0.05). The scores of each dimension in the Chinese Version of Critical Thinking Disposition Inventory (CTDI-CV) scale after training were higher than those before training (P<0.05). Moreover, after training, the correct rate of nursing students' cognition on hospital epidemic prevention and control and the patients' total satisfaction degree to the nursing students' diagnosis and treatment services both increased (P<0.05).

CONCLUSION

The content of the training program for emergency ability of nursing students in emergency department under the COVID-19 epidemic based on the expert consensus of evidence-based and Delphi method was reliable and practical, which helped to improve the emergency ability of nursing students and the correct understanding of the hospital epidemic prevention and control, fully inspired the active learning ability, and enhanced the humanistic care ability and operational skills, and the patient satisfaction was high.

Insight into the microplastics release from disposable face mask: Simulated environment and removal strategy

The fight against the COVID-19 epidemic significantly raises the global demand for personal protective equipment, especially disposable face masks (DFMs). The discarded DFMs may become a potential source of microplastics (MPs), which has attracted much attention. In this work, we identified the detailed source of MPs released from DFMs with laser direct infrared spectroscopy. Polypropylene (PP) and polyurethane (PU) accounted for 24.5% and 57.1% of released MPs, respectively. The melt-blown fabric was a dominant MPs source, however, previous studies underestimated the contribution of mask rope. The captured polyethylene terephthalate (PET), polyamide (PA), polyethylene (PE), and polystyrene (PS) in airborne only shared 18.4% of released MPs. To deepen the understanding of MPs release from medical mask into the aquatic environment, we investigated the effects of environmental factors on MPs release. Based on regression analysis, the effects of temperature, incubation time, and wearing time significantly affect the release of MPs. Besides, acidity, alkalinity, sodium chloride, and humic acid also contributed to the MPs release through corroding, swelling, or repulsion of fibers. Based on the exposure of medical mask to simulated environments, the number of released MPs followed the order: seawater > simulated gut-fluid > freshwater > pure water. Considering the risk of MPs released from DFMs to the environment, we innovatively established a novel flotation removal system combined with cocoamidopropyl betaine, achieving 86% removal efficiency of MPs in water. This work shed the light on the MPs release from DFMs and proposed a removal strategy for the control of MPs pollution.

Intervention of Physical Activity for University Students with Anxiety and Depression during the COVID-19 Pandemic Prevention and Control Period: A Systematic Review and Meta-Analysis

(1) Background: Although physical activity has been widely recognized as an effective way to improve anxiety and depression, we lack a systematic summary of research on improving anxiety and depression during the COVID-19 pandemic. The study aims to systematically analyze how physical activity impacts on this situation in college students during COVID-19. (2) Methods: Both Chinese and English databases (PubMed the Cochrane Library, EMBASE, Web of Science, Scopus, Chinese National Knowledge Infrastructure, Wanfang) were analyzed. All the randomized controlled trials (RCTs) about physical activity intervention for this were included. We received eight eligible RCT experiments before the retrieval time (4 October 2022) in the meta-analysis. (3) Results: Physical activity benefits for college students with significant anxiety were (SMD = -0.50; 95% CI = -0.83 to -0.17; I² = 84%; p < 0.001; Z = 2.98;) and depression (SMD = -0.62; 95% CI = -0.99 to -0.25; I² = 80.7%; p < 0.001; Z = 3.27). Subgroup analyses showed physical activity of different intensities significantly impacted on improving college students' depression and anxiety, but physical activity of 6 < 9 Mets intensity had a greater effect on anxiety than on depression. Interventions of eight weeks or less performed better than those of over eight weeks while interventions less than four times per week had a significant effect on improving the situation. The overall effect of a single intervention of 30 min was more effective than one of over 60 min. (4) Conclusion: Physical activities can effectively improve the situation of anxiety and depression for college students during the COVID-19 pandemic. However, a higher quality RCT experiment is needed to prove it.

Effect of decrease of physical activity on depression and anxiety after the COVID-19 lockdown: A survey study

Purpose

We focused on changes in the amount of physical activity (PA) and depression and anxiety symptoms in people, who were previously regularly physically active, as they were all members of fitness centers at time of lockdown because of COVID-19.

Materials and methods

We sampled 150 fitness center members, tested individually in facilities of fitness centers. Depression and anxiety were measured with subscales of Personality Assessment Inventory (PAI) and PA was measured with global physical activity questionnaire (GPAQ).

Results

We found that depression (t = -1.97; p < 0.05) and anxiety (t = -2.66; p < 0.05) was more present in female participants than male participants, single participants experienced more depression (t = 2.04; p < 0.05) than participants in relationship, unemployed participants experienced more depression (F = 3,24; p < 0.05) and anxiety (F = 5,32; p < 0.01) than employed participants and participants with lower levels of education experienced higher levels of affective depression (F = 3,42; p < 0.05) and physiological anxiety (F = 3,72; p < 0.05) than participants with higher levels of education. Finally, we found that mental health can be influenced by changes in amount of movement-both anxiety (p < 0.05) and depression (p < 0.05) (in whole and its specific dimensions) increased for male participants when there is less strenuous work-related activity, less walking, or cycling to work and when they would spend more time each day sitting. For female participants, affective depression (t = 3.78; p < 0.01) and anxiety (t = 3.23; p < 0.01) increased with increased sitting time. Ex-competitive athletes are particularly immune to anxiety (t = -2.18; p < 0.05) and depression (t = -2.09; p < 0.05).

Discussion

As in some previous studies, our results show that because of lockdown, the most endangered groups for mood disorders are women, singles, unemployed and students, uneducated people and those, who had less PA, and more sitting time. Additionally, those who had some sport competitive history are less endangered for depression and anxiety.

Conclusion

Isolation has great impact on mental health, the most effective solution to stress relief and anxiety is physical exercise, which was limited or non-existent in the time of pandemic. Ex-professional athletes are especially immune to anxiety and depression in events such as COVID-19 lockdown. For future studies we recommend focusing on likelihood of increased depression and anxiety levels in individuals, who were physically active before the isolation period.

Assessing the "negative effect" and "positive effect" of COVID-19 in China

The COVID-19 pandemic lockdowns led to a sharp drop in socio-economic activities in China in 2020, including reductions in fossil fuel use, industry productions, and traffic volumes. China's economy suffered a serious negative effect from COVID-19. However, there is a "positive effect" on CO₂ emissions reduction. Here, for the first time, this paper constructs a new model named "Weighted Multi-regional Hypothetical Extraction Method (WMHEM)" based on a multiregional input-output model. It not only solves the problems of traditional HEM methods such as improper use of assumptions, excessive reliance on industry intermediate input, but also accurately reflects the impact of external shocks on the inter-industry linkages. By using the monthly economic data of each provinces in China during COVID-19 (except Hong Kong，Macao and Taiwan) an the latest Multi-regional input-output tables, the "economic negative effect" and "CO₂ emission positive effect" under COVID-19 in China are measured. Results show that COVID-19 lockdown was estimated to have reduced China's CO₂ emissions substantially between January and March in 2020, with the largest reductions in February. With the spread of coronavirus controlled, China's CO₂ emissions rebounded in April. In addition, key emission reduction sectors and key development encouraged sectors are selected by combining "economic negative effect" and "CO₂ emission positive effect" during COVID-19. Therefore, policies recommendations are put forward based on forward and backward linkages respectively which are from two ends of the supply chain to turn pandemic-related CO₂ emissions declines into firm climate action.

Meaning in life among Chinese undergraduate students in the post-epidemic period: A qualitative interview study

Background

COVID-19 epidemic has lasted for nearly 3 years, and revolutionized social life. In the study, in-depth interviews were conducted with Chinese undergraduate students to explore their understanding and experience of meaning in life. Meaning of life is interpreted from four aspects: life goals, life value, life enthusiasm, and life freedom. These four aspects are independent yet interrelated. Based on the free grasp of life, individuals explore and pursue the true meaning of life goals, acquire life value in evaluating the completion of life goals, and subsequently experience enthusiasm for life. Life enthusiasm and the perception of life value can help individuals to further understand and possess their meaning of life.

Materials and methods

The present study adopts the qualitative method to understand the experience of meaning in life among Chinese undergraduate students. Semi-structured interviews were conducted, and six people participated the study. The Grounded Theory was adopted to analyze the qualitative data.

Results

(1) Chinese undergraduates had clear life goals and obtained a certain sense of achievement and satisfaction when striving for these goals. (2) The life value of Chinese undergraduates was mainly to their families, but there was also a willingness to make due contributions to the country and society. (3) Chinese undergraduates' feelings about life were polarized, but they all expressed the view of "living in the moment and cherishing the present." (4) Chinese undergraduate students see life freedom as freedom of choice and generally believed that COVID-19 did not restrict their lives very much. (5) Chinese undergraduate students gained a deeper understanding of meaning in life after this major public health emergency.

Characteristics of the school adaptation of college freshmen during the COVID-19 epidemic

Few studies have actually explored the impact of the COVID-19 pandemic on mental health in college students, although many studies have suggested that the COVID-19 pandemic poses a great threat to people's mental health in many cohorts. Furthermore, college students may be a particularly vulnerable cohort that needs more attention and access to psychological services due to the psychological changes involved in the transition to college and the characteristics of college students' study habits and lifestyle. Therefore, investigating the basic characteristics of the impact of the COVID-19 pandemic on college freshmen is of great practical importance and has theoretical implications for the identification and provisioning of services to vulnerable cohorts. A total of 5,818 college freshmen completed the College Student Adaptability Inventory. The results suggest that the mean detection rate of the seven dimensions of undergraduate maladjustment to university is 27.13%. Specifically, livelihood self-management adaptability has the highest detection rate (48.93%), while environmental general evaluation has the lowest detection rate (9.81%). Moreover, the school adaptation of college freshmen is impacted by gender, number of siblings, and family socioeconomic status (SES). Specifically, students who are female, an only child, and have a lower SES have lower levels of school adaptation. However, the school adaptation of college freshmen is not influenced by minority status or left-behind status. The findings of the present study suggest that the maladaptation of college freshmen has been a common phenomenon in China during the COVID-19 epidemic. Prevention programs may be most helpful if they pay more attention to effective intervention efforts for students who are female, an only child, and have a lower SES.

Growth-Related Responses to the Threat of COVID-19 among Adolescents

The main objective of our study was to determine whether the experience of the types of pandemic threats included in the study, could activate development responses among adolescents and what the role of the level of stress experienced during the COVID-19 pandemic is in the process of post-traumatic PTG growth. We also made an attempt to investigate whether personality traits and gender were predictors of PTG growth in adolescents. Therefore, the theoretical bases for the interpretation of the obtained results are models of post-traumatic growth (PTG), mainly by Calhoun and Tedeschi. The research was conducted in March 2020. The study subjects were 405 adolescents aged 14 to 20 years, with an average age of 17 years, of whom 59% were females and 41% were males. The following methods were used in the study: IPIP-BFM-20 to estimate five personality traits, PSS- to diagnose perceived stress, and an in-house questionnaire of pandemic threats experienced by adolescents (KŻP). The results showed that the various types of 'pandemic' threats (threats to life, family, and lifestyle) are positive predictors of growth-related changes; additionally, such factors as personality traits (here: extroversion), stress level, and gender had a positive mediating effect on growth-related changes. It was also possible to show that out of the four dimensions of post-traumatic growth, three could be activated under pandemic conditions. These were: changes in relationships with others, greater appreciation of everyday life, and spiritual changes. Changes in self-perception-one of the dimensions of post-traumatic growth, were not activated due to experiencing three types of pandemic threats.

The influence of COVID-19 epidemic on BDI volatility: An evidence from GARCH-MIDAS model

In this study, we use the sample data from Jan 22, 2020 to Jan 21, 2022 to investigate the impacts of added infection number on the volatility of BDI. Under this structure, the control variables (freight rate, Brent crude oil price, container idle rate, port congestion level, global port calls) are added to test whether the information contained in the added infection number is covered. In the GARCH-MIDAS model, we divide the volatility of BDI into the long-term and short-term components, then employ in the least squares regression to empirically test the influences of added infection number on the volatility. From the analysis, we find the added infection numbers effectively impact the BDI volatility. In addition, whether the freight rate, Brent crude oil price, container idle rate, port congestion level, global port calls and other variables are considered alone or at the same time, further the added infection number still significantly influences the volatility of BDI. By studying the ability of the confirmed number to explain the volatility of BDI, a new insight is provided for the trend prediction of BDI that the shipping industry can take the epidemic development of various countries as a reference to achieve the purpose of cost or risk control.

Public engagement in decision-making regarding the management of the COVID-19 epidemic: Views and expectations of the 'publics'

Background

In the management of epidemics, like COVID‐19, trade‐offs have to be made between reducing mortality and morbidity and minimizing socioeconomic and political consequences. Traditionally, epidemic management (EM) has been guided and executed attentively by experts and policymakers. It can, however, still be controversial in the public sphere. In the last decades, public engagement (PE) has been successfully applied in various aspects of healthcare. This leads to the question if PE could be implemented in EM decision‐making.

Methods

From June to October 2020, seven deliberative discussion focus groups were executed with 35 Dutch citizens between 19 and 84 years old. Their views on PE in COVID‐19 management were explored. The deliberative approach allows for the education of participants on the topic before the discussion. The benefits, barriers, timing and possible forms of PE in EM were discussed.

Results

Almost all participants supported PE in EM, as they thought that integrating their experiences and ideas would benefit the quality of EM, and increase awareness and acceptance of measures. A fitting mode for PE was consultation, as it was deemed important to provide the public with possibilities to share ideas and feedback; however, final authority remained with experts. The publics could particularly provide input about communication campaigns and control measures. PE could be executed after the first acute phase of the epidemic and during evaluations.

Conclusions

This paper describes the construction of an empirically informed framework about the values and conditions for PE in EM from the perspective of the public. Participants expressed support to engage certain population groups and considered it valuable for the quality and effectiveness of EM; however, they expressed doubts about the feasibility of PE and the capabilities of citizens. In future studies, these results should be confirmed by a broader audience.

Patient or Public Contribution

No patients or members of the public were involved in the construction and execution of this study. This study was very exploratory, to gain a first insight into the views of the public in the Netherlands, and will be used to develop engagement practices accordingly. At this stage, the involvement of the public was not yet appropriate.

The Structure of the Relationship between Physical Activity and Psychosocial Functioning of Women and Men during the COVID-19 Epidemic in Poland

Since the coronavirus disease (COVID-19) pandemic is a serious crisis in many countries around the world, it is important to conduct empirical research aimed at identifying risks and factors protecting the functioning of people affected by it. For this reason, the goals of the present research were to determine the level of physical activity and the severity of symptoms characteristic of mental disorders, cognitive disorders and the quality of social functioning, as well as the structure of the relationship between physical activity and psychosocial functioning of 226 women and 226 men during the COVID-19 epidemic in Eastern Poland. The research was conducted using the IPAQ-SF Questionnaire, GHQ-28 Questionnaires, TUS Test-6/9 version, the original SFS Scale and a self-developed sociodemographic survey. The collected data indicate that women as compared to men show lower levels of weekly physical activity, walking, moderate activity, vigorous activity and quality of functioning in family relationships, but higher severity of mental health disorders, somatic symptoms, functional disorders, depressive symptoms, cognitive disorders, perceptual work disorders, attention deficits and higher quality of functioning in work relationships. On the other hand, the structural model indicates that physical activity, interacting with mental health disorders and cognitive disorders, is positively associated with the social functioning of the respondents, and gender is the moderator of the occurring dependencies. This suggests that physical activity adapted to the condition of health may be an important component of gender-individualized psychopreventive interventions.

Resumption of school after lockdown in COVID-19 pandemic: Three case reports

BACKGROUND

Students in the 9^th grade of junior high school in Changsha were under a 75 d lockdown due to the coronavirus disease 2019 (COVID-19) pandemic. After the resumption of school post-lockdown, the 9^th grade students in Changsha faced the entrance physical examination test for senior high school.

CASE SUMMARY

We report on 3 cases of occult fracture on the same site in adolescents of the same grade since resumption of school after the lockdown from the COVID-19 pandemic. Three students in the 9^th grade of junior high school who were facing the physical examination in 2 wk were diagnosed with an occult fracture of the distal femur.

CONCLUSION

It is recommended that the students, parents, education providers and policy makers should all pay attention to the physical exercise of students when the resumption of school after lockdown occurs and they should be aware of occult fractures when the adolescents have pain after physical exercise.

Controlling Multiple COVID-19 Epidemic Waves: An Insight from a Multi-scale Model Linking the Behaviour Change Dynamics to the Disease Transmission Dynamics

COVID-19 epidemics exhibited multiple waves regionally and globally since 2020. It is important to understand the insight and underlying mechanisms of the multiple waves of COVID-19 epidemics in order to design more efficient non-pharmaceutical interventions (NPIs) and vaccination strategies to prevent future waves. We propose a multi-scale model by linking the behaviour change dynamics to the disease transmission dynamics to investigate the effect of behaviour dynamics on COVID-19 epidemics using game theory. The proposed multi-scale models are calibrated and key parameters related to disease transmission dynamics and behavioural dynamics with/without vaccination are estimated based on COVID-19 epidemic data (daily reported cases and cumulative deaths) and vaccination data. Our modeling results demonstrate that the feedback loop between behaviour changes and COVID-19 transmission dynamics plays an essential role in inducing multiple epidemic waves. We find that the long period of high-prevalence or persistent deterioration of COVID-19 epidemics could drive almost all of the population to change their behaviours and maintain the altered behaviours. However, the effect of behaviour changes fades out gradually along the progress of epidemics. This suggests that it is essential to have not only persistent, but also effective behaviour changes in order to avoid subsequent epidemic waves. In addition, our model also suggests the importance to maintain the effective altered behaviours during the initial stage of vaccination, and to counteract relaxation of NPIs, it requires quick and massive vaccination to avoid future epidemic waves.

Multifunctional Flexible Humidity Sensor Systems Towards Noncontact Wearable Electronics

In the past decade, the global industry and research attentions on intelligent skin-like electronics have boosted their applications in diverse fields including human healthcare, Internet of Things, human-machine interfaces, artificial intelligence and soft robotics. Among them, flexible humidity sensors play a vital role in noncontact measurements relying on the unique property of rapid response to humidity change. This work presents an overview of recent advances in flexible humidity sensors using various active functional materials for contactless monitoring. Four categories of humidity sensors are highlighted based on resistive, capacitive, impedance-type and voltage-type working mechanisms. Furthermore, typical strategies including chemical doping, structural design and Joule heating are introduced to enhance the performance of humidity sensors. Drawing on the noncontact perception capability, human/plant healthcare management, human-machine interactions as well as integrated humidity sensor-based feedback systems are presented. The burgeoning innovations in this research field will benefit human society, especially during the COVID-19 epidemic, where cross-infection should be averted and contactless sensation is highly desired.

International student perceptions of online medical education during the COVID-19 epidemic

This study aimed to investigate how international students enrolled on medical and surgical bachelor's degree programs (MBBS) in China perceived online medical education course, compared to native Chinese students during the Covid-19 pandemic. The perceptions of 38 MBBS and 31 Chinese sophomores were surveyed using the Chaoxing platform. The international student group's mean satisfaction with online teaching was 2.737 on a 5-point scale, much lower than the Chinese students' mean score of 4.355 (p < 0.05). Similarly, the international students expressed less satisfaction than the Chinese learners with other aspects of the course, including the teacher's level, at 3.964 ± 0.818 versus 4.445 ± 0.548 (p < 0.05); curriculum organization, at 3.651 ± 0.848 versus 4.333 ± 0.568 (p < 0.05); and self-learning level, at 3.634 ± 0.996 versus 3.686 ± 0.949 (p > 0.05), respectively. There were also noteworthy differences between the progress made by the international students in Chinese language learning, which was positively correlated with satisfaction with teaching on the online medical education (p < 0.05). The results suggest that, while online teaching was a necessary response to the Covid-19 pandemic, satisfaction with this mode of education is lower among international students than their Chinese counterparts.

[Influence of COVID-19 Prevention and Control Measures on PM2.5 Concentration, Particle Size Distribution, Chemical Composition, and Source in Zhengzhou, China]

The COVID-19 lockdown was a typical occurrence of extreme emission reduction, which presented an opportunity to study the influence of control measures on particulate matter. Observations were conducted from January 16 to 31, 2020 using online observation instruments to investigate the characteristics of PM_2.5 concentration, particle size distribution, chemical composition, source, and transport before (January 16-23, 2020) and during (January 24-31, 2020) the COVID-19 lockdown in Zhengzhou. The results showed that the atmospheric PM_2.5 concentration decreased by 4.8% during the control period compared with that before the control in Zhengzhou. The particle size distribution characteristics indicated that there was a significant decrease in the mass concentration and number concentration of particles in the size range of 0.06 to 1.6 μm during the control period. The chemical composition characteristics of PM_2.5 showed that secondary inorganic ions (sulfate, nitrate, and ammonium) were the dominant component of PM_2.5, and the significant increase in PM_2.5 was mainly owing to the decrease in NO₃^- concentration during the control period. The main sources of PM_2.5 identified by the positive matrix factorization (PMF) model were secondary sources, combustion sources, vehicle sources, industrial sources, and dust sources. The emissions from vehicle sources, industrial sources, and dust sources decreased significantly during the control period. The results of analyses using the backward trajectory method and potential source contribution factor method indicated that the effects of transport from surrounding areas on PM_2.5 concentration decreased during the control period. In summary, vehicle and industrial sources should be continuously controlled, and regional combined prevention and control should be strengthened in the future in Zhengzhou.

Monitoring COVID-19 spread in Prague local neighborhoods based on the presence of SARS-CoV-2 RNA in wastewater collected throughout the sewer network

Many reports have documented that the presence of SARS-CoV-2 RNA in the influents of municipal wastewater treatment plants (WWTP) correlates with the actual epidemic situation in a given city. However, few data have been reported thus far on measurements upstream of WWTPs, i.e. throughout the sewer network. In this study, the monitoring of the presence of SARS-CoV-2 RNA in Prague wastewater was carried out at selected locations of the Prague sewer network from August 2020 through May 2021. Various locations such as residential areas of various sizes, hospitals, city center areas, student dormitories, transportation hubs (airport, bus terminal), and commercial areas were monitored together with four of the main Prague sewers. The presence of SARS-CoV-2 RNA was determined by reverse transcription - multiplex quantitative polymerase chain reaction (RT-mqPCR) after the precipitation of nucleic acids with PEG 8,000 and RNA isolation with TRIzol™ Reagent. The number of copies of the gene encoding SARS-CoV-2 nucleocapsid (N1) per liter of wastewater was compared with the number of officially registered COVID-19 cases in Prague. Although the data obtained by sampling wastewater from the major Prague sewers were more consistent than those obtained from the small sewers, the correlation between wastewater-based and clinical-testing data was also good for the residential areas with more than 7,000 registered inhabitants. It was shown that monitoring SARS-CoV-2 RNA in wastewater sampled from small sewers could identify isolated occurrences of COVID-19-positive cases in local neighborhoods. This can be very valuable while tracking COVID-19 hotspots within large cities.

Monitoring COVID-19 spread in Prague local neighborhoods based on the presence of SARS-CoV-2 RNA in wastewater collected throughout the sewer network

Many reports have documented that the presence of SARS-CoV-2 RNA in the influents of municipal wastewater treatment plants (WWTP) correlates with the actual epidemic situation in a given city. However, few data have been reported thus far on measurements upstream of WWTPs, i.e. throughout the sewer network. In this study, the monitoring of the presence of SARS-CoV-2 RNA in Prague wastewater was carried out at selected locations of the Prague sewer network from August 2020 through May 2021. Various locations such as residential areas of various sizes, hospitals, city center areas, student dormitories, transportation hubs (airport, bus terminal), and commercial areas were monitored together with four of the main Prague sewers. The presence of SARS-CoV-2 RNA was determined by reverse transcription - multiplex quantitative polymerase chain reaction (RT-mqPCR) after the precipitation of nucleic acids with PEG 8,000 and RNA isolation with TRIzol™ Reagent. The number of copies of the gene encoding SARS-CoV-2 nucleocapsid (N1) per liter of wastewater was compared with the number of officially registered COVID-19 cases in Prague. Although the data obtained by sampling wastewater from the major Prague sewers were more consistent than those obtained from the small sewers, the correlation between wastewater-based and clinical-testing data was also good for the residential areas with more than 7,000 registered inhabitants. It was shown that monitoring SARS-CoV-2 RNA in wastewater sampled from small sewers could identify isolated occurrences of COVID-19-positive cases in local neighborhoods. This can be very valuable while tracking COVID-19 hotspots within large cities.

Investigation of the influence of mineral dust on airborne particulate matter during the COVID-19 epidemic in spring 2020 over China

A regional air quality model system (RAQMS) driven by the Weather Research and Forecasting model (WRF) is applied to investigate the distribution and evolution of mineral dust and anthropogenic aerosols over China in April 2020, when air quality was improved due to reduced human activity during the COVID-19 epidemic, whereas dust storms began to attack China and deteriorated air quality. A dust deflation model was developed and improved mineral dust prediction. Model validation demonstrated that RAQMS was able to reproduce PM₁₀, PM_2.5 and aerosol components reasonably well. China suffered from three dust events in April 2020, with the maximum hourly PM₁₀ concentrations exceeding 700 μg m^-3 in downwind cities over the North China Plain (NCP). Mineral dust dominated PM₁₀ mass (>80%) over the Gobi deserts in north and west China, while it comprised approximately 30-50% of PM₁₀ over wide areas of east China. The domain and monthly mean dust mass fractions in PM₁₀ were estimated to be 47% and 43% over the North China Plain and east China, respectively. On average, mineral dust contributed up to 22% and 21% of PM_2.5 mass over the North China Plain and east China in April 2020, respectively. Sulfate and nitrate produced by heterogeneous chemical reactions on dust surface accounted for approximately 9% and 13% of secondary inorganic aerosols (SIA) concentration over the North China Plain and east China, respectively. The results from this study demonstrated that mineral dust made an important contribution to particulate matter mass during the COVID-19 epidemic in spring 2020 over China.

Modeling and Preliminary Analysis of the Impact of Meteorological Conditions on the COVID-19 Epidemic

Since the COVID-19 epidemic outbreak at the end of 2019, many studies regarding the impact of meteorological factors on the attack have been carried out, and inconsistent conclusions have been reached, indicating the issue's complexity. To more accurately identify the effects and patterns of meteorological factors on the epidemic, we used a combination of logistic regression (LgR) and partial least squares regression (PLSR) modeling to investigate the possible effects of common meteorological factors, including air temperature, relative humidity, wind speed, and surface pressure, on the transmission of the COVID-19 epidemic. Our analysis shows that: (1) Different countries and regions show spatial heterogeneity in the number of diagnosed patients of the epidemic, but this can be roughly classified into three types: "continuous growth", "staged shock", and "finished"; (2) Air temperature is the most significant meteorological factor influencing the transmission of the COVID-19 epidemic. Except for a few areas, regional air temperature changes and the transmission of the epidemic show a significant positive correlation, i.e., an increase in air temperature is conducive to the spread of the epidemic; (3) In different countries and regions studied, wind speed, relative humidity, and surface pressure show inconsistent correlation (and significance) with the number of diagnosed cases but show some regularity.

Designing an integrated responsive-green-cold vaccine supply chain network using Internet-of-Things: artificial intelligence-based solutions

In this paper, a new responsive-green-cold vaccine supply chain network during the COVID-19 pandemic is developed for the first time. According to the proposed network, a new multi-objective, multi-period, multi-echelon mathematical model for the distribution-allocation-location problem is designed. Another important novelty in this paper is that it considers an Internet-of-Things application in the COVID-19 condition in the suggested model to enhance the accuracy, speed, and justice of vaccine injection with existing priorities. Waste management, environmental effects, coverage demand, and delivery time of COVID-19 vaccine simultaneously are therefore considered for the first time. The LP-metric method and meta-heuristic algorithms called Gray Wolf Optimization (GWO), and Variable Neighborhood Search (VNS) algorithms are then used to solve the developed model. The other significant contribution, based on two presented meta-heuristic algorithms, is a new heuristic method called modified GWO (MGWO), and is developed for the first time to solve the model. Therefore, a set of test problems in different sizes is provided. Hence, to evaluate the proposed algorithms, assessment metrics including (1) percentage of domination, (2) the number of Pareto solutions, (3) data envelopment analysis, and (4) diversification metrics and the performance of the convergence are considered. Moreover, the Taguchi method is used to tune the algorithm's parameters. Accordingly, to illustrate the efficiency of the model developed, a real case study in Iran is suggested. Finally, the results of this research show MGO offers higher quality and better performance than other proposed algorithms based on assessment metrics, computational time, and convergence.

Lessons drawn from China and South Korea for managing COVID-19 epidemic: Insights from a comparative modeling study

We conducted a comparative study of the COVID-19 epidemic in three different settings: mainland China, the Guangdong province of China and South Korea, by formulating two disease transmission dynamics models which incorporate epidemic characteristics and setting-specific interventions, and fitting the models to multi-source data to identify initial and effective reproduction numbers and evaluate effectiveness of interventions. We estimated the initial basic reproduction number for South Korea, the Guangdong province and mainland China as 2.6 (95% confidence interval (CI): (2.5, 2.7)), 3.0 (95%CI: (2.6, 3.3)) and 3.8 (95%CI: (3.5,4.2)), respectively, given a serial interval with mean of 5 days with standard deviation of 3 days. We found that the effective reproduction number for the Guangdong province and mainland China has fallen below the threshold 1 since February 8th and 18th respectively, while the effective reproduction number for South Korea remains high until March 2nd Moreover our model-based analysis shows that the COVID-19 epidemics in South Korean is almost under control with the cumulative confirmed cases tending to be stable as of April 14th. Through sensitivity analysis, we show that a coherent and integrated approach with stringent public health interventions is the key to the success of containing the epidemic in China and especially its provinces outside its epicenter. In comparison, we find that the extremely high detection rate is the key factor determining the success in controlling the COVID-19 epidemics in South Korea. The experience of outbreak control in mainland China and South Korea should be a guiding reference for the rest of the world.

A Qualitative Study on Knowledge, Attitude, and Practice of Nursing Students in the Early Stage of the COVID-19 Epidemic and Inspiration for Nursing Education in Mainland China

Background:

At the beginning of the COVID-19 outbreak, there was a lack of sufficient nursing experience for pneumonia caused by COVID-19. All nursing decisions had to be innovatively made and measures taken by nurses using their existing knowledge and skills. This required nurses to have a solid theoretical understanding of infectious diseases and epidemiology, evidence-based solid practice skills, and problem-solving skills. The COVID outbreak reminded undergraduates to master relevant knowledge and abilities during school study.

Methods

Qualitative research on knowledge, attitude, and practice (KAP) of the COVID-19 epidemic was conducted using semi-structured interviews among sophomore nursing students in the university. Based on the characteristics of the KAP of nursing students, we analyzed the deficiencies of the knowledge and ability to deal with large-scale public health emergencies in the second-year nursing education.

Results

A total of 12 subject headings and 41 sublevel headings were identified from three aspects of KAP. The subject headings included knowledge aspect (the origin of the disease, the route of transmission, main symptoms, the epidemiological characteristics of the disease, scientific cognition of information sources), attitude aspect (different emotional experiences, a certain degree of influence, different views on the development trend of the epidemic, support the government's prevention and control strategies), and behavior aspect (do an excellent job in self-protection, help family members to protect, and participate in social anti-epidemic actions). According to this analysis, second-year nursing students have three deficiencies in dealing with large-scale public health emergencies: knowledge of infectious diseases and epidemiology, evidence-based practice skills, and problem- solving ability.

Conclusion

When students start nursing professional courses, the knowledge of infectious diseases and epidemiology, training of evidence-based practice skills, and problem-solving ability should be strengthened to improve the ability of nursing undergraduates to respond to large-scale public health emergencies after entering the workplace.

Factors Associated with Community Awareness on COVID-19 in a Developing Country: Implications for Optimal Risk Communication

Purpose

New COVID-19 variants pose great challenges in protecting the success of vaccination programs. Awareness of community becomes an important component to prevent the spread of COVID-19. This study aims to analyze people's awareness of COVID-19 and identify the implications for optimal risk communication in Vietnam.

Study Methods and Materials

A total of 341 individuals participated in an online cross-sectional study. Community awareness on COVID-19 was examined by using a structured questionnaire. Multivariable Tobit regression was used to examine associated factors with community awareness.

Results

Our results indicated high levels of awareness of local COVID-19 situation, transmission risks, and preventive behavioral practices during the first week of social isolation. Higher awareness of local pandemic situation was associated with female respondents (Coef.: 6.19; 95% CI: 0.51; 11.87) and larger family sizes of above 5 people (Coef.: 9.00; -1.00; 19.00). Respondents between 35-44 years old were shown to be less aware of preventive behavioral practices than other age groups, including the group of participants above 44 years old (Coef.: -0.34; 95% CI: -0.67; -0.02). Lastly, participants who were "fairly satisfied" with information resources had awareness levels of preventive behavioral practices lower than that of "unsatisfied" respondents (Coef.: -0.45; 95% CI: 0.74; -0.16).

Conclusion

This study offers crucial insights into the pandemic awareness of citizens and risk communication effectiveness during COVID-19 in Vietnam. The study findings shall serve the development of policies and interventions aimed at empowering individuals in the local and global fight against coronavirus.

Analysis of Online Consultations and Emergent Treatments of Operative Dentistry and Endodontics during the COVID-19 Epidemic

BACKGROUND

The purpose of the present study is to evaluate the characteristics of online consultations and emergent dental treatments and analyze the status of diseases related to operative dentistry and endodontics (ODE) during the COVID-19 epidemic.

METHODS

Online consultations were collected from 3 February to 21 April 2020. The electronic medical record system was accessed to collect clinical diagnoses and emergent dental treatments from 9 January to 21 April 2020.

RESULTS

A total of 2419 patients visited us and received treatments 2 weeks before the lockdown. The number of patients decreased to 537 during the 76 days of the lockdown. Among them, dental examinations accounted for the majority of visits (88.83%). After 7 April, the outpatient number increased to 36.79 ± 6.63 per day, but the proportion of dental examinations and treatments did not change significantly. A total of 1218 online consultations were completed before the lockdown. The most common dental problem was pulpitis (48.1%). After 7 April, consultations surged from 23.15 ± 8.54 to 44.43 ± 12.63 per day. Consultations related to pulpitis, apical periodontitis, or dental caries remained stable.

CONCLUSIONS

Correct understanding, active treatments, and appropriate psychological interventions for the ODE staff during the COVID-19 epidemic are necessary. Our results may provide references to arrange staff and treat patients more efficiently for future epidemics.

Analysis and modeling of COVID-19 epidemic dynamics in Saudi Arabia using SIR-PSO and machine learning approaches

INTRODUCTION

COVID-19 has become a global concern because it has extensive damage to health, social and economic systems worldwide. Consequently, there is an urgent need to develop tools to understand, analyze, monitor and control further outbreaks of the disease.

METHODOLOGY

The Susceptible Infected Recovered-Particle SwarmOptimization model and the feed-forward artificial neural network model were separately developed to model COVID-19 dynamics based on daily time-series data reported by the Saudi authorities from March 2, 2020 to February 21, 2021. The collected data were divided into training and validation datasets. The effectiveness of the investigated models was evaluated by using various performance metrics. The Susceptible-Infected-Recovered-Particle-Swarm-Optimization model was found to well predict the cumulative infected and recovered cases and to optimally tune the contact rate and the characteristic duration of the illness. The feed-forward artificial neural network model was found to be efficient in modeling daily new and cumulative infections, recoveries and deaths.

RESULTS

The forecasts provided by the investigated models had high coefficient of determination values of more than 0.97 and low mean absolute percentage errors (around 7% on average).

CONCLUSIONS

Both the Susceptible-Infected-Recovered-Particle-Swarm-Optimization and feed-forward artificial neural network models were efficient in modeling COVID-19 dynamics in Saudi Arabia. The results produced by the models can help the Saudi health authorities to analyze the virus dynamics and prepare efficient measures to control any future occurrence of the epidemic.