关键词： Internet access   Middle-aged and older adults   Depressive symptoms   COVID-19  

摘要： Background Amid the COVID-19 pandemic, the mental health of middle-aged and older adults has become an increasing concern, and the role of the internet in addressing this public health crisis has drawn the attention of researchers. This study evaluated the impact of internet access during COVID-19 on depressive symptoms among middle-aged and older adults. Methods Data were derived from China Health and Retirement Longitudinal Study (CHARLS) 2018 and 2020. Difference-in-differences analysis was performed to compare changes in depressive symptoms between the internet users during COVID-19 and those who didn't have access to the internet before and during the pandemic. Results We found that internet access during COVID-19 pandemic significantly reduced middle-aged and older adults' depressive symptoms. Further investigation identified the underlying mechanisms through which internet access helps in alleviating depressive symptoms by reducing the likelihood of experiencing negative emotions about COVID-19. Heterogeneity analyses showed that rural residents and middle-aged individuals benefited more from internet access during the pandemic. Conclusions Since internet access can alleviate middle-aged and older adults' depressive symptoms amidst public health crisis, policy makers should focus on enhancing their access to the internet.

关键词： Priority setting   COVID-19   Pandemic plans   Evaluation   Global comparative analysis   HEALTH  

摘要： Background: The COVID-19 pandemic forced governments across the world to consider how to prioritize resource allocation. Most countries produced pandemic preparedness plans that guide and coordinate healthcare, including how to allocate scarce resources such as ventilators, human resources, and therapeutics. The objective of this study was to compare and contrast the extent to which established parameters for effective priority setting (PS) were incorporated into COVID-19 pandemic response planning in several countries around the world. Methods: We used the Kapriri and Martin framework for effective priority setting and performed a quantitative descriptive analysis to explore whether and how countries' type of health system, political, and economic contexts impacted the inclusion of those parameters in their COVID-19 pandemic plans. We analyzed 86 country plans across six regions of the World Health Organization. Results: The countries sampled represent 40% of nations in AFRO, 54.5% of EMRO, 45% of EURO, 46% of PAHO, 64% of SEARO, and 41% of WPRO. They also represent 39% of all HICs in the world, 39% of Upper-Middle, 54% of Lower-Middle, and 48% of LICs. No pattern in attention to parameters of PS emerged by WHO region or country income levels. The parameters: evidence of political will, stakeholder participation, and use of scientific evidence/ adoption of WHO recommendations were each found in over 80% of plans. We identified a description of a specific PS process in 7% of the plans; explicit criteria for PS in 36.5%; inclusion of publicity strategies in 65%; mention of mechanisms for appealing decisions or implementing procedures to improve internal accountability and reduce corruption in 20%; explicit reference to public values in 15%; and a description of means for enhancing compliance with the decisions in 5%. Conclusion: The findings provide a basis for policymakers to reflect on their prioritization plans and identify areas that need to be strengthened. Over

关键词： Polysaccharides   Traditional Chinese medicine   SARS-CoV-2   COVID-19   Viral entry inhibition   Trained immunity   CORONAVIRUS SPIKE PROTEIN   BETA-GLUCAN   SULFATED POLYSACCHARIDES   DOUBLE-BLIND   YEAST (1,3)-(1,6)-BETA-GLUCAN   MARINE POLYSACCHARIDES   ANTIVIRAL ACTIVITIES   IOTA-CARRAGEENAN   HEPARAN-SULFATE   ISOFERULIC ACID  

摘要： With the global spread of COVID-19 posing ongoing challenges to public health systems, there is an everincreasing demand for effective therapeutics that can mitigate both viral transmission and disease severity. This review surveys the landscape of polysaccharides derived from traditional Chinese medicine, acclaimed for their medicinal properties and potential to contribute to the COVID-19 response. We specifically focus on the capability of these polysaccharides to thwart SARS-CoV-2 entry into host cells, a pivotal step in the viral life cycle that informs transmission and pathogenicity. Moreover, we delve into the concept of trained immunity, an innate immune system feature that polysaccharides may potentiate, offering an avenue for a more moderated yet efficacious immune response against various pathogens, including SARS-CoV-2. Our comprehensive overview aims to bolster understanding of the possible integration of these substances within anti-COVID-19 measures, emphasizing the need for rigorous investigation into their potential applications and underlying mechanisms. The insights provided here strongly support ongoing investigations into the adjunctive use of polysaccharides in the management of COVID-19, with the anticipation that such findings could lead to a deeper appreciation and clearer elucidation of the antiviral potentials inherent in complex Chinese herbal remedies.

关键词： COVID-19   SARS-CoV-2   Saliva   Sample-to-answer   Point-of-care   LAMP   PARTITIONS  

摘要： Highly accessible and highly accurate diagnostics are necessary to combat rapidly-spreading infectious diseases, such as the recent COVID-19 pandemic. While lateral flow antigen tests have become pervasive, they are insufficiently sensitive to detect early or asymptomatic disease. Nucleic acid amplification tests provide the needed sensitivity, but accessibility of these tests continues to be a challenge due to the need for precise sample processing steps. Here we report a sample-to-answer test for saliva samples (saliva-STAT) that utilizes a batterypowered handheld instrument and a low-cost easily-manufacturable sample cassette to perform a nucleic acid amplification test for viral pathogens. To enable a completely automated assay, we leverage thermally responsive alkane partitions (TRAPs) and paramagnetic beads for virus purification and concentration, as well as reagent addition and mixing. Notably, the saliva STAT easily accommodates directly-dispensed saliva samples (in contrast to microfluidic devices), which is necessary for self-testing. Using the saliva-STAT platform, we demonstrate detection of down to 0.2 copies/mu L of SARS-CoV-2 virus in saliva samples. We envision that the saliva-STAT could be used in walk-in clinics, mobile clinics, public testing locations, and in the home. With minor adjustments to the assay, the saliva-STAT platform can easily be adapted for other respiratory viruses, such as Influenza.

关键词： Suicidal ideation   Healthcare workers   Medical students   Public health emergencies   Interrupted time-series analysis  

摘要： Aim To investigate the impact of public health emergencies on the prevalence of suicidal ideation among healthcare workers (HCWs) and medical students. Methods The prevalence of suicidal ideation among HCWs and medical students was searched for analysis. The platforms included PubMed, medRVix, bioRvix, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. Interrupted time-series analysis was employed to determine whether the COVID-19 pandemic influenced the prevalence and trends of suicidal ideation. To account for autocorrelation and heteroskedasticity, Newey-West standard errors were utilized with a lag of order one. Results Seventy studies with 145,641 HCWs and medical students from 30 countries were included in the final analysis, with 30 studies before COVID-19 and 40 studies during the pandemic. Before the pandemic outbreak (April 2020), the monthly increasing rate was 0.063 % (95 % CI: −0.009 %, 0.135 %, z = 1.73, P  = 0.084). The tendency of suicidal ideation prevalence increased by 1.116 % (95%CI: 0.888 %, 1.344 %, z = 9.60, P  < 0.001). In other words, the calculated monthly growth rate of suicidal ideation after the pandemic outbreak is 1.179 % (95%CI: 0.968 %, 1.391 %, z = 10.93, P  < 0.001) per month. The overall growing trend of prevalence of suicidal ideation during the pandemic is 1.896 % per month in America; 1.590 % in Europe; 0.443 % (95%CI: 0.213 %, 0.673 %, z = 3.77, P  < 0.001) in Asia; 1.055 % in HCWs; and 0.645 % in medical students. Conclusion This study highlights that the COVID-19 pandemic can significantly impact the prevalence of suicidal ideation among HCWs and medical students, and the prevalence showed an upward trend.

关键词： Virus model   Hopf bifurcation   Delay differential equations   Optimal control   Basic reproduction number   Stability analysis   Sensitivity index   EPIDEMIC  

摘要： In this manuscript, we analyze a new virus model of SARS-CoV-2 infection with immune response. The initial model was proposed by Mochan et al. [23] to describe an experiment made on Macaques. We consider the latent period of newly infected cells by introducing a delay in the model. We fully analyze the quality properties of the model and investigate strategies to reduce secondary infections. Moreover, we investigate the impact of the latent period on the spread of the infection. We observe due to the delay, the possibility to reach an infection -free state when R0 > 1. This observation is not possible when the delay is not considered. We also demonstrate the occurrence of a Hopf bifurcation when R0 > 1. We further introduce two control parameters to prevent new infections and inhibit viral production, and we formulate an optimal control problem aiming to minimize infections, virus proliferation and the cost of treatment. We establish the existence of the optimal solution and illustrate the theoretical results numerically. In contrast to Mochan et al. [23] results, our simulations show that increased suppression of viral production can change a lethal or chronic infection to a survivable scenario or acute infection. We also observe that the latency period can cause several states of chronic infection before the host recovers totally. Moreover, the density of viruses increases as the latent period is long. The reason being that the immune system is alerted with a delay (after the latent period), which is an advantage for the replication of viruses.

关键词： Smartphone addiction   Psychological resilience   Parental attachment   Anxiety   Depression   COVID-19  

摘要： AbstractSmartphone addiction is an increasingly severe issue in modern society, particularly impacting the mental health of college students during the COVID-19 pandemic. This study aims to explore the relationship between smartphone addiction and mental health issues among college students, and the mediating and moderating roles of psychological resilience and parental attachment. We employed a cross-sectional study design with 100,097 college Chinese students to examine the relationships between smartphone addiction, mental health (anxiety and depression), and the mediating role of psychological resilience. Parental attachment was assessed as a moderator within these relationships. Data were analyzed using multiple regression and mediation/moderation models, controlling for relevant covariates. Our findings revealed a significant positive correlation between smartphone addiction and both anxiety and depression. Psychological resilience mediated these relationships, suggesting that higher resilience levels can mitigate the negative psychological impacts of smartphone addiction. Additionally, parental attachment moderated the effects of smartphone addiction on psychological outcomes; stronger attachment was associated with less pronounced effects of addiction on anxiety and depression. Specifically, for students with low parental attachment, the predictive effect of smartphone addiction on anxiety and depression was more pronounced, whereas higher attachment levels were protective.

关键词： ANN   Adaptive learning   COVID-19   Gradient descent   L2-norm regularization   Levenberg-Marquardt   LSTM   Reptile search algorithm  

摘要： Deep learning models have become essential for managing time-series data across various applications in recent years. COVID-19 case data presents complex time-series patterns with high nonlinearities and dynamic fluctuations. Long short-term memory (LSTM) networks offer a suitable framework for developing prediction models to handle such complexities. However, conventional LSTM networks often have predefined, extensive structures, leading to overfitting issues and difficulties in determining the optimal number of hidden neurons. To address these challenges, we propose Regularized Self-Organizing LSTM (LSTM-ANN-RSA). This method optimizes both the structure and parameters of the network. This study introduces an adaptive learning algorithm with L2-norm regularization to adjust parameters, ensuring prediction accuracy and mitigating overfitting. Additionally, a growing strategy based on hidden neuronal sensitivity automatically determines the LSTM-ANN structure, enhancing compactness and efficiency. The proposed model's efficiency is demonstrated through comparisons with multiple deep learning models (ANN-GD, ANN-LM, ANN-RSA, GRU-ADAM and LSTM-ADAM). The results show that LSTM-ANN-RSA significantly outperformed others in predicting COVID-19 in five countries (Croatia, Greece, Italy, Poland, and Russia), with lower MAPE (2285.018, 64.4903, 205.70, 1611.19, 572.98) and higher R2 (0.99824, 0.99726, 0.99786, 0.9962, 0.99252) values. These findings highlight the proposed model's substantial improvements in predicting the COVID-19 pandemic, enhancing the region's ability to plan for and respond to future epidemics.

摘要： Since December 2019, the COVID-19 pandemic has rapidly disseminated globally, posing significant threats to the world. The dining spaces are high-risk indoor environments for the transmission of SARS-CoV-2, posing challenges for intervention and control. This study, based on surveillance videos from two COVID-19 outbreak cases in restaurants, obtained real data on human behaviors of close contact and surface touch. A respiratory infectious disease transmission model was developed, incorporating four transmission routes: short-range airborne, long-range airborne, fomite and large droplet. The results indicate that diners and staff spent 21.9 %−28.7 % and 17.5 %−27.8 % of their time on speaking, respectively, while spending 85.9 %−90.7 % and 83.4 %−87.6 % of their time on surface touching. The primary transmission routes were short-range (contributing 5.8 %−70.9 %) and long-range airborne (contributing 28.4 %−93.0 %), with fomite and large droplet routes contributing less than 12.0 %. Staff-only mask wearing reduced infection risk by 12.8 %−31.8 %. It is recommended that mandatory mask wearing for staff is necessary, while diners should wear masks as much as possible, and that the equivalent ventilation rate of clean fresh air is suggested to 30.0 m 3 / (h·person). This study provides a scientific support to make non-pharmaceutical interventions in dinning spaces.

摘要： Importance Assessing population-wide risk-benefit ratio of COVID-19 vaccination remains relevant in the current era of Omicron endemicity and boosting. Assessments of mortality risk and cardiovascular events post-vaccination/infection were generally made prior to emergence of milder Omicron and booster rollout. Methods Retrospective cohort study from 6th January to 31st December 2022 (Omicron-predominant transmission), amongst adult Singaporeans aged ≥18 years. Cox regression models adjusted for demographics/comorbidities were used to estimate risk of all-cause mortality and cardiovascular events 0–180 days post-mRNA vaccination/SARS-CoV-2 infection, compared to >180 days post-mRNA vaccination. Risk periods post-vaccination were further stratified by presence/absence of SARS-CoV-2 infection in the preceding 180 days; similarly, risk periods post-infection were further stratified by vaccination in the 180 days preceding infection. Results 3,137,210 adults participated, with 2,047,008 vaccine doses administered (99 % being booster doses) and 1,189,846 infections. 23,028 deaths and 54,017 cardiac events were recorded. No elevated risk of all-cause mortality/cardiovascular events was observed across all age strata post-vaccination. Conversely, all-cause mortality post-infection remained elevated up to >180 days in older adults (≥60 years), compared to person-time > 180 days post-vaccination. For vaccine-breakthrough SARS-CoV-2 infection in older adults vaccinated <180 days prior, risk of mortality was only elevated up to 60 days post-infection, but not beyond. Elevated risk of cardiovascular events 1–2 months after any SARS-CoV-2 infection was observed across all age strata, with elevated risk observed in older adults >180 days post-infection (adjusted-hazards-ratio, aHR = 1.18, 95 %CI = 1.04–1.34). Preceding vaccination within 180 days prior to infection attenuated this risk, with no significantly elevated post-acute risk of cardiovascular events (>180 days: aHR = 1.10