Abstract Global crises exhibit common patterns and interlinkages, from which critical lessons can be learned. In particular, the ongoing COVID-19 pandemic offers an unprecedented moment for unearthing insights helpful for climate change response. This research aims to systematically identify, assess, and prioritize such relevant lessons. To this end, we adopted a Horizon Scanning (HS) approach to collect 553 related lessons from multiple sources, including reviewing 108 peer-reviewed journal articles and two surveys. A total of 372 respondents contributed and ranked relevant lessons, of which 31 experts across countries, sectors, and disciplines had ranked the same lessons ranked in the second survey. Adopting the HS approach was not only helpful to collect relevant lessons, but also effective in promoting the general public’s engagement in scientific research, which is essential to amplify its voice regarding two major crises that are directly affecting the lives and livelihoods of people. Results of this research indicate that both participant groups (experts and non-experts) perceived climate change to be more threatening than COVID-19. However, they expressed different areas of concern regarding the two crises. Among all thematic areas, “Research and innovation” and “Policy and governance” are of supreme importance for COVID-19 and climate change. This research provides invaluable information for actors who are at the frontline of fighting both crises.1. IntroductionWith millions of confirmed cases and deaths, the ongoing COVID-19 pandemic is an unprecedented global crisis in the recent history of humanity (Fan et al., 2020). The pandemic has triggered extraordinary social measures (Cole and Dodds, 2021; Hepburn et al., 2020) and heavily affected the global economy (Kumar and Ayedee, 2021) and imposed serious implications for CO2 emissions and the Paris Agreement on climate change (Shan et al., 2021). The implications of COVID-19 on climate change action are enormous, including putting on hold many climate actions (Loureiro and Alló, 2021). For instance, this includes postponing the 26th conference of parties (COP26) in Glasgow (United Kingdom), an important milestone for committing more ambitious Nationally Determined Contributions (NDCs), for one year due to the challenges of holding an inclusive and ambitious gathering of climate change actors. The outbreak of this pandemic seems to be related to several global problems, for instance, climate change, urbanization, and global travel (Barouki et al., 2021). Despite the fundamental differences between the COVID-19 pandemic and climate change (Manzanedo and Manning, 2020), there are interlinkages (e.g. both are global crises), shared patterns (e.g. serious implications on multiple sectors), and commonalities (e.g. multiple root causes and complex interactions) that are typical for the Anthropocene era (Fuentes et al., 2020; Heyd, 2021; Lancet, 2021). Both, COVID-19 and climate change have interferences with development, research, global cooperation, and resilience (Hepburn et al., 2020; Manzanedo and Manning, 2020). To combat the COVID-19 pandemic, global societies have witnessed massive changes in all life aspects, and governments committed to radical measures to control the spread of COVID-19 and reduce losses of lives (Baldwin and Lenton, 2020). On the other hand, the world has been experiencing climate change effects for decades (IPCC, 2021), yet few such drastic measures have been taken, reflecting the urgency of the climate emergency (Coates et al., 2020). This has raised numerous critical questions on comparable global efforts in fighting climate change (Salas et al., 2020), a threatening crisis that moved down the top global agenda because of the pressing urgency to deal with COVID-19 (Lancet, 2021).Delayed action on both climate change and COVID-19 is threatening. Therefore, policymakers and the global community concerned about such global crises must be able to make informed decisions, based on sound scientific findings (Baldwin and Lenton, 2020; Jin, 2020; Manzanedo and Manning, 2020). The current pandemic outbreak offers an exceptional window into a global crisis and provides invaluable insights and profound lessons into how this crisis may be addressed and which policy approaches are considered favorable(8). Reflecting from the COVID-19 pandemic, these lessons can be of political, social, economic, and policy nature, among others. Examples of such lessons that can be found in the literature stress the importance of global solidarity and international cooperation (Cole and Dodds, 2021; Klenert et al., 2020), emphasize how costly a delayed intervention can be (Fan et al., 2020; Fuentes et al., 2020; Heyd, 2021; Jin, 2020), underline the importance of crisis prevention (Cole and Dodds, 2021; Manzanedo and Manning, 2020), highlight how inequality can be exacerbated without timely action (Klenert et al., 2020; Salas et al., 2020), and draw attention to the centrality of research and innovation in facing new challenges (Ching and Kajino, 2020; Jin, 2020). The term lesson used in the current research, thus, refers to the insights that can be drawn from the COVID-19 pandemic and potentially applied to climate change policy making and implementation. Given the wide-spectrum of potential lessons, we are aiming mainly to provide policy-makers at different levels with up-to-date and evidence-based knowledge that can help in making the right decisions regarding climate change, reflecting from the ongoing COVID-19 pandemic.Although several previous studies have contributed to collecting and analyzing such lessons (Andrieu et al., 2021; Baldwin and Lenton, 2020; Botzen et al., 2021; El Zowalaty et al., 2020; Herrero and Thornton, 2020; Hochachka, 2020; Howarth et al., 2020; Kakderi et al., 2021; Manzanedo and Manning, 2020; Negev et al., 2021; Perkins et al., 2021; Prideaux et al., 2020; Ruiu et al., 2020; Salas, 2020; Sarkis et al., 2020; Sheehan and Fox, 2020), no systematic review of these lessons has been conducted. In addition, the number of collected lessons in these studies was limited and, in many cases, confined to limited thematic areas. Employing the Horizon Scanning (HS) approach enables a more comprehensive overview by expanding the information sources across regions, disciplines, and professions, which can be quite helpful to inform and support decision-making (Hines et al., 2019). Enlarging the information sources through the HS has the potential to allow investigating opportunities, threats signs, and outlooks of phenomena. Concerning the aim of the current research, it allows identifying important lessons that might be missed if a single source of information (e.g., literature) is used. As of the date of writing this paper, this is the first research with this scale to collect a magnitude of lessons from COVID-19 that addresses a wide spectrum of thematic areas from published literature, the public, and experts. Therefore, the ultimate goal is to gather, analyze, rank, and reflect on the most critical lessons that, if addressed, would advance climate change action. This research provides recent, useful information for successfully navigating the challenges of climate change reflecting from the ongoing COVID-19 pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may be associated with long-term health problems termed Long COVID or post COVID-19 syndrome. Symptoms can include fatigue, cognitive dysfunction, pain, anxiety, depression and sleep disturbances. There are few treatments available. Cannabis-based medicinal products (CBMPs) may reduce some of the common symptoms associated with Long COVID as they are known to ameliorate these symptoms occurring in other conditions. We conducted a single arm open label feasibility trial of the safety and tolerability of a full spectrum cannabidiol (CBD)-dominant CBMP for treating the symptoms of Long COVID. The treatment phase ran for a total of 21 weeks, followed by ~3 weeks without the study drug. Participants received up to 3 mL of MediCabilis 5% CBD Oil (50 mg CBD/mL, <2 mg THC/mL) per day orally. We recruited 12 (1 male, 11 female) individuals diagnosed with Long COVID into the trial. Monthly patient reported outcome measures (PROMs) of common symptoms and daily self-report of symptoms were collected via a smartphone app. Key measures of heart rate, activity, sleep, and oxygen saturation were assessed using wearable technology. All patients adhered to the treatment protocol for the duration of the study and there were no serious adverse events. Response rates for the research assessments were high with over 90% completion of PROMs and daily self-report. CBD-dominant CBMPs are safe and well tolerated in individuals diagnosed with Long COVID. Future work with larger samples and incorporating a control group should test the efficacy of this treatment.

A document by Franca Rusconi. Click on the document to view its contents.

Acinetobacter baumannii is a crucial pathogen of nosocomial infection and an alarming threat to the medical community due to the high rate of mortality worldwide. Because of its highly contagious, biofilm-forming nature, virulence characteristics, and multi-drug resistance (MDR), it has been recognized as a red-alert pathogen on a global scale. The main components which strengthen the pathogenicity of A. baumannii are complex gram-negative cell wall structure and specialized virulence factors which facilitate its adhesion and infection spread in the host cells. Higher incidents of infections have been reported in hospitalized patients undergoing treatment with Intensive Care Unit aids and medical devices majorly causing Catheter-Associated Urinary Tract Infection (CAUTI) and Ventilator-associated pneumonia (VAP). This makes the biofilm-forming multi-drug resistant A. baumannii, the most hazardous pathogen in Device Associated Hospital Acquired Infections (DA-HAI). Several investigations unveiled that the outer membrane proteins (OMP) and other adhesion-associated virulence have an anchoring role in biofilm formation which majorly contributes to DA-HAI. Moreover, during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, the infection spread was further aggravated in DA-HAI. Hence, it is important to search for novel therapeutic approaches that will improve the treatment strategy and prevent device-associated infection. This review explores the relationship between adhesion-associated virulence and biofilm formation further it highlights the correlation between antibacterial resistance, and biofilm characterization to elucidate a novel therapeutic approach against this threatful pathogen.

Angiotensin converting enzyme-2 (ACE2), a key component in renin-angiotensin system (RAS) has been identified as the functional receptor for mediating the entry into the cell of SARS-CoV-2. The correlation between anti-ACE2 antibodies and COVID-19 outcome is less well-defined. Herein, serum sample were collected from 134 inpatients, 22 outpatients, 40 convalesces and 12 healthy individuals, with real-time PCR-confirmed SARS-COV-2 infections. The anti-ACE2 antibodies were tested by ELASA and anti-SARS-COV-2 antibodies were analyzed by chemiluminescent immunoassay.We found that patients with COVID-19 show a high prevalence of autoantibodies against ACE2 and exhibit marked increases level compared to healthy control. The highest level of anti-ACE2 was observed in death, male, and longer time of admission group. Thus, significant negative association between serum anti-ACE2 antibodies levels and anti-SARS-COV-2 in different severity group was observed. We conclude that patients with a history of SARS-CoV-2 infection had a high prevalence of Anti-ACE2 antibodies. Its negative correlation with anti-SARS-COV-2 antibodies may lead to pro-inflammatory responses and weaken the protective power of humoral immunity by enhancing RAS pro-inflammatory axis.

Acute Respiratory Distress Syndrome is characterized by the accumulation of inflammatory fluid in the lung alveoli and is the main factor responsible for the high mortality in patients with COVID-19. In addition to the obvious pathogenic function of SARS-CoV-2 viral RNA, surface proteins, in particular, the Spike protein, which binds to the human angiotensin-converting enzyme 2 and is primed by the host serine protease TMPRSS2, play an important role in the development of the ARDS. The clinical worsening in the later phases of COVID-19 is thought to result from Spike protein binding to the pulmonary microvascular endothelium and epithelium, which leads to a damaged respiratory tract and ultimately a systemic inflammatory response or cytokine storm. In this study, we used our SARS-CoV-2 Spike protein Subunit 1-induced K18-hACE2 mouse model to develop an entirely new therapeutic strategy using the reversible, selective, allosteric inhibitor of PTP4A3 phosphatase KVX-053. Our findings suggest that this novel PTP4A3 inhibitor prevents or mitigates the initial pulmonary damage and halts the lethal cytokine storm.

Background: The emergence of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in early 2020 and subsequent implementation of public health and social measures (PHSM) disrupted the epidemiology of respiratory viruses. This work describes the epidemiology of RSV observed during two winter seasons (weeks 40 to 20) and inter-seasonal periods (weeks 21 to 39) during the pandemic between October 2020 and September 2022. Methods: Using data submitted to The European Surveillance System (TESSy) by countries or territories in the World health Organization (WHO) European Region between weeks 40/2020 and 39/2022, we aggregated country-specific weekly RSV counts of sentinel, non-sentinel and Severe Acute Respiratory Infection (SARI) surveillance specimens and calculated percentage positivity. Results for both 2020/21 and 2021/22 seasons and inter-seasons were compared to pre-pandemic 2016/17 to 2019/20 seasons and inter-seasons. Results: Although more specimens were tested than in pre-COVID-19 pandemic seasons, very few RSV detections were reported during the 2020/21 season in all surveillance systems. During the 2021 inter-season, a gradual increase in detections was observed in all systems. In 2021/22, all systems saw early peaks of RSV infection, and during the 2022 inter-seasonal period, patterns of detections were closer to those seen before the COVID-19 pandemic. Conclusion: RSV surveillance continued throughout the COVID-19 pandemic, with an initial reduction in transmission, followed by very high and out-of-season RSV circulation (summer 2021) and then an early start of the 2021/22 season. RSV circulation during the 2022/23 season had not yet normalised.

This paper proposes a varying coefficient Susceptible-Exposed-Infected-Removed (vSEIR) model to dynamically simulate the early mpox epidemic that sparked panic in 2022, considering the time-varying infection rate and the group protected by the smallpox vaccination. We apply the recursive least squares algorithm with a forgetting factor for real-time identification of time-varying infection rates and the efficacy of non-pharmacological interventions. The sparse Hodrick-Prescott (HP) filter, tuned with leave-one-out cross-validation, captures mpox epidemic kinks via the effective reproduction number R t obtained from the discrete vSEIR model. We experiment with this approach in Brazil, Spain, UK and US, comparing COVID-19 and mpox outbreaks based on those kinks and transmission cycles, identifying that except for Spain, mpox epidemic reached its decline period earlier than COVID-19 without strong interventions. Additionally, the result regarding sensitivity analyses shows that the total number of mpox outbreak infections would have increased by 12% without smallpox vaccination and the data uncertainty can bring great variations in R t .

During the Belgian winter and spring season 2022-2023, we investigated the potential of used paper tissue (UPT) as a non-invasive sampling method for the diagnosis of acute respiratory infections. Screening for respiratory pathogens was done using an in-house developed respiratory panel for simultaneous detection of 22 respiratory viruses and 7 non-viral pathogens. The method allowed the identification and typing of respiratory pathogens in symptomatic individuals, as well as in collective samples taken at a community level. Pathogens that were identified in nasal swabs could also be detected in concurrent UPT from the same patient. In all cases that tested positive on an antigen-detection rapid diagnostic test, the corresponding virus could be detected in UPT. The collection of UPT could be useful in epidemiological surveillance of SARS-CoV-2 and other coronaviruses, as well as other respiratory pathogens such as influenzavirus, respiratory syncytial virus, entero/rhinoviruses including EV D68, parainfluenzaviruses and Streptococcus pneumoniae. Multiple respiratory pathogens could be detected in UPTs of collectivities, confirming its applicability for community testing. This is especially interesting for screening in nursing homes, centers for the disabled, schools or other settings were taking nasal or nasopharyngeal samples is cumbersome.

A document by Muhammad haris latif. Click on the document to view its contents.

Backgrounds To our knowledge, there is no available nationwide data on omicron symptom patterns in China mainland. We aim to determine the acute and long COVID-19 symptoms in the omicron-dominant period and to evaluate its association with age, sex and smoking status. Methods We designed a cross-sectional nationwide study and data about self-reported symptoms were collected by an online platform named Wenjuanxing. Eligible participants were aged 25 - 65 years and were symptomatic. To improve the representativeness of sample size, the ratios of the number of people of different ages and genders were weighted by the data from the Seventh National Census (2020 years), and validated by a published nationwide representative study through comparing smoking rates. Descriptive analysis was conducted to report information on demographic characteristics, diagnosis ways and duration time, acute symptoms, hospitalization, severity and long COVID-19 symptoms. And, multivariate Logistic regression models were used to explore the effect of age, sex and smoking on acute and long COVID-19 symptoms. Results A total of 32,528 individuals diagnosed as COVID-19 infection from October 1, 2022 to February 21, 2023 were included. The top three acute symptoms of COVID-19 infection were fever (69.90%), headache (62.63%), sore throat (54.29%). The rates of hospitalization within 7 days, symptoms disappear within 21 days were 3.07% and 68.84%, respectively. Among 3983 COVID-19 patients with 3 months or more time difference between first infection and participation into the study, the long COVID-19 rate was 19.68% and the primary symptoms were muscle weakness (19.39%), headache (17.98%) and smell/taste disorder (15.18%). Compared with male and never smokers, female and current smokers were risk factors for each acute CVOID-19 symptoms, and also had a higher risk for fatigue among long COVID-19 symptoms. Lastly, female and current smokers also were related with more number of symptoms during acute infection period. Conclusions Omicron variant to be milder in terms of severity in China mainland. And, more attention should be given to high-risk population (current smokers and women) to control disease burden caused by COVID-19.

Background: The release of the Healthy China Strategy and the aftermath of COVID-19 have prompted us to deliver more high-level medical talents to meet the urgent needs in the up-coming future. The purpose of this study is to review the current medical education systems in China and analyze its developing direction of medical education from a long-term perspective. Main text: The comprehensive medical education systems in China are analyzed as follows. Current conditions of medical education in China:1. Parallel running of multiple medical education systems; 2. Synergistic development of medical education in different regions; 3. Continuous improvement of the diversified medical curriculum; 4. Multiple departments collaborative management mechanism in medical education. The model of foreign medical education: 1. American model; 2. British model; 3. Japanese model. Prospects for the future of medical education in China: 1. Establishing unified medical degrees with clear objectives; 2. Focusing on general practitioners and primary care; 3. Strengthening medical humanities and public health education; 4. Improving the management mechanism between colleges and affiliated hospitals. Conclusions: This review integrates the current situation of medical education in China and successful foreign medical education models, and then proposes interventions for reform in order to cultivate medical personnel that meet future needs in China. This review may serve as a reference for the educational efforts of medical schools in China.

objective: The objective of this bibliometric inquiry was to scrutinize domains that delve into the repercussions of the COVID-19 pandemic on individuals afflicted with ASD, worldwide scholarly findings of interrelated research, and forthcoming trajectories. Method. To perform a literature analysis, the Web of Science Core Collection (WoScc) database is recommended. Look for literature related to ASD and COVID-19. For visual analysis and network creation of authors, organizations, countries, and keywords, CiteSpace and VosViewer can be utilized. Result. This study analyzed 771 papers and found increasing publications, with the United States, United Kingdom, and Italy leading in relevant literature. The University of London and Happe_Francesca were the most productive in terms of papers and researchers, respectively. Research on the impact of COVID-19 on autism spectrum disorder was mainly found in J AUTISM DEV DISORD. Parenting stress, enhancing adherence, and acute stress disorder were popular topics of investigation. Future research may focus on interventions, qualitative research, Disabilities Monitoring Network, neurodevelopmental disabilities, perceived stress, and barriers. Conclusion. This bibliometric analysis delineates the fundamental structure for assessing the impact of COVID-19 on ASD by scrutinizing crucial indicators. Future research could explore the stress, anxiety, and strategies for individuals with ASD and their The use of telemedicine can be studied in depth, as a new idea for ASD diagnosis and intervention training, it is worthwhile. The use of telemedicine can be studied in depth, as a new idea for ASD diagnosis and intervention training, it is worth exploring, such as Disabilities Monitoring Network, etc.

A document by Esmaeil Mehraeen. Click on the document to view its contents.

Background We analyzed the effects of small-molecule antiviral treatment for coronavirus disease-2019 (COVID-19) Omicron strain in kidney transplant recipients. Methods We enrolled 140 kidney transplant patients admitted for COVID-19-related pneumonia were treated using small-molecule antivirals. Patients were divided into three groups: azvudine (n=62), paxlovid (n=49), and a combination of azvudine+paxlovid (A+P, n=29). Differences in clinical outcomes owing to COVID-19 infections were compared among three groups. Results Paxlovid group had a higher proportion of comorbid diabetes than the other two groups (P=0.032). There were differences in the clinical typing of the coronavirus , with the highest proportion of heavy and critical cases in the A+P group (35.5%). The immunosuppression prior to infection did not differ among the groups; however, after adjusting for immunosuppression during antiviral treatment, differences were observed. Of the 140 patients, 125 (89.29%) had fever, 114 (81.43%) had cough, and 66 (47.1%) had malaise. Combination of two or more symptoms were found in 90% patients. Mean length of hospitalization was slightly longer in the combination group than in the azvudine and paxlovid groups. Four deaths, all in the A+P group; five cases of loss of function, two in the paxlovid group and three in the A+P group; and acute kidney injury occurred in 30 patients with 7 in the azvudine, 17 in paxlovid, and 6 in A+P groups. Conclusion The use of small-molecule medications may be the optimal treatment approach; however, they should be modified based on the patients’ conditions, such as clinical symptoms, laboratory results, paraclinicals, and examinations.

A document by Zina Hakim. Click on the document to view its contents.

Background: Concerns of COVID-19 vaccine safety from pregnant women still widespread. We used transcriptomic profile analysis to study changes of the maternal-fetal interface after vaccination and explore the possible protective effects from vaccination against miscarriage. Methods: We collected decidual tissuesafter uterine curettage from pregnant women in the first trimister with (n = 6) and without a COVID-19 vaccination (n = 6) and performed RNA-sequencing. Furthermore, we ananlyzed our transcriptome datas of samples and other datasets about maternal-fetal interface and miscarrige to analyze the potential link by bioinformatics tools. Results: We identified 879 different expressed genes from pregnant women who received vaccination and found that the COVID-19 vaccine could alter some hazardous RSA-related genes, such as CXCL11, FOS, FOSB, LY96, MMP10, and NCF2. Vaccination also changed some hazardous RSA-related signaling pathway.These molecules induced the transformation of M2 macrophages and promoted the balance of Th1/Th2 immune responses. Finally, these effects on the immune microenvironment of the maternal-fetal interface also showed corresponding positive changes. Conclusion: Many RSA-related signaling molecules were reversed after COVID-19 vaccination, indicating that the vaccine did not cause RSA, and these molecules ultimately may have protective effects on miscarriage by influencing the immune microenvironment at the maternal-fetal interface.

Background: A new one SARS-CoV-2 Variant of Concern (VoC), Omicron, was born in a world weary of COVID-19, which anger and frustration with the pandemic was widespread, with wide-ranging negative impacts on health, social and economic well-being. The Omicron variant, which main types was BA5.2and BF.7 in China, in December 2022 to January 2023 leaded to off-target of the S and N genes, and the kits used were not adequately and independently evaluated when these agents are studied and developed. To ensure the accuracy of coronavirus test results, performance verification of commercial Real-Time quantitative PCR (RT-qPCR) was required. Objective: We performed a clinical evaluation for two Real Time SARS-CoV-2 assay, and to verify them based on different detection reagents and different clinical specimens. Methods: We performed clinical evaluations of two existing Chinese SARS-CoV-2 RT-qPCR kits COVID-19 nucleic acid detection kits (e-Diagnostic Biomedical, Wuhan, China) and 2019-nCoV nucleic acid diagnostic kits (Fosun Biotechnology, Shanghai, China) using BSD ( Bondson) (Guangzhou Bondson Biotechnology Co. Ltd.;batch number 2022101), quality controls provided by the inspection center and a large number of clinically confirmed specimens. Overall, through the BDS performance verification reference product kit, It was best used to verify the performance of the reagent through a large number of clinical specimens for further verification. Results: The coincidence rate for Fosun and e-Diagnostic kits were individually 95% and 100%. Verified that the detection limit for Fosun and e-Diagnostic kits was 300copies/mL. All were below the detection limit for Fosun reagent was 300copies/mL. e-Diagnostic was 500copies/mL. Fosun had the largest CV for ORF1ab and N gene at the the detection limit concentration(4.80%,3.49%), while e-Diagnostic had the smaller (0.93%,1.10%). Negative results were tested in cross-reactivity. During the verification of clinical samples, sequencing analyses had shown that Fosun single gene miss rate was relatively high, especially ORF1ab, followed by N gene miss rate. we survey that all N genes were detected in clinical specimens, ,ORFab dropout (i.e., a negative/low result) occurred in (10.8%) of 225 Omicron variant. Conclusions: Our results endorse the use of these two commercial kits for the diagnosis of SARS-CoV-2 in China, as their clinical performance has been fully validated by a large number of clinically confirmed cases.

Purpose: This study examines which vaccination organization system performed best in the COVID-19 pandemic to improve future vaccination organization. Study design: The vaccination organization of every federal state is categorized as decentralized or centralized and analysed based on their daily vaccination rates and the vaccination time series of the federal state with the highest vaccination rate is analysed by using the Event Study Methodology [ESM]. Findings: In Germany’s federal state with the highest vaccination rate (i.e., Saarland), the change from a system of availability-based offerings to a pre-registration with preferences and automatic appointment allocation system was a significant performance factor. Originality: A quasi-experimental study with a different vaccination organization is setup and the Event Study Methodology [ESM] is applied to the vaccination context. Research limitations: This study is limited on the vaccination organization of high-developped countries with a comprehensive health system such as Germany. Practical implications: A pre-registration and automatic appointment allocation system is recommended as best practice to policy makers and pandemic managers for their vaccination organization given the first half-year experience in the COVID-19 pandemic. Social implications: A cumulative additional vaccination rate of 8.44 per 100 inhabitants and an 14% overperformance is found. The implementation of this system for whole Germany would have resulted in 4% higher protection, estimated 26’596 less infections, US$ 7 million less hospitalization costs, and earlier relaxation of lockdown of two months.

The number of SARS-CoV-2 recombinants identified during the pandemic has increased since the era of Omicron variants, but XBB.1.5 (or Omicron 23A) is the first lineage comprised of hybrid genomes to predominate at the country and global scales. Very interestingly, the XBB.1.5 recombinant, like the Marseille-4B subvariant (B.1.160/20A.EU2) and the pandemic variant B.1.1.7 (20I/Alpha) previously, has its ORF8 gene inactivated by a stop codon. XBB.1.5 was generated through two successive main events: a recombination between SARS-CoV-2 of lineages BA.2.10.1.1 (BJ.1) and BA.2 75.3.1.1.1 (BM.1.1.1) that generated the XBB (22F) lineage; then ORF8 gene inactivation by a stop codon. We further identified that a stop codon was present at 89 (74%) codons of the ORF8 gene in ≥1 of 15,222,404 genomes available in GISAID, and at 15 codons (12%) in ≥1,000 genomes. Thus, it is very likely that stop codons in ORF8 gene contributed on at least 3 occasions and independently during the SARS-CoV-2 pandemic to the evolutionary success of a lineage that became transiently predominant, most recently XBB.1.5. Such association of gene loss with evolutionary success, which suits the recently described Mistigri rule, is an important biological phenomenon very unknown in virology while largely described in cellular organisms.

Objective: The accuracy of clinical coding in COVID-19 is essential for quality of care, disease surveillance, as well as research and reporting. This study aims to describe and categorize consultations between medical coders based on the social media network in Iran on the COVID-19 coding. Method: A clinical coding group in the social network at the national level in Iran was established to follow consultation regarding COVID-19 among coders. We also utilized an online survey, which was designed to extract the problems coders encountered during clinical coding and their opinion on whether these consultations were effective. Herein, we report messages and communication records exchanged among members of this network obtained between 21 February 2020 and 20 November 2020. Finally, we categorised the obtained information and identified the problems for COVID-19 accurate coding in Iran. Results: A total of 1,340 messages in 332 consultations were exchanged amongst 76 coders. We categorised topics of consultations into 11 categories. Most consultations dealt with “suspected or probable” (n = 71), “clinical coding and diagnosis” (n=59) within 332 conversations. In 47% of consultations, the first reply was less than 10 ± 3 min. “Maternal and infant ” and “procedures and drugs ” were the most common subjects with specific answer. Based on the viewpoints of coders, online consultations can reduce the time of clinical coding and increase coding accuracy. Conclusion: The establishment of social networks among medical record coders is an efficient strategy to deal with coding issues during the COVID-19 pandemic and improve the quality of hospital records.

Over the past few decades, researchers have paid more focus to finding the optimal method for controlling infectious diseases. Recently, the idea of optimal control has widely been used to discuss the spread of COVD-19 pandemic. In this article, we consider a mathematical model to show the transmission of this virus with constant rates. Then, the optimal control technique is applied on the model with two different scenarios. The first scenario contains two different controls such as treatment and vaccination rate. However, the second scenario is dealing with treatment and vaccination effect. Accordingly, this study identifies the impact of these control mechanisms as time-dependent interventions using mathematical modeling and an optimal control method with Hamilton technique and Pontryagin's maximum principle. Computational results show that the use of treatment in the high level has the biggest impact in the minimizing the total infected people. Furthermore, the suggested mathematical model with and without control variables are accurately analyzed using the forward-backward Runge Kutta method in MATLAB for initial states and parameters. The findings of optimal control here indicate that the suggested scenarios may effective use for reducing the number of infected individuals and improving public health strategies more widely.

Pathogen spectrum of Hand, foot and mouth disease (HFMD) has substantially changed in the past decade. How do the co-circulating pathogens interact and the coronavirus disease 2019 (COVID-19) intervene the incidence of HFMD remain unclear. Here, we evaluated the virus-virus interaction (VVI) of EVs using Spearman’s Correlation in Nanchang, China. And the impact of COVID-19 intervention on HFMD incidence was estimated using seasonal autoregressive integrated moving average (ARIMA) models. Enterovirus (EV) serotypes were determined by RT-PCR. From 2019 to 2022, 1321 (57.5%) out of 2296 HFMD cases were EV-positive, in which coxsackievirus A6 (CVA6) and CVA16 were the major pathogens, accounting for 34.0%-59.6% and 14.9%-31.4%, respectively. Our analyses provide strong statistical support for the existence of VVIs among enteroviruses, in which CVA6 negatively interacted with CVA16 and EV-A71, and positive VVI between CVA16 and EV-A71 was observed. While CVA6 has a (albeit inconsistent) seasonal pattern in Nanchang, typically peaking in fall-winter months before COVID-19 epidemic, CVA16 and EV-A71 contemporaneously peaks around May, supporting the epidemiological VVIs among these strains. During the COVID-19 epidemic, the seasonal HFMD epidemic peak was restrained, indicating the COVID-19 intervention had mitigated EV transmission. Moreover, we first figured out the serotypes from other enteroviruses, among them CVA4, CVA2, CVA5 and CVB3 were the major agents accounting for 34.8%, 23.9%, 23.9% and 10.9%, respectively. Taken together, CVA6 and CVA16 were currently the most predominant pathogens negatively interacted with each other in Nanchang, while NPIs of COVID-19 outbreaks interfered the interactions by mitigating their incidence and transmission.

Kidney injury is common in patients with Coronavirus Disease-19 (COVID-19). In this study, 49 patients with Omicron associated kidney injury were included, 38 of whomperformed renal biopsy. Patients were divided into 2 groups: Group A for patients developing kidney injury afterSARS-CoV-2 infection and Group B for patients with aggravated renal insufficiency after SARS-CoV-2 infection. The clinical, pathological and prognostic characteristicsof the patients and theirC3 levels were observed.In our center, the clinical diagnoses of patients with COVID-19 associated kidney injury were mainly acute kidney injury(AKI), chronic kidney disease(CKD) and nephrotic syndrome(NS); while the pathological diagnoses were mainly IgA nephropathy(IgAN)、focal segmental glomerulosclerosis(FSGS) and membranous nephritis(MN).80% of COVID-19 associated nephropathy (COVAN) patients had normal serum C3 complement level, and a few patients had increased or decreased C3 level. In renal tissue, C3 deposits were observed in 68.4% of patients.29% of patients experienced deterioration of renal function after treatment, but no patients developed to end-stage renal disease (ESRD). Among all of them, one case presenting with thrombotic microangiopathy (TMA) had a more severe renal pathological lesion and poorer prognosis. We observed differences of clinical and pathological features of patients with COVID-19associated kidney injury between races, regions and virus variants. Asian patients with Omicron associated kidney injury have milder kidney injury and a better renal prognosis.