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For eye protection, data are even less certain. [...]the systematic review and meta-analysis by Derek Chu and colleagues in The Lancet3 is an important milestone in our understanding of the use of personal protective equipment (PPE) and physical distancing for COVID-19. [...]this finding can inform lifting of societal restrictions and safer ways of gathering in the community. Masks worn within households in Beijing, China, prevented secondary transmission of SARS-CoV-2 if worn before symptom onset of the index case.15 Finally, Chu and colleagues reiterate that no one intervention is completely protective and that combinations of physical distancing, face mask use, and other interventions are needed to mitigate the COVID-19 pandemic until we have an effective vaccine. [...]randomised controlled trial data are available, this study provides the best specific evidence for COVID-19 prevention.

Abstract Background A novel coronavirus of zoonotic origin (2019-nCoV) has recently been identified in patients with acute respiratory disease. This virus is genetically similar to SARS coronavirus and bat SARS-like coronaviruses. The outbreak was initially detected in Wuhan, a major city of China, but has subsequently been detected in other provinces of China. Travel-associated cases have also been reported in a few other countries. Outbreaks in health care workers indicate human-to-human transmission. Molecular tests for rapid detection of this virus are urgently needed for early identification of infected patients. Methods We developed two 1-step quantitative real-time reverse-transcription PCR assays to detect two different regions (ORF1b and N) of the viral genome. The primer and probe sets were designed to react with this novel coronavirus and its closely related viruses, such as SARS coronavirus. These assays were evaluated using a panel of positive and negative controls. In addition, respiratory specimens from two 2019-nCoV-infected patients were tested. Results Using RNA extracted from cells infected by SARS coronavirus as a positive control, these assays were shown to have a dynamic range of at least seven orders of magnitude (2x10−4-2000 TCID50/reaction). Using DNA plasmids as positive standards, the detection limits of these assays were found to be below 10 copies per reaction. All negative control samples were negative in the assays. Samples from two 2019-nCoV-infected patients were positive in the tests. Conclusions The established assays can achieve a rapid detection of 2019n-CoV in human samples, thereby allowing early identification of patients.

Qingwu Jiang and colleagues discuss China’s experience of contact tracing, isolation, and quarantine of infected people and their contacts, and mass nucleic acid testing in the second phase of the covid-19 epidemic

Background Air pollution in Beijing, especially PM 2.5 , has received increasing attention in the past years. Although exposure to PM 2.5 has been linked to many health issues, few studies have quantified the impact of PM 2.5 on the risk of influenza-like illness (ILI). The aim of our study is to investigate the association between daily PM 2.5 and ILI risk in Beijing, by means of a generalized additive model. Methods Daily PM 2.5 , meteorological factors, and influenza-like illness (ILI) counts during January 1, 2008 to December 31, 2014 were retrieved. An inverse Gaussian generalized additive model with log link function was used to flexibly model the nonlinear relationship between the PM 2.5 (single- and multiday lagged exposure) and ILI risk, adjusted for the weather conditions, seasonal and year trends. We also assessed if the effect of PM 2.5 differs during flu season versus non-flu season by including the interaction term between PM 2.5 and flu season in the model. Furthermore, a stratified analysis by age groups was conducted to investigate how the effect of PM 2.5 differs across age groups. Results Our findings suggested a strong positive relationships between PM 2.5 and ILI risk at the flu season (October-April) ( p -value < 0.001), after adjusting for the effects of ambient daily temperature and humidity, month and year; whereas no significant association was identified at the non-flu season (May-September) ( p -value = 0.174). A short term delayed effect of PM 2.5 was also identified with 2-day moving average (current day to the previous day) of PM 2.5 yielding the best predictive power. Furthermore, PM 2.5 was strongly associated with ILI risk across all age groups ( p -value < 0.001) at the flu season, but the effect was the most pronounced among adults (age 25–59), followed by young adults (age 15–24), school children (age 5–14) and the elderly (age 60+) and the effect of PM 2.5 was the least pronounced for children under 5 years of age (age < 5). Conclusions Ambient PM 2.5 concentrations were significantly associated with ILI risk in Beijing at the flu season and the effect of PM 2.5 differed across age groups, in Beijing, China.

Evidence suggests that increased microRNA-155 (miR-155) expression in immune cells enhances antitumor immune responses. However, given the reported association of miR-155 with tumorigenesis in various cancers, a debate is provoked on whether miR-155 is oncogenic or tumor suppressive. We aimed to interrogate the impact of tumor miR-155 expression, particularly that of cancer cell-derived miR-155, on antitumor immunity in breast cancer. We performed bioinformatics analysis of human breast cancer databases, murine experiments, and human specimen examination. We revealed that higher tumor miR-155 levels correlate with a favorable antitumor immune profile and better patient outcomes. Murine experiments demonstrated that miR-155 overexpression in breast cancer cells enhanced T cell influx, delayed tumor growth, and sensitized the tumors to immune checkpoint blockade (ICB) therapy. Mechanistically, miR-155 overexpression in breast cancer cells upregulated their CXCL9/10/11 production, which was mediated by SOCS1 inhibition and increased phosphorylated STAT1 (p-STAT1)/p-STAT3 ratios. We further found that serum miR-155 levels in breast cancer patients correlated with tumor miR155 levels and tumor immune status. Our findings suggest that high serum and tumor miR-155 levels may be a favorable prognostic marker for breast cancer patients and that therapeutic elevation of miR-155 in breast tumors may improve the efficacy of ICB therapy via remodeling the antitumor immune landscape.

Hand-foot-and-month disease (HFMD), especially the enterovirus A71 (EV-A71) subtype, is a major health problem in Beijing, China. Previous studies mainly used regressive models to forecast the prevalence of HFMD, ignoring its intrinsic age groups. This study aims to predict HFMD of EV-A71 subtype in three age groups (0–3, 3–6 and > 6 years old) from 2011 to 2018 using residual-convolutional-recurrent neural network (CNNRNN-Res), convolutional-recurrent neural network (CNNRNN) and recurrent neural network (RNN). They were compared with auto-regressio, global auto-regression and vector auto-regression on both short-term and long-term prediction. Results showed that CNNRNN-Res and RNN had higher accuracies on point forecast tasks, as well as robust performances in long-term prediction. Three deep learning models also had better skills in peak intensity forecast, and CNNRNN-Res achieved the best results in the peak month forecast. We also found that three age groups had consistent outbreak trends and similar patterns of prediction errors. These results highlight the superior performance of deep learning models in HFMD prediction and can assist the decision-makers to refine the HFMD control measures according to age groups.

IntroductionTransmission of COVID-19 within families and close contacts accounts for the majority of epidemic growth. Community mask wearing, hand washing and social distancing are thought to be effective but there is little evidence to inform or support community members on COVID-19 risk reduction within families.MethodsA retrospective cohort study of 335 people in 124 families and with at least one laboratory confirmed COVID-19 case was conducted from 28 February to 27 March 2020, in Beijing, China. The outcome of interest was secondary transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the family. Characteristics and practices of primary cases, of well family contacts and household hygiene practices were analysed as predictors of secondary transmission.ResultsThe secondary attack rate in families was 23.0% (77/335). Face mask use by the primary case and family contacts before the primary case developed symptoms was 79% effective in reducing transmission (OR=0.21, 95% CI 0.06 to 0.79). Daily use of chlorine or ethanol based disinfectant in households was 77% effective (OR=0.23, 95% CI 0.07 to 0.84). Wearing a mask after illness onset of the primary case was not significantly protective. The risk of household transmission was 18 times higher with frequent daily close contact with the primary case (OR=18.26, 95% CI 3.93 to 84.79), and four times higher if the primary case had diarrhoea (OR=4.10, 95% CI 1.08 to 15.60). Household crowding was not significant.ConclusionThe study confirms the highest risk of transmission prior to symptom onset, and provides the first evidence of the effectiveness of mask use, disinfection and social distancing in preventing COVID-19. We also found evidence of faecal transmission. This can inform guidelines for community prevention in settings of intense COVID-19 epidemics.

Norovirus (NoV) is a major cause of acute gastroenteritis outbreaks worldwide. A comprehensive understanding of the transmission mode is of great significance for the prevention and control of the NoV infection. Currently, the transmission modes of NoV include contact, food-borne, water-borne and aerosol transmission. The first three modes are more common, while aerosol transmission is seldom reported. In this paper, the source, generation mechanism, infectivity, sampling and related outbreaks of NoV aerosol are summarized and discussed.

Hand, foot, and mouth disease (HFMD) mostly affects the health of infants and preschool children. Many studies of HFMD in different regions have been published. However, the epidemiological characteristics and space-time patterns of individual-level HFMD cases in a major city such as Beijing are unknown. The objective of this study was to investigate epidemiological features and identify high relative risk space-time HFMD clusters at a fine spatial scale. Detailed information on age, occupation, pathogen and gender was used to analyze the epidemiological features of HFMD epidemics. Data on individual-level HFMD cases were examined using Local Indicators of Spatial Association (LISA) analysis to identify the spatial autocorrelation of HFMD incidence. Spatial filtering combined with scan statistics methods were used to detect HFMD clusters. A total of 157,707 HFMD cases (60.25% were male, 39.75% were female) reported in Beijing from 2008 to 2012 included 1465 severe cases and 33 fatal cases. The annual average incidence rate was 164.3 per 100,000 (ranged from 104.2 in 2008 to 231.5 in 2010). Male incidence was higher than female incidence for the 0 to 14-year age group, and 93.88% were nursery children or lived at home. Areas at a higher relative risk were mainly located in the urban-rural transition zones (the percentage of the population at risk ranged from 33.89% in 2011 to 39.58% in 2012) showing High-High positive spatial association for HFMD incidence. The most likely space-time cluster was located in the mid-east part of the Fangshan district, southwest of Beijing. The spatial-time patterns of Beijing HFMD (2008-2012) showed relatively steady. The population at risk were mainly distributed in the urban-rural transition zones. Epidemiological features of Beijing HFMD were generally consistent with the previous research. The findings generated computational insights useful for disease surveillance, risk assessment and early warning.