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<title>13 July, 2023</title>
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<title>Covid-19 Sentry</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
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<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
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<ul>
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<li><a href="#from-preprints">From Preprints</a></li>
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<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
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<li><a href="#from-pubmed">From PubMed</a></li>
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<li><a href="#from-patent-search">From Patent Search</a></li>
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</ul>
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<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
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<li><strong>Evaluating Twitter’s COVID-19 Vaccine Misinformation Removal Policy</strong> -
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Objectives. To assess the efficacy of Twitter’s March 1, 2021 COVID-19 vaccine misinformation removal policy. Methods. We collected over 400 million English-language tweets related to COVID-19 using more than 100 pertinent keywords from February 6, 2020, to December 15, 2022, comparing vaccine-related tweets and corresponding accounts before vs. after the implementation of Twitter’s interventions. We used a comparative interrupted time series analytic approach to compared the content of misinformative (>10% of tweets contain links to misinformative websites) to non-misinformative accounts. Results. We identified 7,084 misinformative accounts and 6,706,999 non-misinformative accounts. Misinformative accounts were 1.43 times more likely to persist (RR=1.43; 95% CI:1.41-1.45; P<0.001) and 30.16 times more likely to become more misinformative (RR=30.16; 95% CI: 28.48 - 31.95; P<0.001) compared to non-misinformative accounts. We did not detect a significant decrease in content from misinformative accounts (RR=0.03; 95% CI: 0.00 - 3.93; P=0.16) compared to pre-policy data; however, we did detect a significant decrease in content from non-misinformative accounts (RR=0.02; 95% CI: 0.00 - 0.32; P=0.005). We did not detect a significant difference between these two groups (RR=1.48; 95% CI: 0.01 - 398.61; P=0.89). Conclusion. Twitter’s vaccine misinformation removal policies do not appear to have been associated with a detectable reduction in content from misinformative, compared to non- misinformative, users or in more misinformative compared to less misinformative tweets. Public Health Implications. Our study highlights the necessity for external evaluations to ascertain the sufficiency of platforms’ self-regulatory measures to safeguard public health.
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🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/cxg6y/" target="_blank">Evaluating Twitter’s COVID-19 Vaccine Misinformation Removal Policy</a>
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<li><strong>Endocytosis Inhibitors Block SARS-CoV-2 Pseudoparticle Infection of Mink Lung Epithelium</strong> -
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Both spill over and spill back of SARS-CoV-2 virus have been reported on mink farms in Europe and the United States. Zoonosis is a public health concern as dangerous mutated forms of the virus could be introduced into the human population through spillback. The purpose of our study was to determine the SARS-CoV-2 entry mechanism using mink lung epithelial cell line (Mv1Lu) and to block entry with drug inhibitors. Mv1Lu cells were susceptible to SARS-CoV-2 viral pseudoparticle infection, validating them as a suitable disease model for COVID-19. Inhibitors of TMPRSS2 and of endocytosis, two pathways of viral entry, were tested to identify those that blocked infection. Dyngo4a, a small molecule endocytosis inhibitor, significantly reduced infection, while TMPRSS2 inhibitors had minimal impact, supporting the conclusion that the entry of the SARS-CoV-2 virus into Mv1Lu cells occurs primarily through endocytosis. The small molecule inhibitors that were effective in this study could potentially be used therapeutically to prevent SARS-CoV-2 infection in mink populations. This study will facilitate the development of therapeutics to prevent zoonotic transmission of SARS-CoV-2 variants to other animals, including humans.
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🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.07.12.548725v1" target="_blank">Endocytosis Inhibitors Block SARS-CoV-2 Pseudoparticle Infection of Mink Lung Epithelium</a>
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<li><strong>The recency and geographical origins of the bat viruses ancestral to SARS-CoV and SARS-CoV-2</strong> -
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The emergence of SARS-CoV in 2002 and SARS-CoV-2 in 2019 has led to increased sampling of related sarbecoviruses circulating primarily in horseshoe bats. These viruses undergo frequent recombination and exhibit spatial structuring across Asia. Employing recombination-aware phylogenetic inference on bat sarbecoviruses, we find that the closest-inferred bat virus ancestors of SARS-CoV and SARS-CoV-2 existed just ~1-3 years prior to their emergence in humans. Phylogeographic analyses examining the movement of related sarbecoviruses demonstrate that they traveled at similar rates to their horseshoe bat hosts and have been circulating for thousands of years in Asia. The closest-inferred bat virus ancestor of SARS-CoV likely circulated in western China, and that of SARS-CoV-2 likely circulated in a region comprising southwest China and northern Laos, both a substantial distance from where they emerged. This distance and recency indicate that the direct ancestors of SARS-CoV and SARS-CoV-2 could not have reached their respective sites of emergence via the bat reservoir alone. Our recombination-aware dating and phylogeographic analyses reveal a more accurate inference of evolutionary history than performing only whole-genome or single gene analyses. These results can guide future sampling efforts and demonstrate that viral genomic fragments extremely closely related to SARS-CoV and SARS-CoV-2 were circulating in horseshoe bats, confirming their importance as the reservoir species for SARS viruses.
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🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.07.12.548617v1" target="_blank">The recency and geographical origins of the bat viruses ancestral to SARS-CoV and SARS-CoV-2</a>
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<li><strong>COVID-19 Case and Mortality Surveillance using Daily SARS-CoV-2 in Wastewater Samples adjusting for Meteorological Conditions and Sample pH</strong> -
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Background Wastewater monitoring is increasingly used for community surveillance of infectious diseases, especially after the COVID-19 pandemic as the genomic footprints of pathogens shed by infected individuals can be traced in the environment. However, detection and concentration of pathogens in the environmental samples and their efficacy in predicting infectious diseases can be influenced by meteorological conditions and quality of samples. Objectives This research examines whether meteorological conditions and sample pH affect SARS-CoV-2 concentrations in wastewater samples, and whether the association of SARS-CoV-2 with COVID-19 cases and mortality improves when adjusted for meteorological conditions and sample pH value in Miami-Dade County, FL. Methods Daily wastewater samples were collected from Miami-Dade Wastewater Treatment Plant in Key Biscayne, Florida from August 2021 to August 2022. The samples were analyzed for pH and spiked with OC43. RNA was extracted from the concentrated wastewater sample and SARS-CoV-2 was quantified using qPCR. COVID-19 and mortality data were acquired from the Centers for Disease Control and Prevention (CDC) and meteorological data from the National Climatic Data Center. COVID-19 case and mortality rates were modelled with respect to time-lagged wastewater SARS-CoV-2 adjusting for meteorological conditions, and sample pH value and OC43 recovery. Results Temperature, dew point, pH values and OC43 recovery showed significant associations with wastewater SARS-CoV-2. Time-lagged wastewater SARS-CoV-2 showed significant associations with COVID-19 case and mortality incidence rates. This association improved when wastewater SARS-CoV-2 levels were adjusted for (or instrumented on) meteorological conditions, OC43 recovery, and sample pH. A 0.47% change in COVID-19 case incidence rate was associated with 1% change in wastewater SARS-CoV-2 (β ~ 0.47; 95% CI = 0.29 - 0.64; p < 0.001). A 0.12 % change in COVID-19 mortality rate was associated with 1 % change in SARS-CoV-2 in wastewater 44 days prior. A 0.07% decline in COVID-19 mortality rate was associated with a unit increase in ambient temperature 28 days prior. Discussion Time lagged wastewater SARS-CoV-2 (and its adjustment for sample pH and RNA recovery) and meteorological conditions can be used for the surveillance of COVID-19 case and mortality. These findings can be extrapolated to improve the surveillance of other infectious diseases by proactive measurements of infectious agent(s) in the wastewater samples, adjusting for meteorological conditions and sample pH value.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.12.23292570v1" target="_blank">COVID-19 Case and Mortality Surveillance using Daily SARS-CoV-2 in Wastewater Samples adjusting for Meteorological Conditions and Sample pH</a>
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<li><strong>Risk Factors for Admission into COVID-19 General Wards, Sub-Intensive and Intensive Care Units among SARS-CoV-2 Positive Subjects in the Municipality of Bologna, Italy</strong> -
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This is a retrospective cohort study aimed at identifying the risk factors for the hospitalization of patients with COVID-19 in the municipality of Bologna. A total of 32500 patients that tested positive for COVID-19 from February 28/2020 to October 13/2021 in the municipality of Bologna were included. The Kaplan-Meier method was used to estimate changes during time of ICU hospitalization for all patients as well as stratifying subjects by sex. A multi-state Cox9s proportional hazard model was fitted to investigate predictors of ICU and non-ICU hospitalization. Age, sex, calendar period of diagnosis, comorbidities and vaccination status of patients at the time of diagnosis were considered as candidate predictors. In general, male sex and advanced age resulted to be poor prognostic factors of COVID-19 outcomes. An exception was found for the over 80 age group which showed a decrease in the risk of ICU hospitalization compared to 70-79 (HR 0.57 95% CI 0.36 - 0.90 for DIAG->ICU; HR 0.40 95% CI 0.28 - 0.58 for HOSP->ICU). Having contracted the disease during the first wave was associated with a significant greater risk of hospitalization than during the second wave, while no difference in the risk of ICU admission was found between the second and third waves. Fully immunized patients showed a significant decrease in the risk of ICU and non-ICU hospitalization compared to the unvaccinated patients (HR 0.23 95% CI 0.16 - 0.31 for DIAG->HOSP; HR 0.10 95% CI 0.01 - 0.73 for DIAG->ICU). Chronic kidney failure and asthma were risk factors for non-ICU hospitalization. Diabetes and embolism were risk factors for both direct ICU and non-ICU hospitalization. The study of factors associated with a negative course of the COVID-19 disease allows to prevent fatal outcomes, establish priorities in the treatment of the disease and improve the management of hospital resources and the pandemic itself.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.12.23292559v1" target="_blank">Risk Factors for Admission into COVID-19 General Wards, Sub-Intensive and Intensive Care Units among SARS-CoV-2 Positive Subjects in the Municipality of Bologna, Italy</a>
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<li><strong>Marburg Virus Disease outbreaks, mathematical models, and disease parameters: a Systematic Review</strong> -
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Recent Marburg virus disease (MVD) outbreaks in Equatorial Guinea and Tanzania highlighted the importance of better understanding this highly lethal infectious pathogen. Past epidemics of Ebola, COVID-19, and other pathogens have re-emphasised the usefulness of mathematical models in guiding public health responses during outbreaks. We conducted a systematic review, registered with PROSPERO (CRD42023393345) and reported according to PRISMA guidelines, of peer-reviewed papers reporting historical outbreaks, modelling studies and epidemiological parameters focused on MVD, including contextual information. We searched PubMed and Web of Science until 31st March 2023. Two reviewers evaluated all titles and abstracts, with consensus-based decision-making. To ensure agreement, 31% (13/42) of studies were double-extracted and a custom-designed quality assessment questionnaire was used to assess the risk of bias. We present detailed outbreak, model, and parameter information on 970 reported cases and 818 deaths from MVD until 31 March 2023. Analysis of historical outbreaks and seroprevalence estimates suggests the possibility of undetected MVD outbreaks, asymptomatic transmission and/or cross-reactivity with other pathogens. Only one study presented a mathematical model of MVD transmission. We estimate an unadjusted, pooled total random effect case fatality ratio for MVD of 61.9% (95% CI: 38.8-80.6%, I^2=93%). We identify key epidemiological parameters relating to transmission and natural history for which there are few estimates. This review provides a comprehensive overview of the epidemiology of MVD, identifying key knowledge gaps about this pathogen. The extensive collection of knowledge gathered here will be crucial in developing mathematical models for use in the early stages of future outbreaks of MVD. All data are published alongside this article with functionality to easily update the database as new data become available.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.10.23292424v1" target="_blank">Marburg Virus Disease outbreaks, mathematical models, and disease parameters: a Systematic Review</a>
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<li><strong>Investigating the ‘Bolsonaro effect’ on the spread of the Covid-19 pandemic: an empirical analysis of observational data in Brazil</strong> -
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Brazil counts among the countries the hardest hit by the Covid-19 pandemic. A great deal has been said about the negative role played by President Bolsonaro9s denialism, but relatively few studies have attempted to measure precisely what impact it actually had on the pandemic. Our paper conducts econometric estimates based on observational data at municipal level to quantitatively assess the ‘Bolsonaro effect’ over time from March 2020 to December 2022. To our knowledge, this paper presents the most comprehensive investigation of Bolsonaro’s influence in the spread of the pandemic from two angles: considering Covid-19 mortality and two key transmission mitigation channels (social distancing and vaccination); and exploring the full pandemic cycle (2020-2022) and its dynamics over time. Controlling for a rich set of relevant variables, our results find a strong and persistent ‘Bolsonaro effect’ on the death rate: municipalities that were more pro-Bolsonaro recorded significantly more fatalities. Furthermore, evidence suggests that the president’s attitude and decisions negatively influenced the population’s behaviour. Firstly, pro-Bolsonaro municipalities presented a lower level of compliance with social distancing measures. Secondly, vaccination was relatively less widespread in places more in favour of the former president. Finally, our analysis points to longer-lasting and damaging repercussions. Regression results are consistent with the hypothesis that the ‘Bolsonaro effect’ impacted not only on Covid-19 vaccination, but has affected vaccination campaigns in general thereby jeopardizing the historical success of the National Immunization Program in Brazil.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.07.23292354v1" target="_blank">Investigating the ‘Bolsonaro effect’ on the spread of the Covid-19 pandemic: an empirical analysis of observational data in Brazil</a>
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<li><strong>Understanding Health Service Utilisation Patterns for Care Home Residents During the COVID-19 Pandemic using Routinely Collected Healthcare Data</strong> -
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Background Healthcare in care homes during the COVID-19 pandemic required a balance, providing treatment while minimising exposure risk. Policy for how residents should receive care changed rapidly throughout the pandemic. A lack of accessible data on care home residents over this time meant policy decisions were difficult to make and verify. This study investigates common patterns of healthcare utilisation for care home residents in relation to COVID-19 testing events, and associations between utilisation patterns and resident characteristics. Methods Linked datasets including secondary care, community care and a care home telehealth app are used to define daily healthcare utilisation sequences for care home residents. We derive four 10-day sets of sequences related to Pillar 1 COVID-19 testing; before [1] and after [2] a resident9s first positive test and before [3] and after [4] a resident9s first test. These sequences are clustered, grouping residents with similar healthcare patterns in each set. Association of individual characteristics (e.g. health conditions such as diabetes and dementia) with healthcare patterns are investigated. Results We demonstrate how routinely collected health data can be used to produce longitudinal descriptions of patient care. Clustered sequences [1,2,3,4] are produced for 3,471 care home residents tested between 01/03/2020-01/09/2021. Clusters characterised by higher levels of utilisation were significantly associated with higher prevalence of diabetes. Dementia is associated with higher levels of care after a testing event, and appears to be correlated with a hospital discharge after a first test. Residents discharged from inpatient care within 10 days of their first test had the same mortality rate as those who stayed in hospital. Conclusion We provide longitudinal, resident-level data on care home resident healthcare during the COVID-19 pandemic. We find that vulnerable residents were associated with higher levels of healthcare usage despite the additional risks. Implications of findings are limited by the challenges of routinely collected data. However, this study demonstrates the potential for further research into healthcare pathways using linked, routinely collected datasets.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.11.23292499v1" target="_blank">Understanding Health Service Utilisation Patterns for Care Home Residents During the COVID-19 Pandemic using Routinely Collected Healthcare Data</a>
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<li><strong>Estimating the instantaneous reproduction number (R_t) by using particle filter</strong> -
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Background Monitoring the transmission of coronavirus disease 2019 (COVID-19) requires accurate estimation of the effective reproduction number (R_t). However, existing methods for calculating R_t may yield biased estimates if important real-world factors, such as delays in confirmation, pre-symptomatic transmissions, or imperfect data observation, are not considered. Method To include real-world factors, we expanded the susceptible-exposed-infectious-recovered (SEIR) model by incorporating pre-symptomatic (P) and asymptomatic (A) states, creating the SEPIAR model. By utilizing both stochastic and deterministic versions of the model, and incorporating predetermined time series of R_t, we generated simulated datasets that simulate real-world challenges in estimating R_t. We then compared the performance of our proposed particle filtering method for estimating R_t with the existing EpiEstim approach based on renewal equations. Results The particle filtering method accurately estimated R_t even in the presence of data with delays, pre-symptomatic transmission, and imperfect observation. When evaluating via the root mean square error (RMSE) metric, the performance of the particle filtering method was better in general and was comparable to the EpiEstim approach if perfectly deconvolved infection time series were provided, and substantially better when R_t exhibited short-term fluctuations and the data was right truncated. Conclusions The SEPIAR model, in conjunction with the particle filtering method, offers a reliable tool for predicting the transmission trend of COVID-19 and assessing the impact of intervention strategies. This approach enables enhanced monitoring of COVID-19 transmission and can inform public health policies aimed at controlling the spread of the disease.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.09.23292422v1" target="_blank">Estimating the instantaneous reproduction number (R_t) by using particle filter</a>
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<li><strong>Impact of COVID-19 on the cascade of care for tuberculosis: A systematic review</strong> -
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Abstract Objectives To describe the impact of the COVID-19 pandemic on the TB care cascade. Methods In this systematic review, the Cochrane library, Scopus, CINAHL, Ebscohost, and PubMed databases were comprehensively searched from the onset of the pandemic, till May 5th, 2022. Eligible studies were those reporting on changes in the TB cascade of care one year before and one year during the COVID-19 pandemic. Due to the expected differences in the contexts of the included studies, a narrative synthesis was conducted. Results Twenty-seven studies, from Asia, North America, Africa, South America, and Europe were included. TB screening decreased by between 1% - 50%, and multidrug resistance tuberculosis (MDR-TB) screening decreased by between 15%-17%. Diagnostic delay increased by between 35 - 45 days, contact tracing decreased by up to 36.1%, and case notification decreased by between 3%-63%. TB treatment enrolment decreased by between 16%-35.0%, treatment completion decreased by around 8.0% and treatment success decreased by up to 17.0%. Conclusion COVID-19 had a detrimental impact on the TB care cascade and these findings suggest a need for policies to protect healthcare systems for TB and other communicable diseases in future health emergencies.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.09.23292326v1" target="_blank">Impact of COVID-19 on the cascade of care for tuberculosis: A systematic review</a>
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<li><strong>Incorrect Versus Correct Mask Utilization in Public Places</strong> -
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Mask usage was mandated by public health authorities globally to decrease the spread of COVID-19. These recommendations were based on data showing that N95 masks and possibly surgical masks, when worn tight against the face, help slow the transmission of the SARS-CoV-2 virus. However, cloth and loose-fitting surgical masks are greatly inferior. Methods: Mask use by a random observation of 100 people in public indoor facilities was recorded and statistically analyzed. Results: Out of 100 people wearing a mask, 37 wore a cloth mask. Another 36 people wore a loosely applied surgical mask. Only 27 people wore a surgical mask that covered the nose and mouth and was applied firmly against the face at its margins. There were no people seen wearing an N95 mask. Overall, people were about 70% more likely to wear a surgical mask than a cloth mask (63 vs 37, p < 0.05). Of those wearing a surgical mask, more people wore it loosely than properly (36 to 27, p=0.17). Overall, people were more likely to wear a cloth mask or improperly applied surgical mask than a properly fitted one (73 vs 27, p < 0.001). Conclusion: In public settings, using cloth or loose-fitting surgical masks was almost 3 times more common than adequately using a tight-fitting surgical mask. Out of the 100 people observed, none wore an N95 respirator mask.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.10.23292470v1" target="_blank">Incorrect Versus Correct Mask Utilization in Public Places</a>
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<li><strong>How do perceptions of Covid-19 risk impact pregnancy-related health decisions? A convergent parallel mixed-methods study protocol.</strong> -
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Introduction: Pregnant people have a higher risk of severe COVID-19 disease. They have been disproportionately impacted by COVID-19 infection control policies, which exacerbated conditions resulting in intimate partner violence, healthcare access, and mental health distress. This project examines the impact of accumulated individual health decisions and describes how perinatal care and health outcomes changed during the COVID-19 pandemic. Objectives: Quantitative strand: Describe differences between 2019, 2021, and 2022 birth groups related to maternal vaccination, perinatal care, and mental health care. Examine the differential impacts on racialized and low-income pregnant people. Qualitative strand: Understand how pregnant people’s perceptions of COVID-19 risk influenced their decision-making about vaccination, perinatal care, social support, and mental health. Methods and analysis: This is a Canadian convergent parallel mixed-methods study. The quantitative strand uses a retrospective cohort design to assess birth group differences in rates of Tdap and COVID-19 vaccination, gestational diabetes screening, length of post-partum hospital stay, and onset of depression, anxiety, and adjustment disorder, using administrative data from ICES, formerly the Institute for Clinical Evaluative Sciences (Ontario) and PopulationData BC (PopData) (British Columbia). Differences by socioeconomic and ethnocultural status will also be examined. The qualitative strand employs qualitative description to interview people who gave birth between May 2020- December 2021 about their COVID-19 risk perception and health decision-making process. Data integration will occur during design and interpretation. Ethics and dissemination: This study received ethical approval from McMaster University and the University of British Columbia. Findings will be disseminated via manuscripts, presentations, and patient-facing infographics.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.10.23292463v1" target="_blank">How do perceptions of Covid-19 risk impact pregnancy-related health decisions? A convergent parallel mixed-methods study protocol.</a>
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<li><strong>Risk-based prediction for optimal timing of booster vaccination for COVID-19 to prevent severe disease</strong> -
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While waning protection from vaccination and natural infection against SARS-CoV-2 infection is well-documented, recent analyses have also found waning of protection against severe COVID-19. This highlights a broader need to understand the optimal timing of COVID-19 booster vaccines specific to an individual to mitigate the risk of severe COVID-19, while accounting for waning of protection and differential risk by age group and immune status. Here we show that more frequent COVID-19 booster vaccination (every 6-12 months) in older age groups and the immunocompromised population would effectively mitigate the burden of severe COVID-19, while frequent boosters in the younger population may only provide modest benefit. Analyzing United States COVID-19 surveillance and seroprevalence data in a microsimulation model, we estimated that in persons 75+ years, annual and semiannual bivalent boosters would reduce annual absolute risk of severe COVID-19 by 311 (277-369) and 578 (494-671) cases, respectively, compared to a one-time bivalent booster dose. In contrast, for persons 18-49 years, the model estimated that annual and semiannual bivalent boosters would reduce annual absolute risk of severe COVID-19 by 20 (13-26) and 37 (24-50) cases per 100,000 persons, respectively, compared to a one-time bivalent booster dose. Persons with prior infection had a much lower benefit of more frequent boosting, while immunocompromised persons had larger benefit. This study underscores the benefit of customizing timing of COVID-19 booster vaccines based on individual risk.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.10.23292473v1" target="_blank">Risk-based prediction for optimal timing of booster vaccination for COVID-19 to prevent severe disease</a>
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<li><strong>Disruption of outdoor activities caused by wildfire smoke shapes circulation of respiratory pathogens</strong> -
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The consequences of wildfires on public health extend beyond injury. Smoke can traverse vast distances, compromising air quality in unaffected areas and exacerbating chronic respiratory conditions. But smoke may affect the circulation and burden of communicable diseases, too. The disruption in air quality and adherence to safety guidelines can impact the time people spend indoors, and this in turns may increase exposure to airborne pathogens like influenza, SARS-CoV-2, RSV. However, the quantification of such disruptions and their implications for the transmission of respiratory diseases remain unclear. Here we study the effects of smoke generated by severe wildfires in the U.S. states of California, Oregon, Washington in September 2020. We assess the impact on human behavior and the potential consequences for the emergence of respiratory diseases. Our findings reveal a significant shift towards indoor activities in counties within Oregon and Washington during wildfires. However, a discernible change in mobility patterns is not evident in California. This discrepancy may arise from the familiarity of Californian residents with wildfires and air quality index alerts, which have become integrated into their daily routines. Consequently, their mobility patterns may be less affected during such incidents compared to individuals in other regions. We then use a deterministic compartmental model of epidemic spread to quantify the impact of the describe behavioral changes on epidemic circulation. We found that counties with disrupted air exhibited higher cumulated and peak incidence of cases compared to unaffected counties, with the exception of California. Additionally, we found that flu-like epidemics –~low reproduction ratio and short generation time~– are most affected by the behavioral changes under study. Our findings may help improve public health response in a context of larger, more frequent wildfires triggered by climate change.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.09.23292078v1" target="_blank">Disruption of outdoor activities caused by wildfire smoke shapes circulation of respiratory pathogens</a>
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<li><strong>Structural, Social, and Contextual factors influencing COVID-19 vaccine uptake: A qualitative methods study among Healthcare Workers and Older People in Uganda.</strong> -
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Background The COVID-19 vaccine rollout program in Uganda was launched in March 2021 with Healthcare Workers (HCWs), older persons (50 years and above), and persons with chronic conditions as priority groups for vaccination. To inform the vaccine rollout efforts, we set out to explore the social and structural factors that influenced the uptake of COVID-19 vaccines among HCWs and older people in Uganda. Methods Between September and October 2021, we conducted 33 in-depth interviews with 25 HCWs aged 21 to 63 years from three hospitals from two districts in the central region of Uganda and eight older people from communities in Wakiso district. Selection was purposive based on sex, occupation, education, cadre of HCWs (doctors, nurses, laboratory technologist, hospital support staff, administrator) and vaccination status. We explored participants knowledge, beliefs, personal experiences, barriers, and facilitators to vaccine uptake and suggestions for future COVID-19 vaccine rollout. Interviews were audio-recorded, data was transcribed and translated from the local language, coded, and analysed by themes. Results Twenty-two of the 25 (88%) HCWs and 3 of the 8 (38%) older people had received at least one dose of the COVID-19 vaccine at the time of interview. The structural facilitating factors to vaccine uptake included access to correct information, fear of a risky work environment, and mandatory vaccination requirements especially for frontline HCWs. Old age, chronic health conditions, and the fear of death are contextual facilitating factors, while influence from leaders was the main social facilitating factor. Myths and misconceptions about COVID-19 vaccines and the fear of side effects were common social barriers to vaccine uptake among HCWs and older people. Long distances to vaccination centres, vaccine stock-outs, and long queues at the vaccination centres were specific barriers to vaccine uptake for older people. The prerequisite of signing a consent form was a specific structural barrier for the HCWs. Transport challenges linked to long distances to the vaccination centres, for older people, and having underlying chronic health conditions, for both older people and HCWs, were the reported contextual factors. Conclusion Future roll out of new vaccines should have a comprehensive information dissemination strategy about the vaccines. Improved access to vaccines through community outreaches, reliable vaccine supply and addressing vaccine misinformation, may enhance COVID-19 vaccine uptake in Uganda and other future mass vaccination campaigns.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.07.10.23292213v1" target="_blank">Structural, Social, and Contextual factors influencing COVID-19 vaccine uptake: A qualitative methods study among Healthcare Workers and Older People in Uganda.</a>
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<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Homologous Booster Study of COVID-19 Protein Subunit Recombinant Vaccine</strong> - <b>Condition</b>: COVID-19<br/><b>Intervention</b>: Biological: SARS-CoV-2 Subunit Recombinant Protein Vaccine<br/><b>Sponsor</b>: PT Bio Farma<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Role of Ivermectin and Colchicine in Treatment of COVID-19: Randomized Controlled Clinical Trial</strong> - <b>Condition</b>: COVID-19<br/><b>Interventions</b>: Drug: Ivermectin Tablets; Drug: Colchicine 0.5 MG; Drug: Standared managment<br/><b>Sponsor</b>: Ain Shams University<br/><b>Completed</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Study to Evaluate the Immunogenicity and Safety of A Recombinant Protein COVID-19 Vaccine as Booster Vaccines</strong> - <b>Conditions</b>: COVID-19; SARS-CoV-2 Infection<br/><b>Interventions</b>: Biological: SCTV01E-2; Biological: SCTV01E<br/><b>Sponsor</b>: Sinocelltech Ltd.<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 Vaccine Hesitancy Counseling Intervention for Pharmacists</strong> - <b>Condition</b>: COVID-19<br/><b>Interventions</b>: Behavioral: Standard implementation webinar and online training; Behavioral: Virtual facilitation<br/><b>Sponsors</b>: University of North Carolina, Chapel Hill; University of Arkansas; University of South Carolina; National Institute on Minority Health and Health Disparities (NIMHD)<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Developing an Effective Intervention to Address Post-Corona-Virus-Disease-2019 Balance Disorders, Weakness and Muscle Fatigue in Individuals Aged 65+</strong> - <b>Condition</b>: COVID-19<br/><b>Intervention</b>: Device: Resistance Training<br/><b>Sponsor</b>: Józef Piłsudski University of Physical Education<br/><b>Recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>LUSZ Treatment Efficacy in Hospitalized COVID-19 Patients</strong> - <b>Conditions</b>: COVID-19; Hospitalized COVID-19 Patients<br/><b>Interventions</b>: Drug: Lopinavir / Ritonavir; Drug: Remdesivir (RDV); Drug: Tocilizumab; Other: Corticosteroid Therapy-enhanced Standard Care (CTSC)<br/><b>Sponsors</b>: Lebanese University; Hospital Saydet Zgharta University Medical Center<br/><b>Recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Multimodal Long Covid19</strong> - <b>Condition</b>: Long COVID-19 Syndrome<br/><b>Intervention</b>: Other: Multimodal intervention in Long Covid19<br/><b>Sponsors</b>: Universidad de Magallanes; Teaching Assistance and Research Center of the University of Magallanes CADI-UMAG; Clinical Hospital Dr. Lautaro Navarro Avaria<br/><b>Active, not recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Phase 1/2 Safety and Immunogenicity Trial of COVID-19 Vaccine COVIVAC (Phase 2)</strong> - <b>Condition</b>: COVID-19<br/><b>Intervention</b>: Biological: COVIVAC vaccine<br/><b>Sponsors</b>: Institute of Vaccines and Medical Biologicals, Vietnam; National Institute of Hygiene and Epidemiology (NIHE), Vietnam; Center for Disease Control of Thai Binh Province, Vietnam<br/><b>Completed</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Immunogenicity and Safety Study of SCB-2023 Vaccine as a Booster in Adults</strong> - <b>Condition</b>: COVID-19<br/><b>Interventions</b>: Biological: SCB-2023 vaccine (trivalent), a recombinant SARS-CoV-2 trimeric S-protein subunit vaccine for COVID-19; intramuscular injection; Biological: SCB-2019 (monovalent), a recombinant SARS-CoV-2 trimeric S-protein subunit vaccine for COVID-19; intramuscular injection<br/><b>Sponsor</b>: Clover Biopharmaceuticals AUS Pty Ltd<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Safety and Immunogenicity Following a Heterologous Booster Dose of Recombinant SARS-CoV-2 Vaccine LYB002</strong> - <b>Condition</b>: COVID-19<br/><b>Interventions</b>: Biological: LYB002V14; Biological: LYB002V14A; Biological: LYB002CA<br/><b>Sponsors</b>: Guangzhou Patronus Biotech Co., Ltd.; Yantai Patronus Biotech Co., Ltd.; Affiliated Hospital of North Sichuan Medical College<br/><b>Active, not recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Phase 2/3 Heterologous Boosting Study With Different Dose Levels of Monovalent SARS-CoV-2 rS Vaccines</strong> - <b>Condition</b>: COVID-19<br/><b>Interventions</b>: Biological: NVX-CoV2373 (5μg); Biological: NVX-CoV2601 (5μg); Biological: NVX-CoV2601(5μg); Biological: NVX-CoV2601 (35μg); Biological: NVX-CoV2601(35μg); Biological: NVX-CoV2601(50μg); Biological: Bivalent BA.4/5<br/><b>Sponsor</b>: Novavax<br/><b>Not yet recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Efficiency and Safety of Paxlovid for COVID-19 Patients With Severe Chronic Kidney Disease</strong> - <b>Conditions</b>: COVID-19; Renal Insufficiency, Chronic<br/><b>Intervention</b>: Drug: Nirmatrelvir/ritonavir<br/><b>Sponsor</b>: Chinese PLA General Hospital<br/><b>Recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Immunogenicity and Safety Following a Heterologous Booster Dose of Recombinant SARS-CoV-2 Vaccine LYB001</strong> - <b>Conditions</b>: COVID-19; Vaccine Reaction<br/><b>Interventions</b>: Biological: LYB001; Biological: CoronaVac<br/><b>Sponsors</b>: Guangzhou Patronus Biotech Co., Ltd.; Yantai Patronus Biotech Co., Ltd.; Affiliated Hospital of North Sichuan Medical College<br/><b>Active, not recruiting</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Efficacy of the Therapy With BRAINMAX® Using fMRI for the Treatment of Patients With Asthenia After COVID-19</strong> - <b>Conditions</b>: Asthenia; COVID-19; Functional MRI; Cognitive Impairment<br/><b>Interventions</b>: Other: Structural and functional MRI; Drug: Ethyl methyl hydroxypyridine succinate + Meldonium; Drug: Placebo<br/><b>Sponsor</b>: Promomed, LLC<br/><b>Completed</b></p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Safety and Efficacy of Anakinra Treatment for Patients With Post Acute Covid Syndrome</strong> - <b>Condition</b>: Post-Acute COVID-19 Syndrome<br/><b>Interventions</b>: Drug: Placebo; Drug: Anakinra 149 MG/ML Prefilled Syringe [Kineret]<br/><b>Sponsor</b>: Hellenic Institute for the Study of Sepsis<br/><b>Not yet recruiting</b></p></li>
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<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Effect of DMARDs on the immunogenicity of vaccines</strong> - Vaccines are important for protecting individuals at increased risk of severe infections, including patients undergoing DMARD therapy. However, DMARD therapy can also compromise the immune system, leading to impaired responses to vaccination. This Review focuses on the impact of DMARDs on influenza and SARS-CoV-2 vaccinations, as such vaccines have been investigated most thoroughly. Various data suggest that B cell depletion therapy, mycophenolate mofetil, cyclophosphamide, azathioprine and…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Characteristics of VOCs and Assessment of Emission Reduction Effect During the Epidemic Lockdown Period in Shenzhen Urban Area</strong> - 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…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluating Z-FA-FMK, a host cathepsin L protease inhibitor, as a potent and broad-spectrum antiviral therapy against SARS-CoV-2 and related coronaviruses</strong> - Even though the World Health Organization announced the end of the COVID-19 pandemic as a global public health emergency on May 5, 2023, SARS-CoV-2 continues to pose a significant health threat worldwide, resulting in substantial numbers of infections and fatalities. This study investigated the antiviral potential of Z-FA-FMK (FMK), a novel host cathepsin L protease inhibitor, against SARS-CoV-2 infection using both in vitro and in vivo models. In vitro assessments of FMK against a diverse set…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Isolation and characterization of Rhodococcus sp. GG1 for metabolic degradation of chloroxylenol</strong> - The coronavirus disease 2019 (COVID-19) pandemic has significantly increased the demand of disinfectant use. Chloroxylenol (para-chloro-meta-xylenol, PCMX) as the major antimicrobial ingredient of disinfectant has been widely detected in water environments, with identified toxicity and potential risk. The assessment of PCMX in domestic wastewater of Macau Special Administrative Region (SAR) showed a positive correlation between PCMX concentration and population density. An indigenous PCMX…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Neutralizing activity of Usnic acid and β-cyclodextrins complex against SARS-CoV-2 spike pseudovirus</strong> - The rapid spread of SARS-CoV-2 and its infection severity require an urgent development of antiviral agents. In this respect, Usnic acid (UA), a natural dibenzofuran derivative, exerts antiviral activity against several viruses, though presenting very low solubility and high cytotoxicity. Here, UA was complexed with β-cyclodextrins (β-CDs), a pharmaceutical excipient used to improve drug solubility. The cytotoxic activity, tested on Vero E6 cells, revealed no effect for β-CDs alone whereas…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Structure-based discovery of thiosemicarbazones as SARS-CoV-2 main protease inhibitors</strong> - Aim: Discovery of novel SARS-CoV-2 main protease (M^(pro)) inhibitors using a structure-based drug discovery strategy. Materials & methods: Virtual screening employing covalent and noncovalent docking was performed to discover M^(pro) inhibitors, which were subsequently evaluated in biochemical and cellular assays. Results: 91 virtual hits were selected for biochemical assays, and four were confirmed as reversible inhibitors of SARS CoV-2 M^(pro) with IC(50) values of 0.4-3 μM. They were also…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Identification of sulphonamide-tethered <em>N</em>-((triazol-4-yl)methyl)isatin derivatives as inhibitors of SARS-CoV-2 main protease</strong> - SARS-CoV-2 pandemic in the end of 2019 led to profound consequences on global health and economy. Till producing successful vaccination strategies, the healthcare sectors suffered from the lack of effective therapeutic agents that could control the spread of infection. Thus, academia and the pharmaceutical sector prioritise SARS-CoV-2 antiviral drug discovery. Here, we exploited previous reports highlighting the anti-SARS-CoV-2 activities of isatin-based molecules to develop novel…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Inhibition of phosphodiesterase 12 results in antiviral activity against several RNA viruses including SARS-CoV-2</strong> - The 2’,5’- oligoadenylate synthetase (OAS) - ribonuclease L (RNAseL) - phosphodiesterase 12 (PDE12) pathway is an essential interferon-induced effector mechanism against RNA virus infection. Inhibition of PDE12 leads to selective amplification of RNAseL activity in infected cells. We aimed to investigate PDE12 as a potential pan-RNA virus antiviral drug target and develop PDE12 inhibitors that elicit antiviral activity against a range of viruses. A library of 18 000 small molecules was screened…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Mitochondria of lung venular capillaries mediate lung-liver crosstalk in pneumonia</strong> - Failure of the lung’s endothelial barrier underlies lung injury, which causes the high mortality Acute Respiratory Distress Syndrome (ARDS). Multiple organ failure predisposes to the mortality, but mechanisms are poorly understood. Here, we show that mitochondrial Uncoupling Protein 2 (UCP2), a component of the mitochondrial inner membrane, plays a role in the barrier failure. Subsequent lung-liver crosstalk mediated by neutrophil activation causes liver congestion. We intranasally instilled…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Cereals as a Source of Bioactive Compounds with Anti-Hypertensive Activity and Their Intake in Times of COVID-19</strong> - Cereals have phytochemical compounds that can diminish the incidence of chronic diseases such as hypertension. The angiotensin-converting enzyme 2 (ACE2) participates in the modulation of blood pressure and is the principal receptor of the virus SARS-CoV-2. The inhibitors of the angiotensin-converting enzyme (ACE) and the block receptors of angiotensin II regulate the expression of ACE2; thus, they could be useful in the treatment of patients infected with SARS-CoV-2. The inferior peptides from…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Recent advances in cholinergic mechanisms as reactions to toxicity, stress, and neuroimmune insults</strong> - This review presents recent studies of the chemical and molecular regulators of acetylcholine (ACh) signaling and the complexity of the small molecule and RNA regulators of those mechanisms that control cholinergic functioning in health and disease. The underlying structural, neurochemical, and transcriptomic concepts, including basic and translational research and clinical studies, shed new light on how these processes inter-change under acute states, age, sex, and COVID-19 infection; all of…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Identification of alpha-linolenic acid as a broad-spectrum antiviral against zika, dengue, herpes simplex, influenza virus and SARS-CoV-2 infection</strong> - Zika virus (ZIKV) has garnered global attention due to its association with severe congenital defects including microcephaly. However, there are no licensed vaccines or drugs against ZIKV infection. Pregnant women have the greatest need for treatment, making drug safety crucial. Alpha-linolenic acid (ALA), a polyunsaturated ω-3 fatty acid, has been used as a health-care product and dietary supplement due to its potential medicinal properties. Here, we demonstrated that ALA inhibits ZIKV…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Mechanism of the Covalent Inhibition of Human Transmembrane Protease Serine 2 as an Original Antiviral Strategy</strong> - The Transmembrane Protease Serine 2 (TMPRSS2) is a human enzyme which is involved in the maturation and post-translation of different proteins. In addition to being overexpressed in cancer cells, TMPRSS2 plays a further fundamental role in favoring viral infections by allowing the fusion of the virus envelope with the cellular membrane, notably in SARS-CoV-2. In this contribution, we resort to multiscale molecular modeling to unravel the structural and dynamical features of TMPRSS2 and its…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Smoke and Spike: Benzo[a]pyrene Enhances SARS-CoV-2 Infection by Boosting NR4A2-Induced ACE2 and TMPRSS2 Expression</strong> - Cigarette smoke aggravates severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, the underlying mechanisms remain unclear. Here, they show that benzo[a]pyrene in cigarette smoke extract facilitates SARS-CoV-2 infection via upregulating angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2). Benzo[a]pyrene trans-activates the promoters of ACE2 and TMPRSS2 by upregulating nuclear receptor subfamily 4 A number 2 (NR4A2) and promoting its…</p></li>
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<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Garbage in, garbage out: how reliable training data improved a virtual screening approach against SARS-CoV-2 MPro</strong> - Introduction: The identification of chemical compounds that interfere with SARS-CoV-2 replication continues to be a priority in several academic and pharmaceutical laboratories. Computational tools and approaches have the power to integrate, process and analyze multiple data in a short time. However, these initiatives may yield unrealistic results if the applied models are not inferred from reliable data and the resulting predictions are not confirmed by experimental evidence. Methods: We…</p></li>
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<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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