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Heterologous boosting is suggested to be of use in populations who have received inactivated COVID-19 vaccines. We aimed to assess the safety and immunogenicity of a heterologous vaccination with the mRNA vaccine CS-2034 versus the inactivated BBIBP-CorV as a fourth dose, as well as the efficacy against the SARS-CoV-2 omicron (BA.5) variant. This trial contains a randomised, double-blind, parallel-controlled study in healthy participants aged 18 years or older (group A) and an open-label cohort in participants 60 years and older (group B), who had received three doses of inactivated whole-virion vaccines at least 6 months before enrolment. Pregnant women and people with major chronic illnesses or a history of allergies were excluded. Eligible participants in group A were stratified by age (18–59 years and ≥60 years) and then randomised by SAS 9.4 in a ratio of 3:1 to receive a dose of the mRNA vaccine (CS-2034, CanSino, Shanghai, China) or inactivated vaccine (BBIBP-CorV, Sinopharm, Beijing, China). Safety and immunogenicity against omicron variants of the fourth dose were evaluated in group A. Participants 60 years and older were involved in group B for safety observations. The primary outcome was geometric mean titres (GMTs) of the neutralising antibodies against omicron and seroconversion rates against BA.5 variant 28 days after the boosting, and incidence of adverse reactions within 28 days. The intention-to-treat group was involved in the safety analysis, while all patients in group A who had blood samples taken before and after the booster were involved in the immunogenicity analysis. This trial was registered at the Chinese Clinical Trial Registry Centre (ChiCTR2200064575). Between Oct 13, and Nov 22, 2022, 320 participants were enrolled in group A (240 in the CS-2034 group and 80 in the BBIBP-CorV group) and 113 in group B. Adverse reactions after vaccination were more frequent in CS-2034 recipients (158 [44·8%]) than BBIBP-CorV recipients (17 [21·3%], p<0·0001). However, most adverse reactions were mild or moderate, with grade 3 adverse reactions only reported by eight (2%) of 353 participants receiving CS-2034. Heterologous boosting with CS-2034 elicited 14·4-fold (GMT 229·3, 95% CI 202·7–259·4 vs 15·9, 13·1–19·4) higher concentration of neutralising antibodies to SARS-CoV-2 omicron variant BA.5 than did homologous boosting with BBIBP-CorV. The seroconversion rates of SARS-CoV-2-specific neutralising antibody responses were much higher in the mRNA heterologous booster regimen compared with BBIBP-CorV homologous booster regimen (original strain 47 [100%] of 47 vs three [18·8%] of 16; BA.1 45 [95·8%] of 48 vs two [12·5%] 16; and BA.5 233 [98·3%] of 240 vs 15 [18·8%] of 80 by day 28). Both the administration of mRNA vaccine CS-2034 and inactivated vaccine BBIBP-CorV as a fourth dose were well tolerated. Heterologous boosting with mRNA vaccine CS-2034 induced higher immune responses and protection against symptomatic SARS-CoV-2 omicron infections compared with homologous boosting, which could support the emergency use authorisation of CS-2034 in adults. Science and Technology Commission of Shanghai, National Natural Science Foundation of China, Jiangsu Provincial Science Fund for Distinguished Young Scholars, and Jiangsu Provincial Key Project of Science and Technology Plan. For the Chinese translation of the abstract see Supplementary Materials section. [ABSTRACT FROM AUTHOR]

• The mortality burden of influenza has been substantial in Shanghai, especially among the elderly. • Excessive mortality associated with influenza B virus is dominated by B(Yamagata) lineage. • The evidence for sex differences in influenza-associated mortality for respiratory and circulatory diseases is limited. Few studies have explored the different lineages of influenza B viruses, which cause excessive fatalities. This study aimed to estimate age- and sex-specific excessive mortality associated with influenza subtypes/lineages in Shanghai, during 2010–2015. We used quasi-Poisson regression models to fit weekly numbers of deaths from various causes by adjusting long-term trend, seasonal trend, and absolute humidity as confounding factors. The mortality burden associated with influenza subtypes/lineages was estimated by age and sex. The average influenza-associated excessive mortality rate in deaths coded as all-cause was 27.66 (95%CI: 22.30–33.88) per 100,000 person-years. The excessive deaths from six underlying causes in people aged ≥65 years weight heavily. Compared to influenza B(Victoria) lineage, influenza B(Yamagata) lineage had more effect on the influenza-associated disease burden, particularly in patients with respiratory and circulatory diseases. There was no statistical significance of sex in the mortality burden associated with influenza. Disproportionate mortality associated with influenza B virus is dominated by B(Yamagata) lineage in Shanghai, and the evidence for sex differences in the influenza-associated mortality burden for respiratory and circulatory diseases is limited. Improving the vaccination of the elderly and strengthening laboratory-based surveillance of influenza B lineages in Shanghai are needed to reduce this influenza's disease burden. [ABSTRACT FROM AUTHOR]

Background: In China mainland, most Mycoplasma pneumoniae related studies are carried out in Beijing and Shanghai, while rare studies are performed in the other regions. In this study, we analyzed the molecular biology characteristics and antimicrobial susceptibility of clinical isolates of M. pneumoniae from 5 regions between January 2017 and December 2018. Methods: Genotyping was performed to 154 M. pneumoniae isolates from 5 cities using PCR and multiple-locus variable-number tandem repeat analysis (MLVA) method. Antimicrobial susceptibility test was performed to all the isolates against 4 antibiotics. Sequencing was performed to the amplification products of the 23S rRNA drug resistant gene. Results: Genotype I was detected in 118 M. pneumoniae isolates (76.6%), and genotype II was identified in 36 isolates (23.4%). The majority (92.2%) of the MLVA genotypes were 4–5–7-2 and 3–5–6-2, which represented the genotype I and II, respectively. The total macrolide (ML) resistance rate was 79.7%. The minimum inhibitory concentration (MIC) of the erythromycin was in a range of 128- > 256 μg/ml, while that for the azithromycin was 2-32 μg/ml. There were mutations in the 23S rRNA in each ML resistance isolate. Jilin city showed the highest prevalence of genotype I (100%) and ML resistance rate (100%), while Jinan showed the lowest prevalence of genotype I (45.5%) and ML resistance rate (54.5%). Conclusions: A large variance was identified in the M. pneumoniae genotype and ML resistance among the 5 cities. The proportion of M. pneumoniae with a genotype II genotype (3–5–6-2) showed an increased trend. [ABSTRACT FROM AUTHOR]

• A total of 78% of asymptomatic infections with Omicron was in presymptomatic stage. • The proportion of asymptomatic Omicron infections was 17.5%. • The infectivity of asymptomatic and mild Omicron infections was similar. • More attention should be paid to asymptomatic cases during quarantine. Asymptomatic infections and mild diseases were more common during the Omicron outbreak in Shanghai, China in 2022. This study aimed to assess the characteristics and viral RNA decay between patients with asymptomatic and mild infections. A total of 55,111 patients infected with SARS-CoV-2 who were quarantined in the National Exhibition & Convention Center (Shanghai) Fangcang shelter hospital within 3 days after diagnosis from April 9 to May 23, 2022 were enrolled. The kinetics of cycle threshold (Ct) values of reverse transcription-polymerase chain reaction were assessed. The influencing factors for disease progression and the risk factors for the viral RNA shedding time (VST) were investigated. On admission, 79.6% (43,852/55,111) of the cases were diagnosed with asymptomatic infections, and 20.4% were mild diseases. However, 78.0% of initially asymptomatic subjects developed mild diseases at the follow-up. The final proportion of asymptomatic infections was 17.5%. The median time of symptom onset, the duration of symptoms, and the VST were 2 days, 5 days, and 7 days, respectively. Female, age 19-40 years, underlying comorbidities with hypertension and diabetes, and vaccination were associated with higher risks of progressing to mildly symptomatic infections. In addition, mildly symptomatic infections were found to be associated with prolonged VST compared with asymptomatic infections. However, the kinetics of viral RNA decay and dynamics of Ct values were similar among asymptomatic subjects, patients with asymptomatic-to-mild infection, and patients with mild infection. A large proportion of initially diagnosed asymptomatic Omicron infections is in the presymptomatic stage. The Omicron infection has a much shorter incubation period and VST than previous variants. The infectivity of asymptomatic infections and mildly symptomatic infections with Omicron is similar. [ABSTRACT FROM AUTHOR]

Mycobacterium kansasii pulmonary disease is frequently misdiagnosed and treated as tuberculosis, especially in countries with high tuberculosis burden. This study aimed to investigate the drug resistance profile of M. kansasii in patients with M. kansasii pulmonary disease in Shanghai and to determine the variations in drug resistance after 2 months of antimycobacterial treatment. All patients with a diagnosis of M. kansasii pulmonary disease from 2017 to 2019 in Shanghai were retrospectively analysed. Whole-genome sequencing was performed, and the minimum inhibitory concentration (MIC) to antimycobacterial drugs was measured using the broth microdilution method. In total, 191 patients had a diagnosis of M. kansasii pulmonary disease. Of them, 24.1% (46/191) had persistent positive culture after 2 months of antimycobacterial treatment. Whole-genome sequencing revealed that the 46 paired isolates had a difference of <17 single nucleotide polymorphisms, thus excluding the possibility of exogenous reinfection. More than 90% of the baseline isolates were sensitive to rifampin, clarithromycin, moxifloxacin, or amikacin, whereas a high resistance to ethambutol (118/191, 61.8%) and 4 μg/mL of isoniazid (32/191, 16.8%) were observed. Two isolates presented high resistance to rifamycin (i.e. a rifampin MIC of >8 μg/mL and a rifabutin MIC of 8 μg/mL) both containing the rpoB mutation (S454L). The increase of MIC to rifampin, ethambutol, and/or isoniazid was identified in 50.0% (23/46) of the patients. A high prevalence of innate resistance to ethambutol and isoniazid was observed among circulating M. kansasii clinical strains in Shanghai. The increase in drug resistance under empirical antimycobacterial treatment highlighted the urgency of definitive species identification before initiating treatment. [ABSTRACT FROM AUTHOR]

• Revealed spatial heterogeneity of NTM-PD, focusing on MKC-PD, MAC-PD, and MABC-PD. • Utilized Bayesian spatial disease mapping to highlight high-risk NTM-PD areas. • Demonstrated distinct demographic and clinical characteristics of NTM-PD patients. • Linked environmental factors to varying NTM-PD distribution patterns. To investigate the spatial heterogeneity of nontuberculous mycobacterial pulmonary disease (NTM-PD) in Shanghai. A population-based retrospective study was conducted using presumptive pulmonary tuberculosis surveillance data of Shanghai between 2010 and 2019. The study described the spatial distribution of NTM-PD notification rates, employing hierarchical Bayesian mapping for high-risk areas and the Getis-Ord Gi* statistic to identify hot spots and explore associated factors. Of 1652 NTM-PD cases, the most common species was Mycobacterium kansasii complex (MKC) (41.9%), followed by Mycobacterium avium complex (MAC) (27.1%) and Mycobacterium abscessus complex (MABC) (16.2%). MKC-PD patients were generally younger males with a higher incidence of pulmonary cavities, while MAC-PD patients were more often farmers or had a history of tuberculosis treatment. MKC-PD hot spots were primarily located in the areas alongside the Huangpu River, while MAC-PD hot spots were mainly in the western agricultural areas. Patients with MKC-PD and MAC-PD exhibited a higher risk of spatial clustering compared to those with MABC-PD. Different types of NTM-PD exhibit distinct patterns of spatial clustering and are associated with various factors. These findings underscore the importance of environmental and host factors in the epidemic of NTM-PD. [Display omitted] [ABSTRACT FROM AUTHOR]

BACKGROUND The nutrients in human milk, particularly amino acids and minerals, are important for infant growth and development. Since there are few reports of amino acids and minerals in Chinese breast milk, we conducted this study to establish a representative preliminary database of breast milk nutrients in Chinese breast milk. In this study, we collected breast milk from healthy mothers in seven cities in western, southern and central China. The composition, content and proportion of total amino acids and ten elements (potassium, sodium, calcium, magnesium, iron, zinc, manganese, copper, selenium and phosphorus) in human milk in different lactation stages were investigated. RESULTS: In this study, it was found that the content of total essential amino acids (671.47 mg 100 mL−1) in Chinese breast milk was higher compared with the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) (574 mg 100 mL−1), but the content of leucine (LEU) (129.01 mg 100 mL−1) and cysteine (CYS) (20.31 mg 100 mL−1) was much lower than that recommended by ESPGHAN. Moreover, it was found that the content of most of these ten elements decreased during lactation, and the content of calcium in Chinese breast milk was lower compared with ESPGHAN. In addition, the content of selenium (7.23–20.55 mg 1000 mL−1) in breast milk from the three cities Nanchang, Shanghai and Guangzhou in China was much higher than that recommended by ESPGHAN. CONCLUSIONS: In a word, amino acids and minerals in Chinese human milk showed a significant difference from other countries. Human milk meal or infant food should be regulated to meet the requirements of the infant and to maintain the balance of the amino acids and minerals. © 2020 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Influenza B virus (IBV) belongs to the Orthomyxoviridae family and generally causes sporadic epidemics but is occasionally deadly to individuals. The current research mainly focuses on clinical and pathological characteristics of IBV. However, to better prevent or treat the disease, one must determine the strategies developed by IBV to invade and disrupt cellular proteins and approach to replicate itself, to suppress antiviral innate immunity, and understand how the host responds to IBV infection. The B/Shanghai/PD114/2018 virus was able to infect alveolar epithelial cells (A549) cells, with good potential for replication. To identify host cellular responses against IBV infection, differentially expressed genes (DEGs) were obtained using RNA sequencing. The GO and KEGG pathway term enrichment analyses with the DEGs were performed, and we found that the DEGs were primary involved in metabolic processes and cellular function, which may be related to the host response, including the innate immune response against the virus. Our transcriptome analysis results demonstrated robust induction of interferon and interferon-stimulated gene expression by IBV in human cells during the early stages of infection, providing a foundation for further studies focused on antiviral drug development and interactions between the virus and host. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the validity and reliability of the Pictorial Scale for Perceived Movement Skill Competence (PMSC) in Chinese children. A total of 241 children (girls, n = 119) aged 4 to 9 years old (6.9 ± 1.53) participated. One week later two random subsamples were selected. One (n = 52) was to determine face validity and the other (n = 56) was to determine test-retest reliability. Internal consistency analyses through Cronbach's alpha and construct validity by confirmatory factor analysis were conducted. Results showed (a) face validity was better for object control skills; (b) internal consistency was adequate for each subscale and all 13 skills (alpha range from.73–.87); (c) Intra-Class Correlations were good for locomotor (.62), object control (.73), and all 13 skills (.78); and (d) the modified two-factor model had a good fit (CFI =.96, TLI =.94, RMSEA =.04, SRMR =.05). The Chinese version of the PMSC is appropriate to use; however, considering the participants were only from Shanghai, results may not be generalizable to all Chinese children. [ABSTRACT FROM AUTHOR]

Using energy conservation measures (ECMs) for building retrofit can significantly reduce building operational carbon emissions (BOCEs) and contribute to Chinese carbon neutrality by 2060. This paper involves 11 feasible ECMs for commercial buildings in hot-summer and cold-winter zone, China, and proposes a quick assessment approach to BOCEs reduction. Prototypical models are simulated for ECMs using EnergyPlus and the emission intensity is corrected by the building shape factor and window-to-wall ratio. Based on pre-simulated results, effects on reducing emissions of individual measures and packages of them are studied to develop regression models in SPSS. The results show that decreasing the U-factor of external walls, lighting power density (LPD), or shading coefficient can reduce BOCEs linearly. BOCEs are most sensitive to LPD and using daylighting control can reduce emissions by 5–15%. In addition, increasing the boilers' efficiency reduces emissions linearly, while performance improvement of chillers or heat pumps reduces emissions logarithmically. Furthermore, utilizing variable speed pumps, heat recovery ventilation, and air-side economizers can reduce emissions by 3.8%, 6.6%, and 15.2%, respectively. Finally, significant interactions exist among measures of enhancing glazing U-factor, adding external shading, using energy-saving lamps, and improving cooling/heating system efficiencies. The developed regression models are validated in a retrofit case in Shanghai. Through assessment, the case can reduce BOCEs by 15.9 kgCO 2 /m2, with a reduction rate of 20.8%. Compared with recorded data, the relative error of assessing emission reduction is −13.0% and that of assessing reduction rate is 0.5%, which are acceptable in the decision-making stage of retrofit strategies. [ABSTRACT FROM AUTHOR]

• The Coupled Map Lattices model is proposed based on anti-risk ability of station. • The relationship between perturbation index and passenger flow is quantified. • The higher topological redundancy, the stronger the anti-risk ability of stations. • The anti-risk ability of stations could resist the spread of failures in the early stage. • The propagation of cascading failures depends on the location and type of stations. In terms of urban rail transit network vulnerability, most studies have focused on the changes of network topology and functional characteristics under disruptive events while ignoring the impacts of cascading failures on network performance. In this study, an improved Coupled Map Lattices model is proposed to address the evolution process of cascading failures on rail transit network. Particularly, the model quantifies important factors of cascading failures integrating quantitative failure spreading mode, anti-risk ability of stations, and perturbation index. The rail transit network vulnerability is then modeled addressing numbers of failed stations, degree of affected passengers, and loss of passenger travel time as a result of cascading failures. The methodology is applied to the metro network of Shanghai, China. Results show that the propagation of network cascading failure depends on the station's anti-risk ability, geographical location, and type of adjacent stations. Stations located in the urban center area are more susceptible to failures of adjacent stations. Furthermore, higher affected passenger volume and station coupling strength would lead to more serious and rapid spreading of failures, and thus more vulnerable of the metro system. However, the anti-risk ability of stations could effectively resist the spread of failures in the early stage, and stations with higher topology redundancy demonstrate stronger anti-risk ability. [ABSTRACT FROM AUTHOR]

Haze is a phenomenon caused by the suspension of fine particulate matters in the air that leads to impaired visibility. In the meteorological practice, a haze day is determined using the observation of visibility and relative humidity, after screening the special weather days of rain, snow, dust, fog, and others. While in the environmental monitoring practice and relevant studies, the term haze is also commonly used and a haze day is determined using the reading of particulate matters (PM). This has actually caused two different kinds of haze days, i.e., meteorological haze days (MHDs) and environmental haze days (EHDs), each with different definitions and standards. Our analysis shows that although MHDs and EHDs overlap, the proportion of MHDs in EHDS is 43% in Beijing, 44% in Shanghai, and 46% in Guangzhou. Meanwhile, there is large percentage of MHDs that are not EHDs, about 21% in Beijing, 42% in Shanghai and 67% in Guangzhou. Therefore, an explicit distinction of the two haze definitions should be made in the study of PM pollution variation and cause in China, which will have important applications in addressing air pollution, formulating environmental policy, and dealing with the health effect of haze in China. • The term haze is widely used in both meteorological and environmental studies. • Only a portion of meteorological haze days belong to PM pollution days, and vice versa. • An explicit distinction of the definition of haze and PM pollution is necessary. [ABSTRACT FROM AUTHOR]