COVID-19 Pandemic In China Research Articles

Trends and determinants of nurses’ mental health following the COVID-19 pandemic in China: a longitudinal, comparative study over a two-year period

Trends and determinants of nurses’ mental health following the COVID-19 pandemic in China: a longitudinal, comparative study over a two-year period

Prediction of ILI following the COVID-19 pandemic in China by using a partial differential equation

Abstract The COVID-19 outbreak has significantly disrupted the lives of individuals worldwide. Following the lifting of COVID-19 interventions, there is a heightened risk of future outbreaks from other circulating respiratory infections, such as influenza-like illness (ILI). Accurate prediction models for ILI cases are crucial in enabling governments to implement necessary measures and persuade individuals to adopt personal precautions against the disease. This paper aims to provide a forecasting model for ILI cases with actual cases. We propose a specific model utilizing the partial differential equation (PDE) that will be developed and validated using real-world data obtained from the Chinese National Influenza Center. Our model combines the effects of transboundary spread among regions in China mainland and human activities’ impact on ILI transmission dynamics. The simulated results demonstrate that our model achieves excellent predictive performance. Additionally, relevant factors influencing the dissemination are further examined in our analysis. Furthermore, we investigate the effectiveness of travel restrictions on ILI cases. Results can be used to utilize to mitigate the spread of disease.

Oral complications during the two waves of COVID-19 pandemic in China: a prospective cross-section analysis of 510 cases using questionnaire

BackgroundOral complications such as parageusia, xerostomia, and oral ulcers are frequently observed in patients with COVID-19. The aim of this study was to understand the oral complications and their influencing factors during the two waves of the COVID-19 pandemic in China between December 2022 and May 2023.MethodsA total of 347 patients during the COVID-19 pandemic from December 2022 and January 2023 and 163 patients during the second COVID-19 pandemic were recruited through the Disease Prevention and Control Reporting System. Data on oral complications were collected via researcher-made questionnaires.ResultsDuring both pandemic periods, more than 50% of the subjects developed oral complications. Specifically, the incidence of parageusia, pathological tongue coating, and xerostomia all exceeded 20%, while the incidence of oral ulcers surpassed 7%. Patients with allotriosmia and xerostomia had a significantly higher likelihood of developing other oral complications. Hospitalized patients requiring supplemental oxygen had a significantly higher incidence of oral complications.ConclusionsThe results of our study underline that oral complications during the COVID-19 pandemic are prevalent, and their incidence has not decreased during the subsequent pandemic. In the context of the ongoing global spread of COVID-19, this study lays the foundation for physicians in recognizing and managing oral complications, which will improve the oral health of communities globally.

Prevalence and influencing factors of suicidal ideation among doctors and nurses during the surge period of the COVID-19 pandemic in China: a multicenter cross-sectional study.

From November 2022 to February 2023, China has experienced a surge period of COVID-19 pandemic and doctors and nurses working in hospitals have suffered from serious psychological crisis because of the medical crowding, which may result in the occurrence of suicidal ideation (SI). This study aims to explore the prevalence and influencing factors of SI during this surge phase. A multicenter cross-sectional study was conducted in China from January 5 to February 9, 2023. Data were collected by online questionnaires, with SI measured by a single item. Ordinal logistic regression analysis and stratified analyses were preformed to identify influencing factors. A total of 5696 doctors and nurses were retained for further analysis, with 25.28% reporting SI during the COVID-19 surge phase. Participants experiencing anxiety symptoms or supporting other departments treating COVID-19 patients were more likely to report SI. Additionally, higher levels of resilience, mindfulness, and perceived social support were protective factors against SI. During the COVID-19 surge phase, over a quarter of doctors and nurses in China suffered from SI, which should be of great concern. Tailored interventions should be implemented to alleviate SI among doctors and nurses when new infectious diseases outbreak in the future.

Intolerance of Uncertainty Worsens Career Indecisiveness and Anxiety Among Chinese NEET During the COVID-19 Pandemic: Mediation Roles of Memes Use and Depression Emoticon Empathy

The term “NEET” refers to individuals aged 15 to 34 years who are not involved in education, employment, or training programs. Recent studies have shown that NEET individuals are at a high risk of experiencing lower well-being and mental health issues. This study aimed to examine the relationship between intolerance of uncertainty (IU), meme use (MU), depression emoticon empathy (DEE), and career indecisiveness and anxiety (CIA) in NEETs who were locked down during the COVID-19 pandemic in China. We hypothesize positive interrelations among study variables. Then, mediation path models were carried out to study the relationship between IU and CIA through MU and DEE. We collected data through an online survey from NEETs (N = 1,404) in China, using questionnaires assessing IU, MU, DEE, and CIA, and Structural Equation Modeling analyses were performed to explore the interrelations among them. We found that IU influenced NEET’s CIA primarily through the independent intermediaries of MU and DEE. Additionally, the chain intermediary of MU → DEE was significant. Our study indicated that MU and DEE partially mediated the relationship between IU and CIA, respectively. Digital communications through MU and DEE are playing an important role in the relationship between IU and CIA, respectively. Therefore, MU and DEE as studied in this research may work as alarm to foretell early of the CIA among NEET. Moreover, our findings could be used as a reference for promoting employment and increasing the employment rate among NEET population and might be a potential target for intervention or service delivery.

Social Support and Psychological Capital Mediate the Effect of Personalities on the Mental Health of Professional Staff in China During COVID-19 Pandemic.

COVID-19-related lockdown can lead to mental health problem, which displays heterogeneous between individuals. The aim of this study was to explore the association between mental health, social support and psychological capital state of professional staff with different personalities during the COVID-19 pandemic in China. A cross-section study was conducted via online survey using the questionnaires of General Health Questionnaire (GHQ-12), Multidimensional Scale of Perceived Social Support (MSPSS), Psychological Capital Questionnaire (PCQ), Eysenck Personality Questionnaire-Revision Short Scale of China (EPQ-RSC). A total of 626 employees were included. Multiple regression analysis was performed to investigate the association of psychological capital, perceived social support, EPQ-N and EPQ-E and their interactions in general mental health. About 2.7% of professionals had mental health. The married had a higher mental health score than the single (P<0.05). The regular exercising workers had the lowest mental health score (P<0.05), and higher psychological capital and social support scores than the non-exercising ones (P<0.01). Multivariate analysis showed that the interaction between social support, psychological capital and neuroticism was statistically significant (β=-0.161, P<0.001) in general mental health with neuroticism ranking the top (β=0.352, P<0.001). Mediation analysis showed that social support modified the effect of psychological capital on mental health, accounting for 25.5% of the total effect, and that both social support and psychological capital mediated the effect of neuroticism or extroversion differentially on mental health. Neuroticism is an influencing factor on mental health of professional staff. Social support and psychological capital played a partial mediating role in the effect of neuroticism or extroversion differentially on mental health in China. The findings suggest that during the COVID-19 pandemic, more social support and psychological capital are needed for the professional individuals with neuroticism to alleviate their stress and improve mental health.

Patient mistreatment, emotional exhaustion and work-family conflict among nurses: a moderated mediation model of social sharing of negative work events and perceived organizational support

BackgroundNursing literature suggested that patient mistreatment has significant impacts on nurses’ emotions and job burnout. Yet, further research is needed to understand the underlying mechanism and the spillover effect on nurses’ families. Leveraging the goal progress theory, this study aimed to examine the association between patient mistreatment, nurses’ emotional exhaustion, and work-family conflict, as well as the mediating role of social sharing of negative work events and the moderating role of perceived organizational support.MethodsDuring the COVID-19 pandemic in China, a cross-sectional study was conducted with a sample of 1627 nurses from the Hematology Specialist Alliance of Chongqing from October to November 2022. Questionnaires were administered to measure patient mistreatment, perceived organizational support, social sharing of negative work events, emotional exhaustion, and work-family conflict. Hierarchical linear regression and conditional processes were used for statistical analyses.ResultsPatient mistreatment was positively associated with emotional exhaustion (β = 0.354, p < 0.001) and work-family conflict (β = 0.314, p < 0.001). Social sharing of negative work events played a partial mediating role in the relationship between patient mistreatment and emotional exhaustion (effect = 0.067, SE = 0.013), and work-family conflict (effect = 0.077, SE = 0.014). Moderated mediation analysis found that the mediation effect was stronger when the perceived organizational support was high.ConclusionOur findings reveal the amplifying effect of social sharing of negative work events on nurses’ emotional exhaustion and work-family conflict. Perceived organizational support strengthens the positive effect of patient mistreatment on the social sharing of negative work events, thus resulting in increased emotional exhaustion and work-family conflict. We also discuss practical implications, limitations, and directions for future research.

Audit firm informatization and audit quality during COVID-19

PurposeCOVID-19 has forced audit firms to change the way they operate. One change has been to rely more on information technology (IT) and IT human capital to overcome COVID-19-related challenges. We refer to audit firms’ use of these two resources as audit firm informatization (AFI). It is important to understand whether AFI helps audit firms address challenges created by the pandemic. Thus, this study examines the impact of AFI on audit quality during the COVID-19 pandemic in China with a focus on IT human capital.Design/methodology/approachWe use a mixed-methods approach. First, we perform multivariate regression analyses on archival data. Specifically, we investigate the relationship between IT human capital and audit quality and the two mechanisms (i.e. improved efficiency and reduced audit risk) underlying the relationship. We also investigate how this relationship is moderated by features of clients, audit firms and individual auditors. Then we use interviews to corroborate the results of our regression analyses.FindingsOur analyses of archival data show that IT human capital positively affects audit quality through improved efficiency and reduced audit risk and that this positive impact is more pronounced for clients in non-manufacturing industries, those with a more opaque information environment, audit firms with greater industry coverage and individual auditors with less experience. Our interview data indicate that audit firms with more advanced AFI and a higher level of IT human capital in particular are less disrupted by the pandemic and are better able to use IT to address challenges associated with COVID-19. Furthermore, the results confirm that improved efficiency and reduced audit risk are the mechanisms through which AFI enhances audit quality. Finally, we identify issues associated with the use of IT.Originality/valueThis study is the first to investigate how IT human capital (and by extension AFI) influences audit quality in the context of the COVID-19 pandemic. Our findings should be of interest to practitioners and setters of auditing standards.

Depression and Anxiety among Migrant Older Adults during the COVID-19 Pandemic in China: Network Analysis of Continuous Cross-Sectional Data.

Many Chinese migrant older adults are more prone to mental health problems due to their "migrant" status. During the COVID-19 pandemic, restrictions on their mobility exacerbated these conditions. Mental health is a crucial dimension of healthy aging. Network analysis offers a novel method for exploring interactions between mental health problems at the symptom level. This study employs network analysis to examine the interactions between comorbid depressive and anxiety symptoms across different stages of the COVID-19 pandemic. Surveys were conducted from September 2019 to January 2020 (T1), September 2020 to January 2021 (T2), and September 2021 onwards (T3). Depression and anxiety symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Expected Influence (EI) and Bridge Expected Influence (Bridge EI) were used to identify central and bridge symptoms in the network. Network stability and accuracy tests were performed. Among the Chinese migrant older adults, the anxiety prevalence was 18.50% at T1, 21.11% at T2, and 9.38% at T3. The prevalence of depression was 26.95% at T1, 55.44% at T2, and 60.24% at T3. The primary central symptoms included 'Afraid something will happen' (A2), 'Irritability' (A6), 'Panic' (A7), 'Feeling of worthlessness' (D6), 'Anhedonia' (D1), and 'Feeling of fear' (A5). The major bridge symptoms included 'Feeling of fear' (A5), 'Panic' (A7), 'Irritability' (A6), 'Fatigue' (D4), 'Anhedonia' (D1), and 'Depressed or sad mood' (D2). Differences in network structure were observed across the periods. The network analysis further revealed the evolving relationships between central and bridge symptoms over time, highlighting the importance of targeted intervention strategies for central and bridge symptoms of comorbid depression and anxiety at different periods.

Understanding carbon resilience under public health emergencies: a synthetic difference-in-differences approach

Public health emergencies influence urban carbon emissions, yet an in-depth understanding of deviations between regional emissions under such emergencies and normal levels is lacking. Inspired by the concept of resilience, we introduce the concept of regional carbon resilience and propose four resilience indicators covering periods during and after emergencies. A synthetic difference-in-differences model is employed to compute these indicators, providing a more suitable approach than traditional methods assuming unchanged levels before and after emergencies. Using the COVID-19 pandemic in China as a case study, focusing on the power and industry sectors, we find that over 40% regions exhibit strong resilience (> 0.9). Average in-resilience (0.764 and 0.783) is higher than post-resilience (0.534 and 0.598) in both sectors, indicating lower resilience during than after emergencies. Significant differences in resilience performance exist across regions, with Hebei (0.93) and Hangzhou (0.92) as top performers, and Qinghai (0.29) and Guiyang (0.36) as the least resilient. Furthermore, a preliminary correlation analysis identifies 22 factors affecting carbon resilience; higher energy consumption, stronger industrial production, and a healthier regional economy positively contribute to resilience with coefficients over + 0.3, while pandemic severity negatively impacts resilience, with coefficients up to -0.58. These findings provide valuable references for policymaking to achieve carbon neutrality goals.

The power of routines: Impact of parent-grandparent coparenting relationship quality on post-lockdown child adjustment over the COVID-19 pandemic in China

Child routines and coparenting relationships are respectively recognized in past literature as valid predictors of child adjustment, representing structured daily living and source of support in children’s lives. Under the difficult times of the COVID-19 pandemic, established family processes were shaken by social and mental challenges, which lacked relevant literature regarding the working mechanism in the Chinese cultural context, where parent-grandparent coparenting families commonly reside. The current longitudinal study explores the role of child routines in the effect of mother-grandmother coparenting relationship quality on child adjustment over the period of the COVID-19 pandemic lockdown. The study collected data from 163 mother-grandmother coparenting families before, during, and after the pandemic lockdown in Beijing, China, in a one-year span. The results showed that the consistency of child routines during the pandemic mediated the effect of mothers’ perceived coparenting relationship quality before the pandemic on child social competence after the lockdown, but not on child behavioral and emotional problems. Grandmother’s perceived coparenting relationship quality before the pandemic negatively predicted behavioral and emotional problems after the lockdown, while no indirect effects were found. The current study reiterates the critical role of routine maintenance in the coparenting context on child social-emotional development, particularly when other parts of daily lives were disturbed. Also, separately examining mothers’ and grandmothers’ perceived coparenting relationship quality validates the idea that caregivers played different roles in the family, resulting in disparities in child development mechanisms.

Association between COVID-19 infection and uveitis flare in patients with Behcet's disease, a retrospective multicenter cohort study.

To explore if COVID-19 infection and its subsequent immunosuppressant adjustment as well as previous vaccination status are associated with higher risks of uveitis flare in patients with Behcet's disease. This retrospective multicenter cohort study was conducted in January 2023 among patients with Behcet's uveitis, during the second wave of the COVID-19 pandemic in China, with an anticipated sample size of 250. The primary objective was to examine the association between COVID-19 infection and the occurrence of uveitis flare. The potential impact of other exposures, including the patient's vaccination status and treatment adjustments to the risk of uveitis flare and the course of COVID-19 infection were also analyzed. 207 patients with COVID-19 infection and 47 patients without COVID-19 infection were included. A total of 127 uveitis flares occurred in the observational period (14.29 events per 100 person-month). COVID-19 infection was found to be significantly associated with a higher rate of uveitis flare (adjusted rate ratio = 4.8, 95% CI 3.7 to 6.3, P < 0.001). However, neither systemic immunosuppressive adjustment nor COVID-19 vaccination status showed a significant association with uveitis flare or the course of COVID-19 infection. This study provides evidence of an association between COVID-19 infection and an increased risk of uveitis flare in patients with Behcet's disease. However, there was no significant evidence to support that baseline immunosuppressive therapy regimens, treatment adjustment after COVID-19 infection, or vaccination status were associated with higher risks of uveitis flare or prolonged COVID-19 course.

Prosocial development in early childhood: strategies of teachers and parents during the COVID-19 pandemic in China

ABSTRACT The COVID-19 pandemic has presented unprecedented challenges for people, including young children. This study focuses on how teachers and parents foster children’s prosocial behaviours during online learning amidst the pandemic. Data were sourced from 100 articles on WeChat Official Service/Subscription Accounts (WOSA) – a popular Chinese social media platform – and from semi-structured interviews with three teachers and six parents, analyzed using content and reflexive thematic analysis methods, respectively. The key findings reveal that children demonstrated increased pandemic-related prosocial behaviours, as a result of specific strategies implemented by both parents and teachers within their sociocultural environment. These findings emphasize the importance of digital platforms and the collaborative practices of teachers and parents in supporting children’s social development during a social crisis, offering insights for shaping educational policies and practices. Future research could explore the long-term impact of pandemic-relevant practices by teachers and parents on children’s well-being across diverse cultural contexts.

Survey on pattern of myopia in school children in Hangzhou after the COVID-19 pandemic: a school-based vision screening study

BackgroundMyopia is a major health issue around the world. Myopia in children has increased significantly during the COVID-19 pandemic in China, but reports are scarce on the prevalence of myopia following the pandemic. This study collected vision screening data of school children in China for five consecutive years to observe the changes in myopia after the pandemic and compare the observed prevalence of myopia before and after the pandemic.MethodsA school-based vision screening study used stratified samplings to collect the vision screening data in school children aged 6–13 from 45 primary schools in Hangzhou. Vision screening data including uncorrected visual acuity(UCVA) and spherical equivalent refraction(SER). Calculating the mean of SER and the prevalence of myopia and hyperopia from 2019 to 2023.ResultsA total of 79,068 screening results (158,136 eyes) were included in the analysis. A substantial myopic shift (approximately -0.30 diopters [D] on average) was found in 2020 and 2021 compared with 2019 in all age groups and a substantial myopic shift (approximately 0.4 D on average) was found in 2022 compared with 2021. A slight myopic shift (approximately -0.14 D on average) was found in 2023 compared with 2022. The prevalence of myopia in all age groups was the highest for five years in 2020 or 2021, which was 31.3% for 6-year-olds, 43.0% for 7-year-olds, and 53.7% for 8-year-olds. A positive change in the prevalence rate of myopia was found at 6 years old (0.59%, 0.12%, 0.36%, 0.25%, p < 0.001). The change in prevalence rate in myopia was shifted slightly in children aged 10–13 years. Children aged 8 to 13 years had a slight increase in myopia prevalence from 2022 to 2023. The prevalence of hyperopia was low and stable in all grade groups, ranging from 0.7% to 2.2% over five years.ConclusionMyopia in children has increased rapidly during the COVID-19 pandemic. After the pandemic, the prevalence of myopia in children gradually decreased temporarily and then rebounded. Myopic shift was more apparent in younger children. Myopic shift in children may be related to the reduction of outdoor time, less light, and near work habits, and further research is needed.

Retrospecting Digital Media Use, Negative Emotions, and Trust Gaps During the COVID-19 Pandemic in China: Cross-Sectional Web-Based Survey.

Retrospecting the trust gaps and their dynamics during the pandemic is crucial for understanding the root causes of postpandemic challenges and offers valuable insights into preparing for future public health emergencies. The COVID-19 pandemic eroded people's trust in strangers and acquaintances, while their trust in family members remained relatively stable. This resulted in 2 trust gaps, namely, the family members-strangers trust gap and the family members-acquaintances trust gap. Widening trust gaps impede social integration and undermine the effective management of public health crises. However, little is known about how digital media use shaped trust gaps during a pandemic. This study aims to investigate the relationships between digital media use, negative emotions, the family members-strangers trust gap, and the family members-acquaintances trust gap during the COVID-19 pandemic in China. We test the mediating role of negative emotions between digital media use and 2 trust gaps and compare the indirect effect of digital media use on 2 trust gaps through negative emotions. A cross-sectional web-based survey was conducted in China between January 31, 2020, and February 9, 2020. A total of 1568 adults participated in the survey. Questions related to digital media use, negative emotions, trust in family members, trust in acquaintances, and trust in strangers during the pandemic were asked. Regression analyses were performed to test the associations between the examined variables. We used a 95% bootstrap CI approach to estimate the mediation effects. Digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), which in turn were positively associated with the family members-strangers trust gap (B=0.15, SE 0.03; P<.001). Likewise, digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), while negative emotions were positively associated with the family members-acquaintances trust gap (B=0.08, SE 0.03; P=.01). Moreover, the indirect effect of digital media use on the family members-strangers trust gap (B=0.03, SE 0.01; 95% CI 0.01-0.04) was stronger than that on the family members-acquaintances trust gap (B=0.01, SE 0.01; 95% CI 0.003-0.027). The results demonstrate that negative emotions resulting from the frequent use of digital media are a key factor that accounts for the widening trust gaps. Considering the increasing reliance on digital media, the findings indicate that the appropriate use of digital media can prevent the overamplification of negative emotions and curb the enlargement of trust gaps. This may help restore social trust and prepare for future public health crises in the postpandemic era.

Aggravated surface O3 pollution primarily driven by meteorological variations in China during the 2020 COVID-19 pandemic lockdown period

Abstract. Due to the lockdown during the COVID-19 pandemic in China from late January to early April in 2020, a significant reduction in primary air pollutants, as compared to the same time period in 2019, has been identified by satellite and ground observations. However, this reduction is in contrast with the increase of surface ozone (O3) concentration in many parts of China during the same period from 2019 to 2020. The reasons for this contrast are studied here from two perspectives: emission changes and inter-annual meteorological variations. Based on top-down constraints of nitrogen oxide (NOx) emissions from TROPOMI measurements and GEOS-Chem model simulations, our analysis reveals that NOx and volatile organic compound (VOC) emission reductions as well as meteorological variations lead to 8 %, −3 % and 1 % changes in O3 over North China, respectively. In South China, however, we find that meteorological variations cause ∼ 30 % increases in O3, which is much larger than −1 % and 2 % changes due to VOC and NOx emission reductions, respectively, and the overall O3 increase in the simulations is consistent with the surface observations. The higher temperature associated with the increase in solar radiation and the decreased relative humidity are the main reasons that led to the surface O3 increase in South China. Collectively, inter-annual meteorological variations had a larger impact than emission reductions on the aggravated surface O3 pollution in China during the lockdown period of the COVID-19 pandemic.

Restricted health service utilization and subsequent positive self-care behavior during the early COVID-19 pandemic in China.

The reallocation of health resources, epidemic prevention and control measures during the COVID-19 pandemic triggered widespread restricted health service utilization, some residents and patients tried positive self-care behavior to maintain their health, yet the efficacy of this intervention remains unclear. Based on the reasoned action approach (RAA) theory, this study aimed to investigate the correlation between self-care behavior and restricted health service utilization among adults in China, trying to discover the vulnerable groups and external and intrinsic factors that affect self-care behavior among Chinese adults. Data on demographics, socioeconomic, health status, and self-care behavior were collected in "The Early China COVID-19 Survey," a cross-sectional anonymous online survey of the general population in China. Self-care behavior was measured by four indicators: weight control (WC), physical activity (PA), prevention behavior (PB), and online medical consultation (OMC). The multiple linear models and binary logistic regression were used to examine whether restricted health service utilization (RHSU) is associated with self-care behaviors; also, adjusted multivariate logistic regression was used to analyze subgroup heterogeneity. In total, 8,428 adult participants completed the survey, the mean OMC score was 1.51 (SD 1.34), the mean PB score was 18.17 (SD 3.44), and the proportion of participants who engaged in WC and PA was 42.30 and 62.57%, respectively. According to the multiple regression model, the RHSU was significantly positively correlated with all four indicators of self-care (WC: OR = 1.34, p < 0.001, PA: OR = 1.34, p < 0.05, MC: OR = 1.30, p < 0.001, PB: coef = 0.16, p < 0.05). We also observed some significant differences in the intensity of this relationship by subgroup analysis, precisely, OMC (high vs. moderate vs. low infection-risk level: OR = 1.48; 1.41; 1.19, p < 0.1), PA (male vs. female: OR = 1.27;1.06; p < 0.05, high vs. Moderate and low infection-risk level: OR = 1.51; 1.17; 1.02, p < 0.05), PB (Chronic disease groups vs. no: coef = 0.46; 0.1, p < 0.05). Restricted health service utilization predicts more positive self-care behavior, and the intensity of partial correlation was significantly different in the subgroups of sex, actual infection risk level of the living area, and chronic diseases. These findings highlight the urgent demand for self-care behavior among Chinese adults during the pandemic and provide new insights for developing self-care and reducing the burden on the healthcare system in the long term.

Scientific uncertainty and the challenges of applying criminal law: Lessons from China's COVID-19 response

This study addresses the complexities of applying criminal law during public health emergencies, particularly under the shadow of scientific uncertainty, and explores the challenge of balancing public health protection with individual rights. The primary aim is to dissect the application of criminal law in the context of the COVID-19 pandemic in China, focusing on the impact of scientific uncertainty on legal decision-making and the efficacy of criminal law interventions in public health crises. This study utilized a doctrinal method combined with case studies, integrating theoretical frameworks on risk and uncertainty with an analysis of China's legal responses to COVID-19. It involved assessing legislative and policy documents alongside judicial decisions, focusing on their alignment with evolving scientific understanding and public health strategies. The study reveals significant hurdles, including the limitations of empirical rules in judicial judgments, the emergence of technocratic bureaucracy, and the complexities surrounding risk mitigation and legal attribution under uncertain conditions. It highlights the inadequacy of traditional criminal law mechanisms to respond dynamically to the evolving landscape of public health emergencies. To address these challenges, the study recommends the development of temporary criminal legislation tailored to public health emergencies, the adoption of risk-based criminal law approaches, and the refinement of individualized risk assessment procedures. These measures aim to provide a more flexible and effective legal framework capable of safeguarding public health while ensuring the protection of individual liberties during crises.

Online teaching and learning at Chinese universities during COVID-19: Insiders’ perspectives

During attempts to prevent and control the COVID-19 pandemic in China, higher education programs shifted their traditional educational models to online models. This paper aimed to explore how Chinese universities organized online teaching and learning during the pandemic. It investigated the factors affecting the implementation of online teaching and provided policy recommendations for improving the quality of education in the post-pandemic period. The primary data for this study came from in-depth interviews with nine students and five teaching and administrative staff at eight major universities in mainland China. Literature was obtained in both English and Chinese from January 2020 to September 2021. Peer-reviewed journals, policy reports, and university documents regarding online education in Chinese universities were reviewed, and their challenges and countermeasures were investigated. The paper found that the implementation of online education was affected by various sources, including technologies, teachers’ teaching skills, network information literacy, and students’ learning motivations and self-directed learning skills. Based on the insiders’ views, the paper suggested that to promote the quality of online education in the post-COVID-19 pandemic, higher education institutes and programs could develop their infrastructure construction, improve teachers’ quality of teaching, and focus on students’ learning motivations.

Clinical characteristics and phylogenetic analysis of human enteric adenovirus type 41 (HAdV-F41) from children with gastroenteritis during SARS-CoV-2 pandemic

Human adenovirus type 41 (HAdV-F41) usually causes pediatrics gastroenteritis. However, it was reported to be associated with the outbreaks of severe acute hepatitis of unknown aetiology (SAHUA) in pediatrics during COVID-19 pandemic. In this study, we investigated the prevalence of enteric HAdV-F41 in 37,920 paediatric gastroenteritis cases from 2017 to 2022 in Guangzhou, China. All children presented were tested negative for SARS-CoV-2 during the “zero-COVID” period. The main clinical symptom of the children was diarrhea (96.5%). No fatalities nor liver abnormal symptoms was found. In 2021, one year since the pandemic of COVID-19, the prevalence of HAdV-F41 abruptly increased from 3.71% to 8.64% (P < 0.001). All of HAdV-F41 circulating worldwide were classified into eight different subtypes (G1-G8) based on the phylogenetic clustering permutation of the four capsid genes of HAdV-F41. G3 was the predominant subtype (56.2%; 77/137). CRV5 isolates from SAHUA cases belong to this subtype, in which N312D and H335D mutations in the short fiber knob were identified in both Guangzhou and CRV5 isolates, presumably changing the virus tropism by directly interacting with the heparin sulfate (HS) receptor. Additionally, a novel recombinant G6 subtype, which is unique and only circulating in China was first identified in this study. This is the first study highlighting the prevalence of HAdV-F41 in paediatric cases of gastroenteritis during COVID-19 pandemic in China. The clinical and viral evolution finding of HAdV-F41 provide insight into the clinical characteristics of children with HAdV-F41 infections as well as the uncertain role of HAdV-F41 in the cause of SAHUA.