The COVID-19 pandemic has been accompanied by a massive infodemic. Yet limited studies have quantified the impact of the COVID-19 infodemic on vaccine hesitancy. This study examined the effect of perceived information overload (IO) and misinformation on vaccine willingness and uptake within a cross-national context. It also investigated how trust in multiple institutions affected vaccine outcomes and moderated the relationship between the infodemic and vaccine attitude and behavior. A cross-national online survey of residents, representative of the general population aged ≥18 in six Asian and Western jurisdictions, was conducted in June 2021. The results showed that perceived IO was positively associated with COVID-19 vaccine willingness and uptake. Belief in misinformation was negatively associated with vaccine willingness and uptake. Institutional trust may increase vaccine willingness and uptake. Moreover, trust in the government and civil societies tended to strengthen the positive effect of IO and reduce the negative impact of misinformation on vaccine willingness and uptake. The relationship between belief in misinformation and getting vaccinated against COVID-19 was unexpectedly stronger among those with a higher level of trust in healthcare professionals. This study contributes to a better understanding of the main and interactive effect of the infodemic and institutional trust on vaccine outcomes during a pandemic.

While most research focuses on the clinical treatment of COVID-19, fewer studies have investigated individuals' responses towards this novel infectious disease. This study aims to report the temporal changes in individuals' psychological wellbeing, perceived discrimination, sociopolitical perceptions and information-seeking behaviours among the general public in Hubei, China. Data were obtained from a two-wave survey of 1902 respondents aged 18–80 in Hubei province during the peak and mitigation stages of the outbreak. The results showed that the prevalence of psychological distress dropped from over 75% to around 15% throughout the study period, but perceived discrimination remained stable. Female, middle-aged, well-educated respondents and those employed in government/public institutions/state-owned enterprises tended to report more distress. While respondents' attention on COVID-19 information kept high and stable, their sources of information diversified across different sociodemographic groups. Over time, people obtained more social support from neighbourhoods than from their friends and relatives or non-government organisations. Over 80% of respondents were satisfied with the performance of the central government, which was notably higher than their ratings on the local government and neighbourhood/village committees. The findings of this research are informative for formulating effective intervention strategies to tackle various psychosocial problems during COVID-19.

PurposeMany physicians express a relatively nihilistic approach to the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Consensus among surgeons regarding the indications for an aggressive approach has not been reached. Current study was aimed to determine whether an aggressive approach, with an extended resection with thrombectomy and adjuvant therapy, would lead to an improved survival for HCC patients with PVTT.MethodsA retrospective review of 116 HCC patients with PVTT admitted from 1996 to 2006 was conducted. Patients were divided into 2 time-period (TP) cohorts, of them, 51 cases in the first 5 years (TP1) and 65 in the last 5 years (TP2).ResultsSurgical operations were performed on 68 patients. Twenty-one surgical resections were performed in TP1 and forty-seven in TP2. The extent of liver resections, as well as the frequency of thrombectomy, was greater in TP2 (P = 0.039). During both time-periods, an aggressive therapy was associated with improved survival (P < 0.02 TP1, P < 0.001 TP2). Overall survival of all patients in TP2 was significantly greater than in TP1 (P < 0.001), with a median survival of 15 months in TP2, whereas in TP1, the survival was only 9 months. The median 1-, 3-year survivals in TP2 (54 and 34%, respectively) were also greater than that in TP1 (31 and 7%, respectively). A multiple logistic regression analysis revealed that radical resection and adjuvant therapy were the independent predictors of overall survival.ConclusionsAn aggressive approach, combining extended liver resection with thrombectomy and adjuvant therapy, leads to an improved survival in the HCC patients with PVTT.

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